Eyelid Surgery (Blepharoplasty)

Removal of excess skin and fat from around the eyelids is called Blepharoplasty.

As we age, the skin around the eyes becomes more loose, wrinkly and sags. The fat (that usually sits around the eyeball, as it sits in it’s socket) begins to push forwards, giving rise to swellings or eyebags.

These bags are most commonly found in the upper lids just above the area where the upper lid meets the nose. In the lower lids, there are often 3 bulges which can meld together forming large bags along the whole length of the lower lids.

Surgery aims to remove excess skin and fat.

Careful counselling and examination must be undertaken prior to surgery as some patients may need lid tightening procedures or brow support techniques in addition to make the surgery successful.

Below are a few of my patients, to illustrate different problems and techniques used.

Patient 1

This lady has a lot of loose skin on her upper lids (Dermatochalasis).This is the main problem, rather than lots of excess fat. I have made some markings in white to show this. After surgery, she is able to wear her eye shadow and has natural looking upper lids.

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Patient 2

This lady has loose skin and also prominent fat pad bulges/bags in the lower lids. Her main issue is with the lower lid bags. After upper and lower lid blepharoplasties, the bags have gone and there is better contour from the lids to the cheeks. I performed a procedure called a Septal reset to achieve this.

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Patient 3

Upper and Lower Lid Blepharoplasties.

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Patient 4

Upper and lower lid Blepharoplasties. The most obvious improvement is with the size of the visible upper lid. This has the effect of "opening up" the eye. She looks less tired.

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Patient 5

Upper lid Blepharoplasty. This is a less complicated procedure than lower lid blepharoplasty. It can be performed under local anaesthetic as a day case. After surgery, this lady has found it now possible to use eye makeup without it smudging.

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Patient 6

Upper and Lower lid Blepharoplasty

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Patient 7

Upper and Lower lid Blepharoplasties combined with internal browpexy since the brow was mobile and I did not want it to drop. The whole lid is revealed.

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Patient 8

Upper and Lower lid Blepharoplasties with a cheek fat pad lift to improve the appearance of the lid cheek junction. The lids appear larger.

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Patient 9

Upper and Lower lid Blepharoplasties. Mainly loose skin removal and placement of the scars into skin creases.

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Patient 10

Upper and Lower lid Blepharoplasties. I have also elevated the fat pads within the cheeks to both support the lower eyelids and to help rejuvenate the cheeks.

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Patient 11

The eyebrows (Brow) in this patient were quite mobile and low/ptotic. When this happens, if too much skin is removed from the upper lids then the brows are pulled down rather than sitting in the normal place. So to prevent this, the brow needs to be fixed so it does not drop. I have used a device called an Endotine to do this. The procedure is a form of browlift or browpexy and involves placement of an absorbable hook just above the brow under the skin. This is placed via the incision in the upper lid when the skin is excised. So no further scars. I have removed the skin lesion on the lid at the same time.

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Patient 12

Quite severe amounts of loose skin. Removal makes a huge difference to her appearance and the way she feels.

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Graham's Qualifications/

BSc (hons)/ MBChB/ FRCS/ FRCS(PLAST)