Upper Blepharoplasty in Liverpool: A Complete Guide to Upper Eyelid Surgery

Excess skin on the upper eyelid is one of the most common changes people notice as they get older, and one of the most frequently misread. Patients often tell us they are sleeping well and feeling well, but that their eyes tell a different story. Others notice that eyeshadow disappears into a fold, that reading for long periods feels heavy, or that the outer edge of their field of vision has narrowed.

Upper blepharoplasty is designed to address excess upper eyelid skin. At Genesis Clinic on Rodney Street, Liverpool, the procedure is carried out by our Consultant Oculoplastic Surgeons, specialists who have trained specifically in surgery of the eyelids and surrounding structures.

This guide explains what the procedure involves, who it may suit, and what to expect.

What is upper blepharoplasty?

Upper blepharoplasty is a surgical procedure that aims to remove excess skin, and where appropriate, a small amount of underlying tissue, from the upper eyelid.

Over time, the skin of the upper eyelid loses elasticity. It can begin to fold over the natural eyelid crease, and in some cases rest on the lashes or encroach on the field of vision. The procedure aims to remove that excess, restoring a more defined eyelid crease and a more open appearance to the eye.

Incisions are typically placed within the natural eyelid crease, which means resulting scars usually sit within the fold and become less noticeable as they mature. The procedure is commonly performed under local anaesthetic, often as a day case, though your surgeon will confirm what is appropriate in your case.

For some patients, the change is primarily aesthetic. For others, particularly where excess skin is affecting the upper field of vision, there is a functional element as well. Your surgeon will assess which applies to you.

Who may be suitable for upper blepharoplasty?

Upper eyelid surgery may be considered by patients who:

• Have excess or loose skin on the upper eyelid

• Notice a fold of skin resting on or near the lashes

• Find that the eyelid crease has become hidden or indistinct

• Experience heaviness in the upper eyelids, particularly later in the day

• Have noticed a reduction in their upper field of vision

An important distinction is whether the heaviness comes from the eyelid itself or from a descended brow. These can look similar to the untrained eye but require different treatment. In some patients both contribute, and a combined approach may be discussed. Assessing this properly requires clinical examination.

It is also worth noting that upper eyelid heaviness can occasionally be caused by ptosis, a drooping of the eyelid margin due to weakness in the muscle that lifts the lid. Ptosis requires a different surgical approach, and distinguishing it from excess skin is an important part of assessment.

Upper blepharoplasty may not be suitable for everyone. Dry eye, certain thyroid conditions, previous eyelid surgery and some medications can all affect suitability. Your surgeon will discuss this with you.

What to expect at your consultation

Understanding your concerns. We start by asking what brought you in and what you notice. Whether your concern is how your eyes look in photographs, difficulty with makeup, or a sense that your vision is being obstructed, all of this is useful.

Clinical assessment. Your surgeon will examine your eyelid skin, eyelid crease position, eyelid margin position, brow position and eyelid function. They may assess your tear film and eye surface, as dry eye can influence both suitability and recovery. If excess skin appears to be affecting your vision, a visual field assessment may be carried out.

Medical history. We will review your general health, medications, including blood thinners, allergies, previous eye or eyelid surgery, and any history of dry eye or thyroid disease.

Discussing options. Your surgeon will explain what the procedure would involve for you, how much skin would be removed, where incisions would sit, and what kind of change you might reasonably expect. If they think brow surgery or ptosis repair would serve you better, either instead of or alongside blepharoplasty, they will say so.

Risks and recovery. You will receive a clear explanation of the risks and a realistic account of recovery.

Time to decide. There is no expectation that you commit on the day. Most patients take time to consider.

Recovery and aftercare

The first few days. Swelling and bruising around the eyelids are common and typically peak within the first two to three days. Cool compresses, as advised by your surgeon, and sleeping with your head elevated can help. You will be given instructions on wound care and any eye drops or ointment you need to use.

The first two weeks. Sutures are typically removed or dissolve within the first week to ten days, depending on the technique used. Bruising usually begins to settle over one to two weeks, though this varies. Many patients feel comfortable returning to desk-based work within a week, but this is individual.

Dry eye and comfort. Temporary dryness, grittiness or watering of the eyes is not unusual after eyelid surgery. This usually settles, and you may be advised to use lubricating drops during this period.

Scars. Incision lines are typically pink initially and soften over subsequent months. Sun protection is generally advised while scars mature.

Longer term. Final results take time to appear as swelling resolves. Several months may pass before the eyelid settles into its final appearance.

Follow-up. You will be reviewed after surgery. If anything concerns you between appointments, particularly changes in vision, increasing pain, or signs of infection, contact the clinic promptly rather than waiting.

Risks and considerations

Your surgeon will discuss risks with you in the context of your own health. In general terms, possible risks of upper blepharoplasty include:

• Bleeding, bruising and swelling

• Infection

• Scarring, usually within the eyelid crease, but healing varies between individuals

• Dry eye or eye surface irritation, which may be temporary or, less commonly, persistent

• Asymmetry between the two eyelids

• Difficulty fully closing the eyes, usually temporary

• Under-correction or over-correction of skin removal

• Change in eyelid crease height or shape

• Altered sensation in the eyelid skin

• Dissatisfaction with the aesthetic outcome

• Very rarely, serious complications affecting vision

Results can vary between individuals. Ageing continues after surgery, and upper blepharoplasty does not prevent future change.

It is also worth being clear about scope. Upper blepharoplasty addresses excess upper eyelid skin. It does not treat under-eye bags, crow's feet, brow position, skin texture or pigmentation. If those are among your concerns, your surgeon will discuss whether other treatments are relevant.

Frequently asked questions

Is upper blepharoplasty painful? The procedure is commonly performed under local anaesthetic, so you should not feel pain during surgery, though you may be aware of pressure or movement. Afterwards, most patients describe discomfort rather than significant pain, typically manageable with simple pain relief. Your surgeon will discuss anaesthetic options with you.

How long does the procedure take? Upper blepharoplasty is often completed within about an hour, though this depends on what is being done. Your surgeon will give you a more specific estimate.

Will the scars be visible? Incisions are usually placed within the natural upper eyelid crease so that resulting scars sit within the fold. Scars typically fade over months, but healing varies between individuals and no scar disappears entirely.

Can it be combined with a brow lift? Sometimes, yes, where both eyelid skin and brow position contribute to the concern. Whether this is appropriate depends on your anatomy and goals, and will be discussed at consultation.

Will it improve my vision? Where excess upper eyelid skin is obstructing the upper field of vision, removing it may improve that. Whether this applies to you is a clinical assessment your surgeon will make.

How long do results last? Results can be long-lasting. However, skin elasticity continues to change with age, and some patients notice gradual change over the years. Your surgeon will give you a realistic sense of what to expect.

Am I too young or too old? There is no fixed age range. Suitability depends on your anatomy, your general health and your goals rather than your age alone.

Who will perform my surgery? Upper blepharoplasty at Genesis Clinic is performed by our Consultant Oculoplastic Surgeons, who specialise in eyelid and orbital surgery.

Considering upper eyelid surgery?

A consultation is the best way to find out whether upper blepharoplasty is likely to suit you. It is an opportunity to have your concerns assessed properly, ask questions, and understand your options, with no obligation to proceed.

Genesis Clinic is a CQC-registered clinic on Rodney Street, Liverpool.

Book a consultation: genesis-clinic.co.uk/eyecare

Results can vary between individuals. Treatment suitability will be assessed and discussed during your consultation. This article is for general information and does not constitute medical advice.