The Different Types of Eyelid Surgery

Eyelid surgery, also known as blepharoplasty may address concerns like drooping eyelids, puffiness under eyes, or excess skin around the eyes (though these results are not a guarantee). 

Blepharoplasty techniques vary depending on the specific needs of the individual, with options available for both upper and lower eyelids.

We’ll explore the different types of eyelid surgery in this article so you may have a better understanding of what each procedure involves and the factors that might be considered when determining an appropriate approach.

Lower Eyelid Surgery

In lower eyelid surgery, a surgeon carefully removes or repositions excessive fat and may tighten the skin or underlying muscles to achieve a certain shape for the lower eyelid area.

Lower eyelid surgery does not address pigmentation or dark circles under the eyes, since these are often the result of thinning skin, visible blood vessels, or hyperpigmentation— all of which require different treatments. 

Upper Eyelid Surgery

Upper eyelid surgery also involves the removing or repositioning of excess skin, fat, or muscle. It may be used to treat conditions like dermatochalasis (excess or lax skin that can cause drooping) and steatoblepharon (prominence of fat pads in the upper eyelid area).

Age-related changes like loss of skin elasticity, weakening connective tissue, or fat prominence can result in a tired or heavy appearance of upper eyelids. These changes may also obstruct vision, making upper blepharoplasty both a cosmetic and functional solution. 

A detailed assessment of the eyelid anatomy, including the skin crease, tarsal platform, and any associated brow ptosis or temporal hooding, helps the surgeon tailor the surgery to the individual’s unique needs. 

Double Eyelid Surgery

Double eyelid surgery or double blepharoplasty creates a defined eyelid crease in individuals who naturally lack one or have a minimal crease. The procedure works by forming an adhesion between two key layers of the eyelid. 

The orbicularis oculi muscle is crucial in this technique, as the muscle is responsible for the natural blinking action, aiding in tear distribution and maintaining eye moisture. 

In non-incisional double blepharoplasty, this muscle is preserved to prevent complications like scar depression or interference with natural functions that may lead to dryness or incomplete eyelid closure. Surgeons must balance these adjustments to minimise risks such as prolonged swelling or difficulty fully closing the eyes.

The depth of the eyelid crease is another factor in determining the success of a double eyelid surgery. Too shallow and the outcome may seem incomplete, while an excessively deep fold may cause a tugging sensation, unnatural scarring, and artificial look. Surgeons will consider skin thickness, distribution of fat, and resistance to the formation of creases, to provide as much as possible a natural-looking result.

Various eyelid surgery techniques exist whether for functional or cosmetic purposes. From upper and lower eyelid procedures to double eyelid surgery, each approach is designed to improve the appearance or function of the eyelids while considering the patient’s unique anatomy and goals. 

However, it’s important to remember that results vary based on factors such as the individual’s anatomy, the extent of the procedure, and the surgical technique used.

Consult thoroughly with a qualified surgeon before deciding on any kind of eyelid surgery. This helps you set realistic outcomes, expectations, and have a clearer understanding of what the procedure can and cannot achieve.

Disclaimer: At Artiste Plastic Surgery, our Plastic Surgeons led by Dr Jack Zoumaras have been trained to the highest possible degree. All surgery has risks and it is always advised to get a second opinion. Risks are very real and we cannot guarantee any result. Results are illustrated as a guide only. All risks are managed and any need for revision surgery or complications (1-5%) can be managed by our specialist plastic surgeons.

Any statements on how you will feel is based on Level V Evidence:

Level V:  How you will feel after plastic surgery varies between individuals, depending on psychological and physical factors. Our internal research is based on how patients in our practice feel after surgery.

The blogs are not a substitute for a medical consultation and do not form as part of the doctor to patient relationship.