An upper blepharoplasty is the surgical reduction of excess skin on the upper eyelids. It focuses on the physical structure of the upper eyelid and addresses tissue that may begin to weigh down the lid over time.
The procedure steps can involve skin removal, fat repositioning, or occasionally muscle adjustment, depending on the structural needs. While upper blepharoplasty is most commonly performed as a surgical procedure, some non-surgical approaches may be suitable in certain cases. However, compared with surgical methods, these do tend to have limitations when it comes to the results that can be achieved.
This blog will explain surgical upper eyelid reduction, what to expect during recovery, and some of the current non-surgical methods that may be used. If you would like to discuss your options with a qualified and experienced surgeon, you are welcome to contact our team at Rodin Clinic to arrange an in-person consultation.
What causes upper eyelid heaviness?
Sometimes, the skin on the upper eyelids experiences skin laxity and causes heaviness over time. This tends to occur due to a combination of collagen loss, changes in the elasticity of the skin, and the natural effects of ageing. Some patients also experience small bulges due to fat pads shifting forward, which can add more volume in the upper lid area.
There are also anatomical differences from person to person. Some people may have a heavier upper lid fold from a younger age, due to the way their upper eyelid skin naturally folds or how their brow sits. In those cases, an upper blepharoplasty can still be performed, but the goals of the procedure and the detailed procedure steps may be slightly different to the goals and steps when addressing age-related changes. Identifying the exact cause of the tissue redundancy is just one of the factors that determines whether someone is suitable for a surgical or non-surgical approach.
How is a surgical upper blepharoplasty performed?
During a surgical upper blepharoplasty, a small incision is made in the crease of the upper eyelid, where it can be well hidden once healed. The excess skin is then carefully trimmed, and if needed, some of the fat underneath the eyelid is either removed or repositioned. A small section of muscle may also be adjusted, although this depends on the structure of the eyelid and how much tissue is contributing to the fold.
The incision is closed with fine sutures that are typically removed within the first week. The overall shape of the eyelid and the natural crease are taken into account throughout the procedure to maintain symmetry and structure.
What to expect during recovery
Recovery from an upper blepharoplasty often involves some swelling and bruising around the eyes during the first week. Most patients will experience tightness or pulling in the eyelids for a few days after the procedure, which is expected and will settle over time as the tissue adjusts.
Cold compresses are often recommended during the initial 48 hours, which can help manage swelling and make the area feel more comfortable. By the second week, most of the bruising will have settled down. Some residual swelling can persist for longer, although it tends to be minor and less noticeable over time.
Strenuous activity, including heavy lifting and exercise, should be avoided during the early stages of healing, as this can increase swelling or put pressure on the surgical site. Most surgeons will give personalised advice around when normal activity can be resumed, based on how the eyelid is healing and whether the stitches have been removed without issue.
Scarring from the procedure is usually discreet, since the incision is placed in the natural eyelid crease. Over time, the scar will generally flatten and fade in colour, although this process can take a few months.
What are the non-surgical options for upper eyelid reduction?
While surgery is generally the most direct and structural way to reduce upper eyelid heaviness, there are a few non-surgical methods that may be used in very specific cases. These approaches tend to aim for mild changes.
Radiofrequency treatments, for example, may offer some skin tightening in the upper lid area. These work by heating the tissue to stimulate collagen production, which can lead to a slight contraction of the skin over time. However, the effect is usually subtle and not permanent, and repeated sessions are often needed to maintain any change.
Plasma-based devices can also be used to treat very mild skin redundancy. These work by creating a controlled injury to the upper layer of skin, which in turn leads to skin contraction as it heals. That said, plasma treatments are typically only effective when the excess skin is minimal. They aren’t suitable when there is a large fold or significant volume pressing down on the lash line.
Ultimately, non-surgical methods may be an option for those who aren’t ready for surgery or who have very mild structural changes, but their effect will always be more limited. The results also typically don’t last as long, and in many cases, the upper blepharoplasty may still be needed later on if the tissue continues to change.
Our Specialist Plastic Surgeon at Rodin Clinic Perth: Dr Robert Choa
To discuss your options for an upper eyelid reduction procedure, you can meet with a qualified plastic surgeon such as Dr Rob Choa, who will work with you to understand your needs.
The anatomy of the upper lid is complex and closely linked to other areas of the face, including the brow and orbital structures. Having an experienced and qualified Specialist Plastic Surgeon assess the area is an important step in ensuring that your chosen approach is suitable.
To get in touch with our team at Rodin Clinic in Perth, please fill out our online form, email us at reception@rodinclinic.com.au or call us at 08 9389 9522.