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Eye Lid Reduction and Eye Bag Removal

As we get older, it is common to notice changes in the appearance of our eyes. The eye lids may start to sag, or become puffy as early as our early thirties, and the skin may begin to show excessive wrinkles with advancing years. These changes occur because the skin of the eyelids becomes weaker, allowing the fat that naturally cushions the eyeball to fall forward, creating ‘bags’. This has the effect of making the eyes look smaller, and the face look older and tired. These same effects can be seen in younger patients, often in their twenties, who develop excessive skin and fat during childhood or adolescence, and in patients with eye changes associated with thyroid disease.

Eye lid reduction and eye bag removal, also known as blepharoplasty, is a common cosmetic surgical procedure to remedy these symptoms. It is often combined with a brow lift, or a facelift to achieve a more youthful appearance. Surgery to the upper eye lids is referred to as upper blepharoplasty, and surgery to the eye bags is referred to as lower blepharoplasty. When combined, the purpose is to tighten hooded eyelids, restore their normal contours, and to eliminate fatty bulges. The procedure does not correct fine crow’s feet wrinkles – can be treated very effectively through non-surgical options (such as Botox®) – nor dark circles under the eyes caused by excessive skin pigmentation.

On the upper lid, an elliptical incision is made across the crease of the eyelid, allowing the removal of excess skin, and, in some cases, a thin strip of the underlying muscle. In addition, a small amount of fat may also be removed.

On the lower lid, there are two popular techniques. Traditionally, an incision is made just below the lower lashes, allowing a small ellipse of skin and muscle to be removed, along with the small pads of fat. Where there is a fatty bulge, with no excessive skin, a transconjunctival or incisionless blepharoplasty may be possible. An incision is made, hidden just inside the lower eyelid, healing naturally without the use of stitches.

The procedure may be performed under either local anaesthetic with sedation, or under general anaesthetic, and usually takes around two hours if both upper and lower lids are being operated on. Most cases may be performed as a day cases – not requiring an overnight stay at the Hospital – but an overnight stay may be necessary in some instances.

Following surgery, ice packs may be used to reduce swelling and bruising. For the first few days after surgery, patients are advised to rest quietly, with only gentle activity. Strenuous activity should be avoided for two weeks.

At the time of your consultation at the Alexandra Private Hospital, your surgeon will discuss the various options available to you, in line with your specific medical circumstances. You should always feel free to ask your surgeon any questions that you have regarding the surgery, and discuss any areas that may seem unclear. The goal of your surgeon and the Hospital staff is to make your entire experience as comfortable, and worry-free as possible.


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"Just to say a big thank you to all the people involved in making my blepharoplasty operation a huge success. It has made me feel a whole lot better in myself...
This operation was something I’ve been meaning to do for quite a long time now. From coming into Alexandra Hospital to leaving on my short stay, everyone helped me in reassurance of my operation...THANK YOU ALL

- Phillip