Eyelid Surgery FAQs

1. Are there any non-surgical alternatives to eyelid surgery?

This really depends on an analysis of the eyes to the rest of the face and brow and in relation to what you wish to achieve. More complex enhancement will require surgical correction but if the problem is limited to a specific concern such then a medical alternative such as a dermal filler, chemical peel, dermabrasion or skin laser, may be best for you. The skin of the eyelids is the thinnest skin in the body and so any treatment be it surgical or non-surgical will need to be tailored and gentle.

2. Is a brow lift or eyelid surgery best for sagging eyelids?

The relative components contributing to a tired or sad look around the eyes needs to be assessed by an experienced surgeon and I think that an artistic eye is helpful to relate the eyes and brow to the dimensions and harmony of the other structures of face. Sometimes the appearance of heaviness in the upper eyelids is more to do with sagging or droop in the brow rather than the upper eyelids themselves and in fact no surgery of the upper eyelids would then be necessary. Often there is a component in the brow and the upper eyelid and then perhaps both of these need to be addressed.

3. What is the best approach for tear troughs?

The tear trough is a furrow where the tissue fullness seen in youth has been lost. This can be from one’s lifestyle, or contributed by one’s genetic makeup; sometimes it is simply the effect of the passage of time. There is usually a loss of fat and so my preferred technique is to replace the fat and what better place to get the fat from than from the adjacent areas in the lower eyelid where there may be an excess or bulging of fat from the fat pads or eyelid bags under the eyes. Historically, surgeons remove the fat from the bags under the eyes but more and more I prefer to move it from where it is unsightly and producing a bulge to where it can help to soften the depression of the tear trough. Alternatively, it is possible to place fat as a graft from elsewhere but this needs careful and deep placement otherwise the result may not be smooth. For some people a filler may be used.

4. Will there be visible scars left from eyelid surgery?

The scars from eyelid surgery usually heal remarkably well. I place them just under the lower eyelid lashes and then a centimetre or so in one of the laughter lines at the sides of the eyes. In the upper eyelids the scar is well hidden in the crease of the upper eyelid and again for a centimetre or so in one of the laughter lines at the outer corner of the eyes. After healing is complete, they should be difficult to detect, and of course we do undertake the procedure in men who cannot cover the scars with make-up, confirming that the scars are usually very inconspicuous.

5. Can eyelid surgery deal with wrinkles around the eyes?

The wrinkles at the outer corners of the eyes are improved and softened but not always removed unless a more aggressive operation is considered which partially divides the muscle causing these wrinkles. If a significant problem, then Botox is often the best solution either instead of or in conjunction with eyelid surgery. Similarly, Botox is effective in softening the wrinkles between the eyebrows but there is an advanced technique where the muscles causing these wrinkles can be removed via the upper eyelid incision at the same time as upper eyelid surgery, this can lead to the same effects as the Botox but is more permanent.