Oculoplastic Service

Blepharoplasty

Blepharoplasty (Eyelid Surgery), involves the removal of excess skin and fat from the eyelids to improve appearance, reduce under-eye bags and create a more youthful look.

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Blepharoplasty (Eyelid Surgery) is a surgical procedure performed to improve the cosmetic appearance of the eyelids. It is also known as eyelid reduction or eyelid surgery.

Blepharoplasty improves hooded or drooping eyelids or eye bags by removing excess fat or skin. The aim is to reduce the signs of ageing around the eyes and create a more youthful, refreshed appearance.

Blepharoplasty is one of the most common functional and cosmetic procedures performed in facial plastic surgery. The recovery time is short, and the procedure is low risk. An eyelid lift can be performed on the upper, lower, or both eyelids.

What is the difference between upper and lower blepharoplasty?

Blepharoplasty can be performed on both the upper and lower eyelids. Furthermore, some patients may benefit from both procedures to tend to their concerns.

Upper Eyelid Blepharoplasty

Blepharoplasty can be performed on the upper eyelids for both cosmetic and medical reasons, to remove excess/droopy skin and fat, resulting in a more youthful appearance and enhanced vision.

Lower Eyelid Blepharoplasty

Lower eyelid blepharoplasty is performed to improve the appearance of dark circles, hollow under-eye regions, and eye bags. Miss Hawkes can also perform a 'fat transfer', which includes the repositioning of existing fat, to create a more youthful appearance under the eyes.

Why undergo eyelid surgery?

The eyes are the most important feature of the face. They display emotion and expression, but they are also the first part of the face to show signs of ageing. Because of their structural complexity and function, the eyelids are also one of the face’s most delicate areas.

The presence of fine lines, excess skin, and 'eye bags' can give the appearance of tiredness and an ageing face, which is the most common reason patients seek eyelid surgery. Most patients wish for a more youthful appearance.

In some patients, the eyelids may be asymmetrical. In these cases, blepharoplasty may be performed to improve symmetry.

Excessive, overhanging skin may obscure the field of vision in some patients. Patients who are affected may not be able to see their entire field of vision. Therefore, eyelid surgery can be performed to remove the obstruction and improve vision.

Upper and lower eyelid blepharoplasty remains one of the most popular cosmetic procedures. A specialist in ophthalmic plastic surgery, known as an oculoplastic surgeon, is the most experienced and best suited to perform this kind of surgery.

How long do results last?

While results vary from patient to patient, most people are satisfied with their blepharoplasty results for 10-15 years.

Most patients don’t have a second procedure because they’re so satisfied with the results of the first one.

Why should I choose Miss Hawkes for blepharoplasty?

Miss Elizabeth Hawkes is a consultant ophthalmic surgeon, oculoplastic surgeon and experienced cosmetic doctor. Natural enhancement of the face and eye is paramount to Miss Hawkes. She boasts an extensive knowledge of the delicate eye area, forehead and face. Miss Hawkes provides treatments in a safe, medical environment at the award-winning private London clinic, the Cadogan Clinic.

Visit her YouTube channel to see Miss Elizabeth Hawkes perform Upper Eyelid Blepharoplasty Surgery.

TESTIMONIALS

Happy patients

I consulted with Ms Hawkes for a concern about my eyelids and questions around blepharoplasty. She has been very helpful in explaining how it works, transparent about the expectations of the results on my case specifically and the risk. We also discussed other alternatives not involving surgery. I felt very confident after the consultation and decided to proceed with the surgery (lower & upper). On the day of the surgery, I felt reassured, it all went very smoothly. I am now more than 6 weeks post op, the results are incredible, the scars are almost invisible. We looked together at before and after photos last week, and it is impressive. I am very happy with the results, looking more fresh, rested and youthful. I would recommend anyone who is bothered by dropping eyelids to get a consultation with Ms Hawkes.

February 23, 2023

Extremely pleased with my how refreshed my eyes are now following Upper Blepharoplasty in December. Friends have commented on how amazing they look, and even my husband has said ... its the best thing I've had done. Thank you so very much

January 27, 2023

I am extremely happy with my eye blepharoplasty . I highly recommend Elizabeth Hawkes my procedure from start to finish went so smoothly and I felt very comfortable .

January 17, 2023

Elizabeth is very reassuring and provides a comprehensive service. Im not the type to seek out cosmetic procedures but was bothered by my hooded eyes and so with a degree of anxiety and much research as to who was 'the best', I went for a consultation with Elizabeth. She immediately put me at ease with her thorough explanation of the procedure and all the photographs of before and after and what to expect. I wanted a natural look in that no-one would notice specifically other than 'I looked fresh' and that is exactly what I have got. Im delighted with the results. They take a few weeks to settle down but I recovered quickly, the scars have almost disappeared already and any inbalances I perceived in the first few weeks have also now equalised. I have very natural eyes from a decade or so again and have received many compliments on how 'well' Im looking. My eyes are bright and sparkling again. Thank you and I cannot recommend Elizabeth more highly. Super skilled, listens, and delivers.

January 06, 2023

I am thrilled with the results of my upper and lower lid blepharoplasty surgery. Elizabeth was very considerate and understanding of my apprehension; she has an excellent bedside manner and put me totally at ease. The healing process for me was straightforward and pain-free. I could not be happier and more delighted, that I decided to go ahead with the surgery and that through my research, I chose Elizabeth to be my surgeon. I have no hesitation in highly recommending her.

October 28, 2022

I found Miss Hawkes to be very approachable, kind and very professional. I was able to call or e-Mail if I had any concerns and she would always reply as soon as possible. My recovery from my surgery was longer than I expected, mostly due to severe swelling, but Miss Hawkes reassured me that all the issues would settle in time. Now everything has settled, I am very satisfied with the surgery and would highly recommend Miss Hawkes to anyone considering eye surgery.

July 31, 2022

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Frequently Asked Questions

Dr Hawkes is available to address your inquiries. Should you have questions, we kindly invite you to reach out.

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At what age should I consider blepharoplasty?

Eyelid surgery is usually performed on people over 40 when the signs of ageing have manifested. However, many people in their 30s opt for blepharoplasty with valid reasons, such as pronounced bags under the eyes or excess upper eyelid skin.

Can fine lines and wrinkles be treated with a blepharoplasty?

The skin around the eyes is very delicate and can show signs of ageing easily. Many patients want to know if eyelid surgery can help them get rid of wrinkles around their eyes. The skin under the eyes appears smoother and firmer after blepharoplasty because excess tissue is removed and muscles are tightened. The procedure removes wrinkles caused by sagging skin or under-eye bags, but it does not treat other common eye wrinkles. Blepharoplasty (Eyelid Surgery) can be performed alone to treat eye wrinkles, but Miss Hawkes can also combine it with other procedures. Depending on the type and intensity of the eye wrinkles to be treated, Miss Hawkes may recommend one of the following treatments: * Anti-wrinkle injections * Dermal fillers * Eyebrow or forehead lift

Can I combine blepharoplasty with dermal fillers?

Besides blepharoplasty, Miss Hawkes will sometimes offer non-surgical cosmetic solutions such as tear trough fillers, temple fillers and mid-face enhancements, as the lower eyelids are part of the mid-face.

Does Miss Hawkes perform revision surgery?

Yes, Miss Hawkes is frequently consulted for second or even third opinions after surgery has been performed elsewhere. Revision blepharoplasty surgery is complex and is best managed by a dedicated oculoplastic surgeon.

How do I wash or apply makeup after a blepharoplasty?

* **1-2 days after surgery** - You can shower or bathe anytime from the neck down. Do not wet your face until Miss Hawkes says it is safe to do so. * **3-7 days after surgery** - You can backwash your hair with gentle products. If soap reaches the eyelid, pat them gently and avoid picking at the crust. * **5-8 days after surgery** - Your stitches will be removed. You can wash your face as normal after the stitches have been removed, but care must be taken for the first month after surgery. * **14+ days after surgery** - You can now apply eye cream and makeup. Avoid applying creams or makeup to the surgical sites for the first two weeks after the procedure. At this stage, you can also recommence contact lens wear (if applicable).

How do the eyes age?

Ageing around the eyes can be caused by a number of factors. First, the skin sags as a result of the loss of elastin (an essential protein for skin elasticity). This results in dermatochalasis, or excess skin. Second, the underlying major eyelid muscle (orbicularis oculi), which encircles the eye, becomes weak and bulky, which also contributes to eyelid heaviness. Another sign of ageing is the presence of eye bags. This is due to the forward prolapse of orbital fat, which cannot be held back by the weakening orbital septum over time. In severe cases, excess overhanging skin can obscure a patient’s field of vision. Eyelid surgery is performed to improve the eyelids by remodelling their structure. This can involve complex combinations of skin removal, muscle tightening, and fat repositioning or removal. Because each eyelid is unique, Miss Hawkes tailors each individual’s surgical plan and procedure.

How is blepharoplasty performed?

The way the surgery is performed varies, but all forms of blepharoplasty require a surgeon experienced in oculoplastics. The operation takes 45 mins-2 hours (depending on the number of eyelids requiring surgery) and can be performed under local anaesthetic, general anaesthetic, or sedation.

How long do blepharoplasty results last?

Blepharoplasty is a long-term procedure that produces excellent, natural-looking results. It can give you a younger appearance by improving the cosmetic appearance of your eyelids. The full effect, however, does not last forever. The natural ageing process will continue. While results vary from patient to patient, most people are happy with their blepharoplasty results for 10-15 years. Most patients don’t have a second procedure because they’re content with the first one.

How long do I have to stay in the hospital?

Eyelid surgery is performed in a day case setting with no overnight stay; therefore, you will be discharged after a short time in recovery and an observation period.

How long does eyelid surgery take?

The procedure takes between 45 minutes and 2 hours, depending on the complexity and number of eyelids requiring surgery. Miss Hawkes performs blepharoplasty in a dedicated day case surgical centre.

How long will I be off work?

Typically, upper blepharoplasty patients can return to work after 7-10 days For lower blepharoplasty, the recovery time is longer, at 10-14 days. You should take 2 weeks off work as the lower eyelids recover more slowly due to prolonged swelling. However, all patients are different, with some returning to work earlier, and others needing more time off for their recovery. Pricing is approximate and will be confirmed following your consultation.

How much does blepharoplasty cost?

The cost of upper and lower eyelid blepharoplasty varies. However, a blepharoplasty procedure with Miss Elizabeth Hawkes at the award-winning Cadogan Clinic in London, typically starts at £5850.

How should I prepare for blepharoplasty treatment?

* Miss Hawkes will provide all pre-operative advice during your consultation. * **Stop smoking.** Smoking reduces the blood supply to the skin and can slow healing. Stopping smoking will help the healing phase * Miss Hawkes discusses your individual requirements for medications, including sometimes liaising with you other doctors, to achieve the safest balance between her surgical requirements and your underlying medical conditions. In general, patients are asked to **stop taking** **aspirin, anti-inflammatory drugs, blood thinners, and herbal supplements 2 weeks before the surgery** as they may cause excessive bleeding. * **Plan for after surgery.** Plan for support during your recovery and for someone to accompany/drive you home from the hospital. All of your post-operative medication (antibiotic creams and drops), as well as an ice-mask, will be provided after the operation to take home.

How should I travel after the operation?

After the procedure, someone should accompany/drive you home. Don’t drive yourself home.

I am afraid of general anaesthetic. Can I have eyelid surgery performed under local anaesthetic?

Miss Hawkes can operate with local, sedation or general anaesthetic, and the decision is guided by patient choice.

Is blepharoplasty surgery painful?

Blepharoplasty is not considered painful. In the postoperative recovery period, pain is also minimal. Discomfort can be relieved with painkillers or ointments prescribed by Miss Hawkes. However, most patients do not require painkillers after the procedure.

Is eyelid surgery safe?

Blepharoplasty is a safe procedure, but as with all facial cosmetic surgery procedures, there are risks. There is a small risk of infection, scarring, bleeding and bruising. Miss Hawkes performs all blepharoplasty procedures in a safe, clinical environment at the award-winning Cadogan Clinic in London.

What are some genetic reasons for having eyelid surgery?

Excess or ‘saggy’ upper eyelid skin and lower eyelid bags can sometimes run in families. Do not be upset if you have these changes as your 20s and 30s. Miss Hawkes will talk about why the changes might have developed in the consultation and also a solution for you, which may involve surgical or non-surgical techniques.

What are the potential risks and complications with a blepharoplasty?

All surgical procedures involve risk, although serious risks are unlikely with blepharoplasty. **Common, temporary:** * Swollen or numb eyelids * Bruising and swelling * Irritation of the eyes * Watering eyes/transient worsening of dry eye symptoms * Flare of blepharitis **Rare:** * Blurred or double vision - Temporary * Blood pooling under the skin (haematoma) * Poor scarring * Long term worsening of dry eye symptoms **Very rare:** * Infection * Injury to the eye muscles * Drooping of the eyelid * Ectropion **Extremely rare:** * Visual impairment – Extremely rare, and many people find that their vision improves in the long term

What happens during a blepharoplasty consultation?

Before surgery, Miss Hawkes will invite you to an in-person consultation lasting between 30 minutes. Miss Hawkes will ask about your overall health and medical history, as well as listen to your concerns. She will go over the standard risks/benefits and determine whether there are any additional risks in your case. She will also advise you on possible outcomes and assist you in setting realistic and attainable goals. Miss Hawkes will then perform an eye examination and take a number of precise eyelid measurements. Examining the eye is necessary because there is an eye inside the eyelids, and it is critical to maintaini the functional aspect that the eyelids play. Miss Hawkes will then photograph you and offer pre-operative advice, including sharing before and after results.

What happens during the recovery period?

Recovery from blepharoplasty is fast, but please plan for 1-2 weeks off work after surgery. You may experience bruising or swelling, which will usually subside after 14 days. Miss Hawkes will remove your stitches on days 5-8. Please remember that your vision may be blurry on the first day. **During your recovery:** * Rest with your head elevated for 7 days - Sleep on your back and avoid sleeping on your side or face. Use several pillows under your head to prevent fluid build-up, which can worsen swelling. * Use regular ice compressions for 7 days – This can be an ice pack (provided) or frozen peas wrapped in a clean tea towel. * Use the prescribed ointment or eyedrops as directed. **Please avoid:** * Strenuous exercise, and straining for 4 weeks - Extreme physical activity may delay the healing of bruising and swelling * Smoking - Stop smoking as it irritates the eyes, delays healing and can cause scars to become more visible. * UV light – Wearing sunglasses from day 1 post-surgery can help protect your eyes from the sun and wind and reduce the chance of scar pigmentation. * Wearing eye makeup and contact lenses for 2 weeks Most patients can resume their everyday routines after two weeks, though this varies depending on the individual.

What type of anaesthetic will I receive during the procedure

Miss Hawkes can perform eyelid surgery under local anaesthetic, general anaesthetic, or ‘twilight’ sedation. Miss Hawkes recommends **local anaesthesia or twilight sedation for upper eyelid surgery**. However, you can opt to have the surgery performed under general anaesthetic. Miss Hawkes recommends **general anaesthetic for lower eyelid surgery.** Miss Hawkes recommends a **general anaesthetic for combined surgery** of the upper and lower eyelids, due to the length of the procedure. **Note**: Twilight sedation is a combination of local anaesthetic and sedation. During twilight sedation, the patient receives anaesthetic medication to numb a specific part of the body and a sedative to allow them to feel sleepy while still being awake and responsive.

Where are the incisions made?

**Upper blepharoplasty** - The incision for upper blepharoplasty is made along the eyelid natural skin crease. **Lower blepharoplasty** - The incision for lower blepharoplasty is either placed just below the lash line (transcutaneous)or inside the lower eyelid (and therefore without an external scar, known as transconjunctival).

Where can I receive treatment for blepharoplasty in London?

![The Cadogan Clinic Exterior](/assets/clinic-door-b13de31d7bf527615257151baa2804f3.webp) The Cadogan Clinic: 120 Sloane St, London SW1X 9BW Miss Elizabeth Hawkes offers blepharoplasty in London at The Cadogan Clinic, on Sloane Street, London.

Who is suitable for eyelid surgery?

Blepharoplasty is suitable for both men and women. It’s usually patients over the age of 40 who notice signs of excess skin or prominent lower eye bags. However, some patients in their 20s or 30s have a genetic predisposition for excess skin or lower eyelid bags and can benefit from eyelid surgery. **Suitable candidates for blepharoplasty are/possess:** * Bothered by signs of ageing in the eye area * Excessive drooping of the eyelids * Eyelid puffiness * Wrinkled skin of the eyelid * Presence of dark circles under the eyes * Realistic expectations * Tired appearance of the eyes Miss Hawkes will determine your suitability for a blepharoplasty during your pre-operative consultation.

Will I be left with noticeable scarring?

Blepharoplasty leaves minimal scarring, and it is uncommon for patients to have a visible scar after the procedure. Upper blepharoplasty scars are well hidden in the natural eyelid skin crease. Lower blepharoplasty scars are hidden by the eyelashes. Please follow all of Miss Hawkes’ aftercare instructions to help the scarring process.

Will I need revision surgery?

As with all cosmetic surgical procedures, the ‘perfect’ result may not be achieved in a single procedure. Additional refinements may be required, but this is unlikely. Most patients are satisfied with their blepharoplasty results for 10-15 years. Even though you can expect the effects of eyelid surgery to last for many years, the natural ageing process will continue. As a result, drooping and bulging of the eyelids may reoccur. If drooping and bulging of the eyelids reoccur - this is not because of postoperative complications or failures. A revision blepharoplasty can be considered in this case.

Will I need to wear a bandage after blepharoplasty?

Bandages are not required. Sometimes dressings are applied.

Will the results appear natural?

Blepharoplasty produces long-lasting, natural-looking outcomes. The surgery can bring life-changing results. In modern times, less muscle fat and skin are removed, which contributes to the natural aesthetics of the result. The fat is repositioned rather than removed.

Which concerns can blepharoplasty help with?

Blepharoplasty can help with a number of medical and cosmetic concerns, including: * Droopy eyelids * Eye bags * Excess eyelid skin * Excess skin around the eyes * Visual impairment due to excess skin * Hooded eyes

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