# Blepharoplasty (Eyelid Surgery): The Complete Patient Guide URL: https://mohamedmohyudin.co.uk/eye-health/blepharoplasty-complete-patient-guide/ Last updated: 2026-09-08 Original clinical review: 2026-08-13; later editorial additions are source-based. ## Quick answer Blepharoplasty (eyelid surgery) removes excess skin and fat from the upper or lower eyelids. With Mr Mohamed Mohyudin, an oculoplastic fellowship-trained consultant in West Yorkshire, upper blepharoplasty is usually a 45–60 minute procedure under local anaesthetic at Spire Elland Hospital. Most patients return to desk work within 7–10 days, with bruising settling over 2 weeks. ## Key facts - Upper lid surgery usually done under local anaesthetic in under an hour - Back to desk work in about 7–10 days for most patients - Performed by an oculoplastic fellowship-trained consultant surgeon - Functional cases (vision blocked by hooded lids) and cosmetic cases both treated ## Introduction Blepharoplasty — eyelid surgery — is one of the most commonly performed aesthetic and functional procedures in ophthalmology. Despite this, there is a great deal of confusion about who needs it, what it involves, and what results are realistic. As an oculoplastics specialist with double fellowship training, eyelid surgery is a central part of my practice. This is the guide I wish every patient read before their first consultation. ## Upper vs lower eyelid blepharoplasty — they are different operations Upper eyelid blepharoplasty removes excess skin and sometimes a small strip of orbicularis muscle from the upper eyelid. When drooping upper eyelid skin is hooding the visual axis, the operation is functional — it genuinely improves the visual field. When the skin is loose but not obstructing vision, it is aesthetic. Lower eyelid blepharoplasty addresses the 'bags under the eyes' — fat pads that protrude beneath the lower lids, creating shadowing and a tired appearance. The approach can be external (skin incision just below the lash line) or transconjunctival (internal, no skin scar), depending on whether excess skin needs to be removed as well. ## Am I a candidate? - Upper lid: if your upper eyelid skin rests on your lashes, obscures your peripheral vision, or you find yourself lifting your brow to see clearly, you are likely a functional candidate. - Upper lid aesthetic: if you simply dislike the heaviness or hooding of your upper eyelids and wish to look more refreshed. - Lower lid: persistent 'bags' — fat prolapse beneath the lower lids — that are unchanged by sleep or diet. - Not a candidate: significant dry eye disease (surgery can temporarily worsen dryness), certain thyroid eye disease states, unrealistic expectations about result. ## Can I get upper blepharoplasty on the NHS? Upper blepharoplasty is available on the NHS when there is documented functional impairment — specifically, when the excess upper eyelid skin significantly restricts the superior visual field. This is assessed by a formal visual field test. The criteria are strict, and many patients who feel their vision is affected do not meet the threshold. Aesthetic blepharoplasty (lower eyelid or upper eyelid without functional impairment) is not funded by the NHS. ## The procedure Upper blepharoplasty: performed under local anaesthetic as a day case. A carefully planned ellipse of skin is marked, excised, and the wound closed with fine sutures. The operation takes 30–60 minutes. You are awake throughout and can go home the same day. Lower blepharoplasty: typically performed under local anaesthetic with sedation, or occasionally general anaesthetic. The transconjunctival approach leaves no external scar; the external approach allows removal of excess lower lid skin. ## Recovery - Expect bruising and swelling for 1–2 weeks. Cold packs for the first 48 hours. - Sutures removed at 5–7 days. - Most patients return to office work within 10–14 days. - Final cosmetic result is typically visible at 3–6 months once swelling has fully resolved. - Avoid strenuous exercise for 2 weeks. - Avoid eye makeup for 2 weeks post-operatively. ## Scarring The upper eyelid scar is hidden in the natural lid crease and is typically imperceptible once healed. Lower eyelid scars (when an external approach is used) are placed just below the lash line and heal to a fine, barely visible line in the vast majority of patients. ## Cost Private upper blepharoplasty in the UK typically ranges from £2,000–£3,500 per procedure (both upper lids). Lower blepharoplasty is generally £2,500–£4,000. Combined upper and lower lid surgery is possible and the total cost is usually less than the sum of each separately. Costs include consultation, surgery and follow-up. ## Is this ptosis or is it extra skin? If the lash line sits too low on the pupil, that is ptosis and needs a muscle operation, with or without skin removal. If the margin is in the right place and a fold of skin rests on the lashes, that is dermatochalasis — classic upper blepharoplasty. Mixing them up is the commonest reason people are unhappy with ‘eyelid surgery’ done as a skin-only tidy. An oculoplastic assessment measures both. ## What does upper blepharoplasty cost with Mr Mohyudin in Yorkshire? Self-pay upper blepharoplasty at Spire Elland starts from £3,000 for both upper lids (practice figure, July 2026), including the usual package items stated on the payment pages. Combined upper and lower work is quoted after examining the fat pads and skin. UK ranges of £2,000–£3,500 elsewhere are context, not a second price list. Functional cases with documented field loss may be NHS-funded; aesthetic cases are not. ## Who should skip surgery even if they dislike their lids? Skip if you cannot accept a scar in the crease, even a fine one. Skip if you want a permanently surprised brow — that is a brow-lift conversation, and over-resecting lid skin to fake a brow-lift is how people look operated. Skip if you are mid-work-up for myasthenia or a nerve palsy. Book a consultation anyway if the field of vision is blocked: that visit may end as ‘NHS criteria met’ rather than a self-pay list. ## How should you weigh appearance, vision and eye comfort? Describe what bothers you in your own words before choosing an operation: heavy upper lids, skin touching the lashes, lower-lid bags or a tired appearance. Those concerns may arise from different structures. Ask the surgeon to explain which part of the proposed procedure addresses each concern, what it will not change and whether a brow or ptosis assessment is relevant. Use the consultation to discuss your baseline dryness, previous eye surgery and expectations about symmetry. Ask to see the recovery plan, including wound care, follow-up and whom to contact urgently. Plan time away from public-facing work around the possibility of visible bruising rather than a promised photograph-ready date. A useful quote identifies whether it covers upper lids, lower lids or both and which anaesthetic and hospital fees are included. You should have time to consider the risks and alternatives without pressure to book. ## Questions to take to your appointment - Which anatomical change is responsible for the concern I can see? - Could the operation worsen dry-eye symptoms or closure? - What does the quote include, and what would a revision involve? ## Sources - [NHS: eyelid surgery — suitability, recovery and risks](https://www.nhs.uk/tests-and-treatments/cosmetic-procedures/cosmetic-surgery/eyelid-surgery/) - [Moorfields Eye Hospital: ptosis (droopy eyelid)](https://www.moorfields.nhs.uk/eye-conditions/ptosis-droopy-eyelid) ## FAQs ### Will blepharoplasty make me look surprised or unnatural? A well-planned blepharoplasty should look refreshed and natural — not operated. The key is conservative skin excision (removing too much is worse than removing too little) and careful attention to the lid crease position. Results look most natural when performed by an oculoplastics specialist who understands eyelid anatomy intimately. Look for a surgeon with specific training in eyelid procedures, not just general cosmetic surgery. ### How long do blepharoplasty results last? Upper eyelid blepharoplasty results typically last 5–10 years, as the skin continues to age. Some patients need a revision procedure at some point. Lower eyelid results for fat removal are generally permanent, as fat does not return, though skin laxity may increase with further ageing. ### I was told my vision is affected by my eyelids. Will the NHS fund my surgery? Possibly. NHS-funded blepharoplasty requires a formal visual field test showing a significant superior field restriction (often >30 degrees of the visual field obscured). Your GP can refer you to an NHS ophthalmologist for assessment. If you do not meet the NHS threshold but still find the hooding bothersome, private surgery is the alternative. ### Where is the operation done? Privately, at Spire Elland Hospital, Elland Lane, HX5 9EB. Upper lids are usually local anaesthetic, day case. Call 01422 324000. No GP referral for self-pay. ### Can I have cataract surgery and blepharoplasty together? Sometimes they are staged rather than combined, because drops, taping and swelling after lids can annoy a fresh cataract wound, and a heavy lid can fool some measurements. Sequence is individual. Do not assume one anaesthetic will cover both just because both are ‘eye operations’.