Blepharoplasty in Sydney: upper and lower eyelid surgery
Blepharoplasty can refine heavy upper eyelids, under-eye bags or selected lower-lid concerns. The right operation depends on what is actually creating the tired or heavy appearance, not simply where it is noticed.
At MA360, the assessment distinguishes excess skin and fat from eyelid droop, brow descent, hollowing, dry-eye symptoms and lower-lid laxity. This helps determine whether upper blepharoplasty, lower blepharoplasty, a combined approach or a different treatment is more appropriate.
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- Procedure
- Upper, lower or combined eyelid surgery
- Timing
- Often 60-90 minutes; combined surgery may take longer
- Early recovery
- Expect visible swelling and bruising
- Results
- Long-lasting, while natural ageing continues
Eyelid surgery is planned for the individual concern
These cases show different starting anatomy and treatment goals. They are individual outcomes, not a prediction of another patient's result.
A stable crease for eyelids that looked puffy and heavy
This patient described an upper-eyelid fold that could disappear from day to day. Planning focused on clearer definition without an exaggerated crease.
Read this case study
Upper-eyelid correction for a visible difference between the eyes
One eye appeared more open because the creases and tissue distribution were different. The plan considered the asymmetry rather than applying the same change to both sides.
Read this case studyBlepharoplasty is not the answer to every eye-area concern
Several issues can look similar in photographs but need different treatment. Recognising them before surgery protects function and makes the expected change more realistic.
True eyelid droop
Ptosis relates to eyelid-opening function. Removing skin alone may not correct it and can leave the original problem visible.
Brow descent
A low brow can push tissue towards the upper lid. Brow position should be assessed before deciding how much eyelid skin can be safely removed.
Hollowing or shadow
Tear-trough hollowing, cheek support and pigmentation can create darkness without a true eye bag. Blepharoplasty does not directly treat every cause of dark circles.
Dry eye and lid laxity
Existing dryness, previous eye surgery, thyroid eye disease, incomplete closure or lower-lid looseness may alter suitability and surgical planning.
What changes from one blepharoplasty to another
The incision and tissue adjustment are chosen after examining the eyelids, not from a standard template. Upper and lower procedures have different risks, scars and recovery patterns.
Technique matters, especially when protecting eye closure
A 2025 systematic review of randomised trials on upper blepharoplasty reported that outcomes varied with surgical technique. In the included studies, removing muscle with skin was associated with more lagophthalmos, or incomplete eyelid closure, than skin-only excision. The review supports careful tissue selection rather than assuming that more removal creates a better result. It examined upper blepharoplasty and should not be generalised to every lower-eyelid procedure. Read the systematic review on PubMed.
A clear plan starts with eyelid function
At MA360's Chatswood and Hurstville clinics, the consultation connects the appearance you notice with the anatomy causing it. This is where suitability, alternatives, recovery and a personalised quotation can be discussed without reducing the decision to a package.
History and eye comfort
Dryness, contact lenses, vision procedures, thyroid disease, allergies, medicines and previous eyelid surgery all inform the plan.
Functional examination
Eye closure, eyelid opening, brow position, lower-lid tone, asymmetry and skin or fat distribution are assessed.
Design and consent
The proposed incision, tissue adjustment, likely scar, trade-offs, alternatives and risks are explained before a decision is made.
Surgery and review
Most patients return home after observation with written aftercare, urgent contact information and planned follow-up.
Plan for bruising first, refinement later
Many patients allow roughly one to two weeks before returning to less visible social commitments, but the exact downtime differs between upper, lower and combined surgery. Swelling can make the eyelids look uneven or over-corrected before they settle.
First 72 hours
Swelling, bruising, tightness, watering, dryness, light sensitivity and temporary blur can occur. Follow the written plan for compresses, cleaning and medication.
First week
Bruising may change colour as it fades. Upper-lid sutures are often reviewed or removed around this stage when non-dissolving sutures are used.
Weeks two to four
The eye area usually looks more settled, although puffiness, numbness, firmness and side-to-side differences may remain.
Following months
Scars soften and the eyelid contour continues to refine. Lower-eyelid and combined procedures can take longer to fully settle.
Common temporary effects
- Swelling, bruising and mild tenderness
- Watery or dry-feeling eyes
- Temporary blur or light sensitivity
- Tightness, altered sensation or itch
- Early asymmetry while swelling differs between sides
General care principles
- Use compresses, drops and medicines only as directed
- Keep the head elevated if advised
- Avoid rubbing the eyes or disturbing incisions
- Resume contact lenses, makeup, exercise and swimming only when cleared
- Protect healing scars from strong sun and attend scheduled reviews
Understand the full risk profile
All surgery carries risk. Upper, lower and combined blepharoplasty have overlapping but different complication profiles.
- Bleeding, infection, delayed healing or noticeable scarring
- Dry eye, irritation, watering or difficulty closing the eyelids
- Asymmetry, contour irregularity, persistent swelling or dissatisfaction
- Lower-lid retraction, lid lag or ectropion after lower-eyelid surgery
- Temporary or persistent altered sensation and eye-muscle disturbance
- Need for observation, treatment or revision surgery
- Rare vision-threatening bleeding or visual change
Know when not to wait
Routine bruising and swelling should be distinguished from symptoms that are severe, one-sided or changing quickly.
Seek immediate assessment
Contact the surgical team urgently for rapidly increasing swelling, escalating pain, marked bleeding, fever, spreading redness, inability to close the eye or new double vision. Sudden reduction or loss of vision, severe eye pain, eye bulging or neurological symptoms require emergency care; call 000.
Blepharoplasty FAQs
What is the difference between upper and lower blepharoplasty?
Upper blepharoplasty usually addresses excess upper-lid skin and selected fullness. Lower blepharoplasty is planned around under-eye fat prominence, skin, the lid-cheek transition and lower-lid support. The incisions, techniques and risks are different.
Can blepharoplasty treat hooded eyelids?
It may help when true upper-eyelid skin excess is creating the hood. A low brow, ptosis or a naturally full eyelid can look similar, so examination is needed before deciding whether skin removal is suitable.
Will lower blepharoplasty remove dark circles?
Not always. Surgery may soften shadow caused by prominent fat or an uneven lid-cheek transition, but pigmentation, visible blood vessels, thin skin and hollowing can remain. The cause of the darkness needs to be identified first.
Is eyelid ptosis corrected by blepharoplasty?
Ptosis is weakness or dysfunction in eyelid opening and is different from loose skin. It may require a separate ptosis procedure. Blepharoplasty alone should not be assumed to correct it.
Where are blepharoplasty scars placed?
An upper incision is usually positioned in the natural eyelid crease. A lower incision may sit just below the lashes or inside the lower eyelid. Scars generally soften, but their visibility and healing vary.
Is blepharoplasty painful?
Anaesthesia is selected for the planned procedure. During recovery, patients more commonly describe tightness, tenderness, stinging or pressure than severe pain. Pain that is intense, increasing or associated with visual symptoms needs urgent review.
How much downtime should I plan?
Visible bruising and swelling commonly last one to two weeks, but lower or combined surgery may remain puffy for longer. Work demands, healing and comfort around other people should all be considered when planning time away.
How long do blepharoplasty results last?
The removed or repositioned tissue does not simply return, so the change can be long-lasting. However, the brow, skin and surrounding face continue to age. Longevity cannot be reduced to one reliable number for every patient.
Can upper blepharoplasty improve vision?
It may improve the superior visual field when documented excess upper-lid skin obstructs vision. A functional assessment is different from cosmetic planning and may require formal examination or visual-field testing.
How much does blepharoplasty cost in Sydney?
Cost depends on whether surgery involves the upper eyelids, lower eyelids or both, as well as the technique, anaesthesia and complexity. A written quotation can be provided after examination and a personalised surgical plan.
Explore related MA360 information
These pages cover related eyelid concerns, non-surgical eye-area options, clinical examples and clinic information.
Eyelid procedures and cases
Other eye-area options
Medical Aesthetics 360
This article provides general information and does not replace individual medical or eye-care advice. Suitability, alternatives, expected recovery and risks are discussed during consultation. Surgical experiences and results vary between individuals.