What it does
Upper blepharoplasty addresses three things, in order of frequency:
- Skin excess (dermatochalasis) — redundant upper lid skin that drapes over the lash line or covers the natural crease
- Excess pre-aponeurotic fat — bulging at the inner upper lid that creates a "puffy" look even when no skin redundancy is present
- Loss of crease definition — when the natural fold has been buried under hooded skin and the operation restores it
The procedure does not change brow position, does not affect eyelash position or growth, and does not change the colour of the eyelid skin.
Technique step by step
The operation is performed under local anaesthesia with oral sedation, or general for combined procedures. Time: 40–60 minutes.
- Marking (15 minutes). The patient sits upright with eyes closed and then open. The new crease line is marked at the existing or planned crease level. The amount of skin to remove is calculated by the "pinch test" — gently elevating skin until lash line just begins to lift.
- Anaesthesia. Local lidocaine with adrenaline infiltrated along the marked lines.
- Skin excision. The marked ellipse of skin is removed sharply with scissors or scalpel.
- Muscle and fat. A small strip of orbicularis muscle is removed where appropriate. Pre-aponeurotic fat is addressed conservatively if bulging.
- Closure. Continuous 6-0 suture along the incision. The crease is restored.
- The other eye. Same procedure mirrored, checked for symmetry.
What the result looks like
The lid platform becomes visible again (or visible for the first time, depending on starting anatomy). The eye reads as more open and less tired. The crease has a clean line. The natural eye shape is preserved.
What it should not look like: surprised, hollow, "wide-eyed," or different from the patient before surgery in a way that makes them unrecognizable. If it does, too much was removed.
Recovery profile
- Day 0: Steri-strips over the incision. Cold compresses every 20 minutes.
- Day 1–3: Maximum swelling. Vision feels heavy but is not impaired.
- Day 5–7: Sutures removed. Bruising shifts from purple to yellow.
- Day 10–14: Most bruising gone. Back to social and work.
- Week 4: Scar is pink but flat.
- Month 3: Scar fading; final crease position visible.
- Month 6: Final result.
Frequently asked questions
Can upper blepharoplasty correct hooded lids if my brow is also drooping?
Partially. If brow descent is significant, upper bleph alone may not address the heaviness — and removing more skin to compensate for brow position is a classic error that produces a 'starved' look. Honest assessment identifies how much of the heaviness is brow vs skin. Sometimes brow lift alone is the right answer; sometimes both procedures together; rarely upper bleph alone in cases of true brow ptosis.
Will the scar be visible?
The incision sits in the natural upper lid crease. For the first 6 weeks it's pink/visible from close range; by 3 months it's faint; by 6 months it's typically invisible to anyone who isn't looking for it. Patients can wear concealer over it from day 14.
Can I have upper bleph done in my 30s?
Rarely the right answer — most people in their 30s with 'heavy eyelids' actually have brow descent, fat ptosis, or hereditary fullness, not the dermatochalasis that upper bleph addresses. If true skin redundancy is present in a 30-something (genetic, post-thyroid disease, severe sun damage), upper bleph can be considered — but conservative.
Does upper blepharoplasty improve vision?
Yes when hooded skin is genuinely obstructing the superior visual field — a finding that can be documented by formal visual field testing in ophthalmology. In some healthcare systems this is the threshold for functional (insurance-covered) blepharoplasty. The visual improvement is often subtle to the patient because the brain has adapted to the obstruction over years.
What's the chance of asymmetric result?
Some asymmetry in healing in the first 8 weeks is normal — typically resolves by 3 months. Persistent asymmetry beyond 6 months affects perhaps 3–5% of cases meaningfully; usually addressable by minor revision under local anaesthesia.
Not sure if you're a candidate?
Blepharoplasty is most successful when patient anatomy, age, and goals align with what surgery can realistically deliver. Send three facial photos (front, profile, eyes-closed) and Doç. Dr. Erdal will give you an honest, no-pressure suitability assessment before you commit to anything.
Ready to discuss your case?
Doç. Dr. Erdal personally reviews every enquiry. Honest assessment of whether blepharoplasty is right for you, with no pressure to book.