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Eyelid Surgery (Blepharoplasty): Upper, Lower, Scars, Recovery and the Things Clinics Leave Out
What eyelid surgery can change, what it cannot, how to tell an eyelid problem from a brow problem, and why the best results often remove less than you expect.
Eyelid surgery, or blepharoplasty, removes or repositions excess skin, muscle and fat from the upper eyelids, the lower eyelids, or both. Upper eyelid surgery treats heavy, hooded lids. Lower eyelid surgery treats bags and, in some cases, loose skin under the eyes. It is usually performed under local anaesthetic with or without sedation, or under general anaesthetic, and takes about one to two hours depending on whether upper, lower or both are treated. Most people return to social life in ten to fourteen days. The final result settles over about three months.
It is one of the most effective facial operations, and one where restraint matters most. The eyelids protect the eye, and removing too much skin or fat can leave the eyes dry, hollow or unable to close properly. This guide explains what each operation involves, who it suits, and what to ask.
What eyelid surgery is — and what it cannot do
Upper eyelid surgery removes a crescent of excess skin, and sometimes a strip of muscle and a small amount of fat, through an incision in the natural eyelid crease. The lid looks less heavy, the crease becomes visible again, and in some people the upper field of vision improves.
Lower eyelid surgery treats bags, which are fat that has pushed forwards under the eye. Depending on the technique, the fat is removed, or repositioned to fill the hollow between the eyelid and the cheek (the tear trough). Where there is also loose skin, a small amount of skin is removed.
Eyelid surgery does not lift a descended brow. If heaviness comes from the brow, a brow lift is needed, either instead of eyelid surgery or together with it.
It does not correct a drooping eyelid margin. A drooping lid margin (ptosis), where the lid covers part of the pupil, is a problem with the muscle that opens the eye and needs a different repair, which can be done at the same time.
It does not treat dark circles caused by pigment or visible blood vessels. It does not remove crow's feet, which respond to anti-wrinkle injections. It does not change the shape of the outer eye corner (see almond eye surgery). It does not lift the cheek.
The most important thing on this page: less is often more, and the eye must still close
Two principles separate a natural result from an operated one.
Remove only what is truly excess. Older techniques removed large amounts of fat from both lids. Over years, this can leave the eyes looking hollow, sunken and older, because the face naturally loses fat with age. Modern eyelid surgery is more conservative. In the lower lid in particular, fat is often repositioned rather than removed.
Protect eyelid function. The upper lid must still close fully, and the lower lid must stay against the eye. Removing too much upper eyelid skin can stop the eye closing completely (lagophthalmos) and cause dryness. Lower eyelid surgery through the skin can pull the lower lid down, showing white below the iris, or turn it outwards. These problems are uncommon but difficult to correct, and they are why the lower lid's tone is assessed before surgery and often supported during it.
The consultation should also check whether you already have dry eye, and whether your brows are part of the problem.
Brow or eyelid?
Many people who think they need upper eyelid surgery have brows that have dropped. Try this in a mirror. Relax your forehead, then lift your eyebrows gently with your fingertips to where they sat when you were younger.
If the hooding largely disappears, the brow is the main problem.
If loose skin still sits on the eyelid, the eyelid is contributing too.
This matters because many people with low brows raise their forehead all day to keep their eyes clear. If eyelid skin alone is removed, the forehead relaxes, the brows settle lower, and the eye can look heavier than before. A surgeon should assess brow position before any upper eyelid operation.
Why people consider it
Heavy, hooded upper lids, where eye make-up disappears into the fold, the eyes look smaller or tired, or the lids feel heavy by the end of the day.
A restricted upper field of vision from excess skin.
Bags under the eyes that persist regardless of sleep.
A tired look from bags and hollows under the eyes.
Loose, crepey skin on the lower lids.
Upper eyelid surgery
The excess skin is marked with you sitting up and your eyes open, so the crease is placed at the correct height. Through an incision in the natural crease, the skin is removed, and a thin strip of muscle and a small amount of fat may be removed as well, usually from the inner corner. Sometimes a gland at the outer corner that has dropped is repositioned. The incision is closed with fine stitches, and the scar lies within the crease, visible only when the eye is closed and fading over a few months.
Lower eyelid surgery
Transconjunctival (from inside the eyelid). The incision is placed on the inner surface of the lower lid, so there is no visible scar. Fat is removed or repositioned. It suits bags with good skin tone and carries a lower risk of lower lid pull-down. Small amounts of loose skin can be treated with a skin pinch or resurfacing.
Transcutaneous (just below the lashes). The incision runs just below the lower lashes and into a laugh line at the outer corner. It allows skin and muscle to be tightened and removed as well as fat to be treated. It suits more loose skin but carries a higher risk of lower lid malposition, so the lower lid is often supported at the outer corner at the same time (canthopexy).
Fat repositioning and fat grafting. Instead of removing the fat, the surgeon can move it into the hollow under the bag to smooth the transition to the cheek. Small amounts of facial fat transfer can also fill hollows.
Lower Eyelid Surgery: Why Facial Anatomy Matters
Lower eyelid surgery (lower blepharoplasty) requires a precise understanding of not only the eyelid, but the anatomy of the entire face. Because significant complications can occur following lower eyelid surgery, careful patient assessment, surgical planning and anatomical expertise are essential.
Dr. Feryal Yıldız believes that lower blepharoplasty should be performed by a plastic surgeon with a comprehensive understanding of facial anatomy, including the relationship between the lower eyelid, midface, cheek and surrounding support structures.
For Dr. Yıldız, successful lower eyelid rejuvenation is not about treating the eyelid in isolation. It is about understanding the face as a whole to achieve a safe, balanced and natural-looking result.
Who this suits
Eyelid surgery suits adults in good health with excess upper eyelid skin, bags under the eyes, or loose lower eyelid skin. Most patients are over 35, but some have hereditary bags or hooding from a younger age.
Tell your surgeon if you have dry eye, wear contact lenses, have had laser eye surgery, have glaucoma or thyroid eye disease, or take blood-thinning medicines or supplements. You should also not smoke, or be willing to stop well before and after surgery.
Realistic expectations matter most: a fresher, more rested eye, not a different one.
Who this does not suit
Patients with pre-existing conditions such as dry eye should be carefully evaluated before undergoing lower eyelid surgery (lower blepharoplasty). Dr. Feryal Yıldız emphasizes that existing ocular surface problems should be appropriately assessed and managed before surgery, as they may affect both surgical planning and recovery.
For her, safe blepharoplasty begins before the operation — with careful patient selection, comprehensive evaluation and optimization of any pre-existing eye conditions.
The operation and the first weeks
Eyelid surgery is usually performed under local anaesthetic, with or without sedation, or under general anaesthetic, especially when combined with other procedures. You usually go home the same day.
After surgery, the eyelids are swollen and bruised, and they may feel tight. Vision can be blurred for a day or two from swelling and ointment. Watering or a gritty feeling is common. Some people have swelling of the clear membrane over the white of the eye (chemosis), which usually settles over days to weeks.
After surgery:
- Keep your head raised, including while sleeping, for the first week.
- Use cold compresses as instructed for the first 48 hours.
- Use the eye drops and ointment you are prescribed.
- Do not rub your eyes.
- Avoid contact lenses for about two weeks, and eye make-up until you are cleared.
- Rest your eyes, and limit long periods of reading or screen time in the first days.
- Avoid bending, heavy lifting and strenuous exercise for two weeks.
- Wear sunglasses outdoors.
- Do not smoke.
Seek emergency help immediately if you have sudden severe pain, rapidly increasing swelling around the eye, or any loss of vision. These can signal bleeding behind the eye, which is very rare but needs urgent treatment.
The recovery timeline
Days 1–3. Swelling and bruising are at their peak. Rest with your head raised and use cold compresses.
Days 4–7. Upper eyelid stitches are usually removed. Swelling is easing.
Weeks 1–2. Bruising fades. Most people return to social life and work at ten to fourteen days, and bruising can usually be covered with make-up once the wounds have healed.
Weeks 2–6. Residual swelling settles, especially in the lower lids. Contact lenses can usually be worn again after about two weeks.
Around 3 months. The final result is visible.
Months 3–6. The upper eyelid scar fades to a fine line within the crease.
How long it lasts
The results of upper eyelid surgery usually last many years, although the skin continues to age and the brows may descend over time. Lower eyelid bags treated by removing or repositioning fat rarely return, although the skin and cheek continue to age.
Risks and complications
No operation is risk-free, and a page that leaves this section out is not worth trusting. The recognised risks of eyelid surgery include:
Asymmetry between the two eyes.
Over-removal of skin or fat, leaving hollow eyes or eyelids that do not close fully.
Under-correction, leaving residual excess skin or bags.
Dry eye, irritation and watering. These are usually temporary.
Difficulty closing the eyes fully. It is usually temporary.
Lower eyelid malposition. The lid can be pulled down or turned outwards, particularly after lower lid surgery through the skin.
Chemosis. Swelling of the membrane over the eye is usually temporary.
Visible or raised scars, or small white cysts along the incision (milia), which are easily treated.
Unmasking of a drooping upper eyelid margin or a low brow that was not obvious before.
Double vision. It is rare and usually temporary, from swelling or injury to an eye muscle.
Infection and bleeding. Bleeding behind the eye is very rare but can threaten vision and needs emergency treatment.
Further surgery, for any of the above.
Anaesthetic risks, if sedation or general anaesthetic is used.
Combining eyelid surgery with other procedures
Eyelid surgery is often combined with a brow lift when both the brow and eyelid contribute to heaviness, with facial fat transfer for hollows, with support of the outer corner (see almond eye surgery) during lower lid surgery, or with a facelift.
If you are travelling to Istanbul for surgery
Patients come to us from the UK, Ireland, Germany, France, the Gulf and elsewhere. Travelling for surgery is a reasonable decision, and it needs more planning than surgery at home.
Assessment. Brow position, eyelid skin, fat, lower lid tone and eye health decide the plan. This assessment must be made in person.
How long to stay. Plan to stay until your stitches are removed and your eyes have been reviewed, typically about a week.
Flying. Cabin air is dry. Use your lubricating drops during the flight, and wear sunglasses.
Aftercare at home. Arrange who will review your healing once you are home. Health systems in your home country are generally under no obligation to provide routine aftercare or revision for private surgery performed abroad, though they will treat a genuine emergency.
Revision terms in writing. Agree in advance what happens if the result needs further treatment: who performs it, where, and who pays.
Your records. Take home your operation note and your discharge instructions.
Choosing a surgeon
Check the qualification, not the adjective. Ask which specialist register the surgeon is on, in which country, and verify it independently.
Ask whether your problem is the eyelid, the brow or both, and ask them to show you with your forehead relaxed.
For lower lids, ask whether fat will be removed or repositioned, and which incision they recommend and why.
Ask how they protect eyelid closure and the lower lid position, and what they will do if you have dry eye.
Ask to see results at a year or more.
Ask who will be operating on the day.
Be wary of pressure. Time-limited pricing, a decision expected on the day, or surgery packaged with sightseeing all suggest that commercial priorities come before clinical ones.
Frequently asked questions
What is blepharoplasty?
Eyelid surgery that removes or repositions excess skin, muscle and fat from the upper eyelids, the lower eyelids, or both.
Will there be scars?
Upper eyelid scars lie in the natural crease and are visible only when the eye is closed, fading over a few months. Lower eyelid surgery from the inside of the lid leaves no visible scar. Surgery through the skin leaves a fine line just below the lashes.
How long does recovery take?
Most people return to social life and work in ten to fourteen days. The final result appears at about three months.
Is it painful?
Most people describe tightness and mild discomfort rather than significant pain, controlled with ordinary painkillers.
Can eyelid surgery remove dark circles?
Only if the darkness is a shadow caused by a bag or a hollow. Dark circles from pigment or visible blood vessels do not respond to surgery.
Will it get rid of my eye bags permanently?
Bags treated by removing or repositioning fat rarely return, although the surrounding skin and cheek continue to age.
Do I need a brow lift instead?
If lifting your brows with your fingertips removes most of the hooding, a brow lift may be part of the answer. Your surgeon should assess this before recommending eyelid surgery.
Can it improve my vision?
If excess upper eyelid skin restricts your upper field of vision, removing it can improve it.
Is it done under local anaesthetic?
Often, especially for upper eyelids, with or without sedation. Lower eyelids and combined procedures are often done under general anaesthetic.
How long does it last?
Upper eyelid results usually last many years. Treated lower eyelid bags rarely return. The eyelids continue to age.
Can it be combined with other procedures?
Yes. It is often combined with a brow lift, fat transfer, support of the outer eye corner or a facelift.
Arranging a consultation
If you are considering eyelid surgery, the useful next step is a proper assessment. That means an examination of your eyelids, brows and eye health, an honest answer to whether the eyelid, the brow or both are the problem, and a clear explanation of which technique suits you and why.
You are welcome to contact the clinic to arrange a consultation with Op. Dr. Feryal Yıldız. There is no obligation to proceed, and you should not be asked to decide on the day.
