Upper vs Lower Blepharoplasty: Which Do You Actually Need?

Upper blepharoplasty

Upper blepharoplasty focuses on the upper eyelid region. It is a surgical procedure that helps to remove and reposition excess skin tissue that can create a heavy or tired appearance.

Skin elasticity starts to reduce as we age, especially on our upper lids. This is why we see sagging skin or excess eyelid skin start to appear. For some people, significant excess skin in this area can impact their peripheral vision.

Upper eyelid surgery involves the careful removal of skin by your surgeon along the natural eyelid crease. This helps to remove excess skin, muscle, or any protruding fat.

This technique ensures that any scarring is hidden in the natural crease and that any natural movement of the upper lids is retained.

The main goal of upper eyelid procedures is to improve the eyelid contour and to give you a refreshed appearance.

Mr Ridha focuses on being precise and pays attention to detail, so that he can maintain the natural shape of the eye and ensures that your blepharoplasty results do not look unnatural.

What does an upper blepharoplasty treat?

We use an upper blepharoplasty to:

•   Remove excess skin on the upper lid
•   Remove drooping skin on the upper eyelid area
•   Tighten loose skin that affects the lash line
•   Reduce excess fat leading hooded eyelids
•   Refresh a tired appearance around the eyes

The results from an upper blepharoplasty are subtle but can transform the eye area. We aim to help our patients’ eyes look brighter and more awake.

Upper blepharoplasty recovery is straightforward. You will likely see some swelling and bruising for a week or two.

Most patients return to desk based jobs after a week. If you have a more physically demanding job, you may need to take 2-3 weeks off work.

Lower blepharoplasty

A lower blepharoplasty focusses on the under eye area and lower eyelid. It is a procedure that we use to reduce puffiness, eye bags, and remove any loose skin under the eyes.

If you have puffy eye bags that sleep and a good skincare routine are not shifting, lower eyelid surgery is a great option.

This is because eye bags are the result of protruding fat pads beneath the eyes, and changes in skin texture over the years.

A lower blepharoplasty procedure typically involves fat repositioning or removal. Your surgeon will make an incision below the lash line or within the lower eyelid.

This helps to hide any visible scars and ensure a smooth transition between the lower eyelid and upper cheek.

Your surgeon may also remove excess skin to provide skin tightening benefits. This will improve lower eyelid laxity and provide a more smooth under eye contour.

What does a lower blepharoplasty treat?

We use a lower blepharoplasty to treat:

•   Puffy under eye bags
•   Loose skin beneath the eyes
•   Dark circles that result from shadows or structural volume loss
•   Sagging skin in the under eye area
•   Wrinkled or crepey skin

The aim of this surgery is to provide a natural eyelid rejuvenation that helps you look fresh, relaxed and provides a healthier appearance to the eye area.

As with upper eyelid surgery, you may also experience swelling and bruising for 7-10 days.

Most patients return to light activities after one week. You should avoid any strenuous activity for about a month.

What is open rhinoplasty?

The open technique for a nose job involves making a small incision across the columella. This is the strip of skin that sits between both nostrils. We may also need to do further incisions inside the nose.

Open rhinoplasty allows your cosmetic surgeon to lift the nasal skin to easily review and assess your nasal structures. This includes your nasal bone and cartilage. It also means that it can be easier to stabilise the nose after surgery.

While open rhinoplasty can allow for more precise adjustments to the nose, it is a more complex and longer procedure. As a result, you often need a longer recovery time.

You may see some external scars on the rim of the nose, but these are only visible when you tilt your head backwards.

Why do people consider open rhinoplasty?

We may recommend open rhinoplasty surgery if you need:

•   Significant reshaping to the nasal bridge or nasal tip
•   Complex functional concerns
•   Correction of a deviated septum to improve breathing difficulties
•   Reconstructive surgery after damage to the nose or nasal fracture
•   Revision rhinoplasty following a previous surgery
•   When cartilage grafts are needed to help strengthen the nose

We prefer to use open rhinoplasty surgery for revision procedures, when scar tissue from previous surgeries may be present.

Who is suitable for open rhinoplasty?

Mr Ridha may advise for you to have open rhinoplasty if you:

•   Need a complex structural change
•   Have challenging nasal anatomy
•   Need revision rhinoplasty
•   Want to improve functional and cosmetic issues
•   Improve any breathing problems relating to the nose

If we believe you need precise modifications to your nose, extensive reshaping or your case is quite complex, we may suggest open nose surgery as the most appropriate technique.

Recovery and results from open rhinoplasty

As this nose job involves both internal and external incisions, you may see a small visible scar afterwards. This may become less visible over time.

Even with the most qualified surgeon, open rhinoplasty patients will see more swelling than closed surgery.

The most intense swelling is in the first 2-4 weeks. Most patients return to work after 1-2 weeks. Your surgeon will advise how long you will need during your consultation.

It can take 12-18 months for your nose to fully recover, especially around the nasal tip.  This is when your final results will show.

Combining upper and lower blepharoplasty

For total eye rejuvenation, it might be beneficial to combine upper and lower blepharoplasty.

The visible signs of ageing tend to show on both areas of the eyes. This may include excess skin and droopy lids on the upper eyelid with eyebags or dark circles under the eyes.

Treating both eye areas can help you achieve a more balanced and refreshed appearance.

We may recommend upper and lower eyelid surgery to patients with:

•   Significant excess skin
•   Under eye bags
•   Skin laxity issues on the upper and lower lids
•   Droopy skin that affects both the lower and upper eye area
•   Excess fat on the upper and lower lids
•   An overall tired appearance

Another benefit of combining upper and lower eyelid surgery is that you will only need one recovery period.

Depending on your individual needs, we use combined procedures to provide full facial rejuvenation.

If your brow position is contributing to heavy upper lids, we may include a brow lift to open up the eye area.

If you have hollow under eyes, we may use dermal fillers to add volume and definition to the under eye area. This is usually completed after the skin has fully healed from surgery.

Take a look at what a brow lift and dermal fillers to freshen up the eye area.

For most patients recovery from eyelid surgery is simple and fairly quick.

You can expect swelling and bruising for the first 7-10 days. 

The best way to look after your eyes during this time is to use a cold compress to reduce swelling. You should also keep your head elevated.

Mr Ridha will provide you with aftercare instructions that you should follow to support healing.

During the recovery period you may notice:

•   Tightness and mild discomfort around the eyes
•   Temporary dryness or watery eyes
•   Bruising above and underneath the eyes

During the early healing period, you should avoid strenuous exercise, heavy lifting, and wearing contact lenses.

You should only wear make-up after two weeks. This is when most of the swelling and bruising should have gone down.

Any scars are usually hidden with the natural crease for upper surgery, and close to the lash line for lower surgery.

Upper or lower eyelid surgery – which one is right for me?

Blepharoplasty surgery is not one size fits all. It will all depend on your skin condition, facial structure and what concerns you want to address.

You may benefit from upper blepharoplasty if:

•   You want excess skin removal from the upper lids
•   You have a heavy upper lid that is affecting your vision

You may benefit from lower blepharoplasty if:

•   You have protruding fat pads
•   Loose skin under the eyes
•   Dark circles
•   Eye bags

You many benefit from combined procedures if:

•   You are experiencing the visible signs of ageing in both areas
•   You want comprehensive rejuvenation to the eye area

Talk to Mr Hyder Ridha about upper and lower blepharoplasty

If you want to know more about how eyelid surgery can rejuvenate your eye area, the best place to start is with a consultation with Mr Hyder Ridha at HR Plastic surgery.

Mr Hyder Ridha, a fully-trained cosmetic and plastic surgeon. He specialises in facial surgery, including blepharoplasty, brow lift and facelift surgery.

Mr Ridha is on the specialist register for plastic surgery, the British Association of Aesthetic Plastic surgeons (BAAPS). Mr Ridha is also a fellow of the Royal College of Surgeons.

During your consultation, he will assess your skin condition and skin quality on the upper and lower eyelids. He will also look at your medical history and discuss what results you are hoping to achieve.

The goal from any eyelid surgery is to ensure we keep your natural eye shape, to help you look more rested, and to bring more balance to your facial features.

Start your journey to a younger-looking eye area today by getting in touch with our team.