Upper blepharoplasty surgery is a procedure that focuses on the upper eyelids, but it’s more technical than it might sound at first. It’s a type of eyelid surgery that a plastic surgeon performs to address excess skin or tissue on the upper lids that can affect the way the eyelids sit and function. While it’s commonly associated with cosmetic reasons, upper blepharoplasty can also have a practical side for some patients, particularly when excess skin begins to weigh on the lashes or restrict the upper field of vision.

What actually happens during an upper blepharoplasty?

During upper blepharoplasty surgery, the surgeon will make precise incisions along the natural crease of the upper eyelid. This placement helps to ensure that the incision lines are as inconspicuous as possible once healed. Through these incisions, the surgeon removes excess skin and may also adjust small amounts of fat or muscle if needed. The goal is to refine the structure of the eyelid without changing its natural shape. Once the adjustments are complete, the incisions are closed with fine sutures.

The procedure is typically performed under local anaesthetic with sedation, although some surgeons may offer general anaesthetic, depending on patient preference and the details of the surgery. It’s generally considered a day procedure, which means patients can go home soon after the surgery is performed, once the anaesthetic has worn off and the surgeon is satisfied with their initial recovery.

How long does upper blepharoplasty take?

An upper blepharoplasty usually takes around one to two hours, though this can vary slightly depending on the complexity of the case and whether it’s being performed alongside another procedure, such as lower eyelid surgery or a brow lift. Even though it’s a relatively short operation, it still involves delicate work around one of the most intricate areas of the face, which is why the planning and precision involved are so important.

Before the procedure, patients will have a pre-surgical consultation where their eyelid anatomy is assessed. This includes looking at how the eyelid skin folds, the position of the brow, and whether the upper eyelid muscles are functioning as they should. From there, the surgeon can determine how much skin or tissue should be removed and where exactly the incisions should be made. This planning phase helps ensure the results are proportionate and tailored to each individual’s facial structure.

What to expect straight after surgery

Straight after upper blepharoplasty, patients usually spend a short time in recovery before being able to return home. The eyelids may feel tight or heavy for the first day or two, which is completely normal and part of the initial healing response. The area around the eyes will likely have some swelling and bruising, which can extend slightly to the cheeks. Applying cold compresses at intervals in the first 24 to 48 hours can help reduce swelling.

Patients are often advised to keep their head elevated, even during sleep, for the first week to help control swelling. While the eyes might feel slightly dry or watery, this usually improves as healing progresses. Eye drops or ointments may be prescribed to keep the eyes comfortable during the early recovery stage.

When can normal activities resume?

Most patients can return to light daily activities within a few days, though anything strenuous should be avoided for around two weeks or longer if advised. It’s important that you allow the incisions to heal properly and avoid increasing blood pressure to the face too soon after surgery, as this can cause swelling to worsen.

Reading, watching television, or using digital screens can often be resumed after a couple of days, though some patients may prefer to wait until the eyes feel less sensitive. Makeup and contact lenses are usually best avoided until the surgeon confirms that the incisions have healed enough, which is generally around the two-week mark.

How does recovery progress over the following weeks?

Over the weeks after upper blepharoplasty, swelling and bruising gradually fade. The eyelid skin, which can initially appear slightly firm or raised, will begin to soften as the tissue heals. Most patients find that the majority of swelling has subsided by around three to four weeks, though subtle changes can continue over a few months as the tissue settles into its new position.

During this time, surgeons often recommend gentle eyelid massage or specific aftercare steps to support the healing process, but these will depend on individual recovery progress. Sutures are usually removed after five to seven days, and it’s at this point that patients can get a clearer sense of how the incision lines are healing. Over time, these fine lines tend to fade and blend into the natural eyelid crease.

Are there any risks involved?

Like any surgical procedure, upper blepharoplasty carries some risks, although complications are uncommon when performed by a qualified plastic surgeon. Possible risks include infection, bleeding, delayed wound healing, or asymmetry between the eyelids. Temporary side effects can also include dryness, mild irritation, or sensitivity to light.

To help reduce these risks, surgeons will usually ask about any medical conditions, allergies, or medications during the consultation stage. Patients who smoke are often advised to stop before surgery, as smoking can interfere with healing and blood flow. Following all pre- and post-operative instructions closely plays an important role in ensuring a steady recovery.

How long do the results last?

The results of upper blepharoplasty are long-lasting, as the removal of excess skin is permanent. However, the natural ageing process continues, and changes to the skin and surrounding tissues will still occur over time. Most patients find that the results remain stable for many years before any noticeable changes develop again.

It’s important that patients understand the surgery doesn’t stop the natural ageing process, but it does address existing skin redundancy at the time it’s performed. Good skin care, sun protection, and maintaining overall skin health can help support long-term results.

What should patients discuss with their surgeon beforehand?

Before undergoing upper blepharoplasty, it’s important that patients have a detailed discussion with their surgeon about what can realistically be achieved. This includes talking through the surgical plan, incision placement, expected recovery time, and any previous eye conditions or surgeries that might affect the procedure.

The consultation is also the time for the surgeon to assess whether upper blepharoplasty alone is suitable or whether other factors, such as brow position or lower eyelid changes, are also contributing to the patient’s concerns. Addressing these aspects together can help ensure that the surgery aligns with the patient’s overall facial anatomy rather than just the eyelids in isolation.

What kind of results can patients expect?

Once swelling has reduced, the upper eyelids typically appear lighter and less weighed down by excess tissue. The natural crease of the eyelid tends to become more visible again, giving the eyes a more open appearance. Scarring is minimal and sits discreetly within the eyelid crease, making it barely noticeable once fully healed.

These results develop gradually as the tissue continues to heal over the months after surgery. Patients are usually reviewed at various points during recovery to ensure that the healing process is progressing as expected.

Dr Laniewski: Blepharoplasty in Sydney (Woollahra) & Central Coast (Bella Vista & Erina)

Dr Peter Laniewski is a Specialist Plastic Surgeon with over 20 years of advanced surgical training and clinical experience.

For those considering upper blepharoplasty, it’s important that the procedure is performed by a plastic surgeon who regularly performs eyelid surgeries and understands the delicate balance between function and appearance.

Please contact our team to book a consultation with Dr Laniewski in Sydney (Woollahra), or Central Coast (Bella Vista or Erina).

Further reading about the blepharoplasty procedure:

What Is Upper Blepharoplasty Surgery? 24/02/202619/12/2025 by Dr Peter Laniewski