What are the best solutions for sagging eyelids?

How eye lift surgery or blepharoplasty may help improve the look of sagging eyelids and brows.

Sagging eyelids and brows can make you look tired and older than your years. In some cases, heavy lids may even start to interfere with your vision. If you feel unhappy with your droopy eyes, cosmetic surgery in the form of an eye lift or blepharoplasty may provide a solution.

Mr Venkat V Ramakrishnan, a Consultant Plastic surgeon at Nuffield Health Brentwood Hospital says, people seek out surgery for various reasons.

"Sometimes eyelids may sag so much that they rest on the lashline, and impede vision. Other patients simply say they don’t like the way their lids look, and complain they can no longer see eyeshadow on their lids."

Mr Ramakrishnan advises, "Non-surgical treatments are not effective at lifting drooping skin on the eyelid. The best and most satisfying treatment for this problem is an upper eye lift, or upper blepharoplasty, which reduces the amount of skin on the upper eyelid."

Blepharoplasty is the second most common plastic surgery operation in the UK, and Mr Ramakrishnan says patients are normally very satisfied with the results.

Why do droopy eyes develop?

Hooded eyes are often an inherited feature which gets worse with age. 

With age, the skin on the upper lid loses its elasticity, and becomes baggy.

Fat that naturally sits in the rim of the eye socket to cushion the eye starts to bulge forward as the tissue that previously held it in place weakens with age. This creates puffy, full, heavy lids.

During a blepharoplasty, a four-to-five centimetre incision is made in the natural crease of  the upper eyelid. Excess skin is removed and the incision is then stitched up and sealed with surgical glue.

Sometimes fat on the lid  is removed during a blepharoplasty. However, Mr Ramakrishnan says this must be done very cautiously, as removing too much fat can leave eyes looking hollow and gaunt, which is not a youthful look.

He explains, "If fat has herniated, or bulged forward due to weakening support, pushing the fat pad back and fixing it there with internal stitches can give a better result."

As with any cosmetic surgery, it is essential that you have more than one consultation with your surgeon and he or she understands your expectations and you understand what the surgeon can offer. Although photographs of previous work may help to understand the general idea of the process, it cannot be used as a means of assessing surgeon’s work or the expected result in your case. Each patient is different and you may be only shown the best results. Recommendation from previous patients and medical or nursing professionals, and good research into the surgeon’s qualification and reputation are the best way to choose a surgeon.

As the eyes are an important feature of your appearance, most surgeons will advise that you opt for conservative surgery as a radical eye lift can dramatically alter your appearance.

After a blepharoplasty, you may suffer bruising for two weeks or more. However, the waterproof glue or tape over the stitches means that you can wash your face and shower immediately. The single running stitch in the eyelid is removed after five days. You can use make up to conceal bruising after the first week. Mr Ramakrishnan says, ‘Swelling is not usually a major problem, though there may be some puffiness. This resolves within days, and most patients are delighted with their final result."

Interested in eye lift surgery?

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Last updated Wednesday 26 February 2020

First published on Monday 24 August 2015