Blepharoplasty, often called eyelid surgery or an “eye lift” is one of the most popular cosmetic procedures for refreshing the eye area and restoring a youthful, alert appearance. It can also help improve vision if droopy or excess skin begins to obstruct the upper visual field. But not all blepharoplasties are the same. There are two main types: upper blepharoplasty and lower blepharoplasty each targeting different concerns, using different techniques, and carrying slightly different recovery paths.
Here, we explain the differences, benefits, limitations, what to expect, and how to choose between them.
What Is Blepharoplasty?
Blepharoplasty is a surgical procedure to remove or reposition excess skin, fat, and sometimes muscle around the eyelids. As we age (or sometimes due to genetics), the skin around the eyes loses elasticity and fat may accumulate, causing:
- Hooded or droopy upper eyelids
- Puffiness or bags beneath the eyes
- A tired, aged, or fatigued appearance
- In some cases, impaired vision due to overhanging upper eyelid skin
By surgically correcting these issues, blepharoplasty can rejuvenate the eyes, making them look more open, rested, and youthful.
At Signature Clinic, blepharoplasty is offered under local anaesthetic as a day-case procedure. It is available for upper eyelids, lower eyelids, or both at once.
Upper Blepharoplasty: What It Does & How It’s Done
What It Addresses
Upper blepharoplasty targets:
- Excess or sagging skin on the upper eyelids
- Hooded or “heavy” upper lids that may give a tired look
- Sometimes, fat deposits causing bulges on the upper lid
In some cases, the extra skin may partially block peripheral vision or pressure the lids, causing discomfort. Removing this skin can improve both appearance and function.
The Procedure
- An incision is made discreetly along the natural crease of the upper eyelid, where it remains hidden when the eyes are open.
- Excess skin (and sometimes fat or muscle) is removed or repositioned.
- Closure is done with fine sutures, which heal quickly and are often barely visible once healed.
- At Signature Clinic the procedure is done under local anaesthetic and typically takes 1–2 hours.
Benefits of Upper Blepharoplasty
- A more open, rested, and youthful-looking eye area.
- Reduction of the “heavy lid” or “droopy eye” appearance.
- Potential improvement in vision or peripheral vision if excess skin was obstructing sight.
- Very minimal visible scarring, since the incision sits in the natural crease.
- Relatively fast recovery may return to work within about a week.
Lower Blepharoplasty: What It Does & How It’s Done
What It Addresses
Lower blepharoplasty focuses on the area beneath the eyes. It’s used for:
- Under-eye bags or puffiness
- Excess or sagging skin under the eyes
- Fine lines, wrinkles, and crepey skin under the eyelids
- Deep lines or hollowness due to fat pocket bulging
These issues often make someone appear tired or older, even if they are well rested. Lower blepharoplasty can refresh and smooth the lower eyelid region.
The Procedure
- An incision is typically made just below the lower lash line, or sometimes inside the lower eyelid (transconjunctival approach) if only fat is being removed or repositioned and no excess skin needs trimming.
- Excess fat may be removed or redistributed, excess skin trimmed if needed, and in some cases ligaments or supporting tissue tightened.
- If the transconjunctival method is used (inside the eyelid), no external scar is visible. If skin is removed, a very fine suture just under the lash line is used.
Benefits of Lower Blepharoplasty
- Reduction or elimination of under-eye bags, puffiness, and under-eye bulges.
- Smoother, firmer, more youthful-looking lower eyelid area.
- In many cases, the results erase years from your face and restore a refreshed look.
- With skilled surgical execution, scarring is minimal, often hidden or barely visible.
Combined Upper + Lower Blepharoplasty
For many patients, upper and lower eyelid concerns coexist with sagging upper lids and under-eye bags together. In those cases, combined upper and lower blepharoplasty offers a comprehensive rejuvenation of the eye area, bringing balance and symmetry. This approach aims to create a refreshed, harmonious result that targets both hooded lids and under-eye puffiness or wrinkles.
At Signature Clinic, both surgeries can be performed under local anaesthesia as a day-case procedure.
Upper vs Lower: Key Differences at a Glance
Are There Medical / Functional Benefits?
While blepharoplasty is often thought of as a cosmetic procedure, many patients benefit from functional improvements too especially with upper blepharoplasty.
- Improved vision / wider field of vision: If droopy or hooded lids were interfering with peripheral vision, removing the excess skin can restore clearer sight.
- Reduced heaviness / eyelid fatigue: Some patients habitually lift their brows to compensate for heavy lids. After blepharoplasty, this strain is relieved.
- Long-lasting changes: Unlike fillers or injectables, blepharoplasty provides a structural, long-term solution.
Procedure Time & Recovery (What to Expect)
At Signature Clinic:
- Blepharoplasty (upper or lower) is done under local anaesthesia as a day-case procedure.
- Typical duration: 1–3 hours, depending on whether upper, lower, or both are done.
- Stitches usually dissolve in 7 and 10 days post-surgery.
- Return to work is often possible within 4–7 days, though this depends on your individual healing and the nature of your job.
- Final visible results of smooth, refreshed eyelid skin and reduction in puffiness or hooding typically appear as healing progresses over a few weeks.
Many patients combine blepharoplasty with other facial rejuvenation treatments for a more comprehensive result, but alone it can deliver significant aesthetic and functional improvements.
Which Should You Choose: Upper or Lower (or Both)?
Consider the following when deciding:
- Main concern Upper lid hooding / drooping + excess skin on upper lids → Upper blepharoplasty.
- Main concern: Under-eye bags, puffiness, hollowness, sagging lower eyelids → Lower blepharoplasty.
- Multiple concerns (upper droop + under-eye bags) → Combined upper + lower blepharoplasty.
- Functional issue (vision obstruction due to hooded upper lids) → Upper blepharoplasty may be justified medically.
- The goal is aesthetic rejuvenation / long-term refreshed eyes → A tailored approach with surgeon’s advice is best.
At Signature Clinic, surgeons recommend treatment plans on an individual basis, they assess your eyelid anatomy, skin quality, and personal goals before advising upper vs lower vs combined surgery.
Why Choose Signature Clinic for Blepharoplasty?
- UK’s largest provider of cosmetic surgery, with multiple clinic locations.
- Experienced, GMC-registered surgeons who specialise in eyelid surgery and other facial procedures.
- Day-case procedures under local anaesthetic no need for general anaesthetic, hospital stay, or lengthy downtime.
- Discreet incisions with minimal or hidden scarring.
- Transparent pricing and aftercare, with clear information about recovery times and what to expect.
Is Blepharoplasty Right for You?
Blepharoplasty can be life-changing not just for appearance but also for comfort, self-esteem, and sometimes function. That said, it’s important to have realistic expectations, to understand what the surgery can and cannot do, and to follow all pre- and post-operative advice carefully.
You may be a good candidate if:
- You have noticeable drooping upper lids, hooding, or sagging skin.
- You have puffiness, under-eye bags or sagging lower eyelid skin.
- You want a more alert, youthful, rested appearance.
- Any skin excess is stable (i.e. you’re not planning major weight loss or dramatic facial changes).
- You understand the recovery process and associated risks, and are under the care of a qualified, experienced surgeon.
If you meet these criteria, upper, lower, or combined blepharoplasty could provide excellent results with relatively low downtime and long-lasting benefits.
Blepharoplasty Frequently Asked Questions (FAQ)
Q: How long does blepharoplasty take?
A: Typically between 1–3 hours depending on whether upper, lower, or both eyelids are treated.
Q: Is it done under general anaesthetic?
A: No, at Signature Clinic, blepharoplasty is performed under local anaesthetic as a day-case procedure.
Q: When can I return to work?
A: Most patients can return within 4–7 days, though full healing and final results often take 2–4 weeks.
Q: Will there be visible scars?
A: Scars are generally minimal and well-hidden upper lid scars in the natural crease, lower lid scars either under the lash line or internal (if transconjunctival approach is used).
Q: Will blepharoplasty improve my vision?
A: If excess skin on the upper lids was obstructing peripheral vision, removing it can enhance the field of view.
Whether you’re bothered by droopy lids, under-eye bags, or simply want a fresher, more youthful gaze, blepharoplasty offers a highly effective, relatively low-downtime solution. Understanding the difference between upper and lower blepharoplasty helps you make an informed decision tailored to your needs.
At Signature Clinic, expert surgeons, day-case convenience and a track record of success make blepharoplasty a reliable option for those seeking both aesthetic and functional improvement. If you’re considering eyelid surgery, our free consultation can clarify whether upper, lower, or combined blepharoplasty is the right path for you.
Disclaimer: *This guide is intended for informational purposes only and should not be considered as medical advice. Always consult a qualified healthcare professional before making any decisions related to cosmetic surgery or other medical procedures.
