If you’ve been researching eyelid surgery, you’ve probably noticed that “blepharoplasty” is rarely just one thing. Most clinics talk about upper blepharoplasty, lower blepharoplasty, or both, but the differences between them are rarely explained clearly. What actually separates the two procedures? Which one addresses your concern? And when do you need both?
This guide answers all of that plainly, based on the thousands of blepharoplasty consultations performed at Signature Clinic across our UK locations.
What is blepharoplasty?
Blepharoplasty, commonly called a bleph or eyelid surgery, is a surgical procedure that removes excess skin, fat, or muscle from around the eyelids to create a more rested, open, and youthful appearance. It is one of the most commonly performed cosmetic surgical procedures in the UK, and for good reason: the eyes are often the first area of the face to show signs of ageing, fatigue, or hereditary traits.
The procedure is divided into two distinct operations that address two completely different anatomical areas.
Upper blepharoplasty: addressing hooded or heavy eyelids
Upper blepharoplasty targets the area between the eyebrow and the eyelashes. It is designed for people who have excess skin drooping over the upper eyelid, a condition commonly known as hooded eyelids.
Who needs upper blepharoplasty?
You may be a good candidate for upper eyelid surgery if you
- Notice your upper eyelid skin folding down over your lash line
- Feel heaviness or a weighed-down sensation over your eyes
- Look tired or older than you feel, despite being well-rested.
- Find that eyelid skin is beginning to affect your peripheral vision
- I have been told you have dermatochalasis (excess upper eyelid skin)
Hooded eyelids are largely a result of the natural ageing process, and as the skin loses elasticity over time, gravity pulls the upper eyelid tissue downward. However, the condition is also strongly hereditary, which is why many patients in their 30s or early 40s seek upper bleph surgery well before significant ageing has occurred.
What does the procedure involve?
Upper blepharoplasty is typically performed under local anaesthetic as a day-case procedure, meaning you go home the same day. The surgeon makes a precise incision along the natural crease of the upper eyelid, a crease that already exists, and removes a carefully calculated amount of excess skin. In some cases, a small amount of fat is also removed or repositioned.
The incision is hidden within the natural eyelid fold, meaning scarring is virtually invisible once healed.
The procedure usually takes between 45 minutes and 1.5 hours, depending on whether one or both eyes are treated.
Upper blepharoplasty cost in the UK
At Signature Clinic, upper blepharoplasty is priced at £2,395 under local anaesthetic, or £3,895 under general anaesthetic. All prices are fully inclusive, with no hidden costs, and your quote covers surgery, aftercare, and all follow-up appointments.
Prices shown were correct at the time of publishing. Please refer to our blepharoplasty procedure page for the most up-to-date pricing.
Lower blepharoplasty: addressing eye bags and under-eye puffiness
Lower blepharoplasty addresses a completely different area, the space between the lower lash line and the upper cheek. It is the procedure for people whose primary concern is under-eye bags, puffiness, hollowing, or excess skin beneath the eye.
Who needs lower blepharoplasty?
Lower eyelid surgery may be right for you if you:
- Have persistent puffiness or bags under your eyes that don’t improve with sleep
- Notice fat pads bulging forward beneath the lower lids
- Have a hollowed or sunken appearance under your eyes (tear trough)
- Have loose or crepey skin beneath the lower lash line
- Look consistently tired, regardless of how much rest you get
Unlike upper eyelid heaviness, lower eye bags are very often genetic rather than purely age-related. Many patients present in their late 20s or 30s with significant under-eye bags that have been present for much of their adult life.
What does the procedure involve?
Lower blepharoplasty is a more technically complex procedure than upper blepharoplasty. There are two main surgical approaches:
Transcutaneous lower blepharoplasty: the surgeon makes an incision just below the lower lash line, allowing direct access to remove or reposition excess skin and fat. This approach is suited to patients who have both excess skin and prominent fat pads.
Transconjunctival lower blepharoplasty: the incision is made on the inside of the lower eyelid, leaving no visible external scar. This technique is preferred when fat redistribution is the primary goal, and there is no significant excess skin.
Your surgeon will recommend the most appropriate approach during your consultation, based on a thorough assessment of your lower eyelid anatomy and goals.
Lower blepharoplasty cost in the UK
At Signature Clinic, lower blepharoplasty is priced at £2,695 under local anaesthetic, or £4,195 under general anaesthetic. Transconjunctival lower blepharoplasty, the scarless internal approach, is priced at £2,995. All prices are fully inclusive with no hidden fees.
Prices shown were correct at the time of publishing. Please refer to our blepharoplasty procedure page for the most up-to-date pricing.
Upper and lower blepharoplasty: when you need both
Many patients benefit from having upper and lower blepharoplasty performed together. Combined bleph surgery allows the surgeon to comprehensively rejuvenate the entire eye area in a single procedure and recovery period. Combining both procedures is typically more cost-effective than having them separately, and the recovery timeline is broadly the same, since you are already managing downtime for one procedure. At Signature Clinic, combined upper and lower blepharoplasty is £4,195 under local anaesthetic, a saving compared to having each procedure separately. For patients who prefer a general anaesthetic, the combined price is £7,500. Prices shown were correct at the time of publishing. Please refer to our blepharoplasty procedure page for the most up-to-date pricing. The decision to combine procedures is always made collaboratively with your doctor in consultation, never assumed. Some patients have strong concerns about only one area, and combining unnecessarily adds cost and surgical time without benefit.Key differences at a glance
| Upper Blepharoplasty | Lower Blepharoplasty | |
|---|---|---|
| Target area | Upper eyelid, between brow and lashes | Lower lid, beneath lash line |
| Primary concern | Hooded or heavy eyelids | Eye bags, puffiness, under-eye hollowing |
| Common cause | Ageing + genetics | Genetics (often younger onset) |
| Anaesthetic | Local or general | Local or general |
| Incision location | Natural upper eyelid crease | Below the lash line or inside the lower lid |
| Procedure time | 1–2 hours | 1–2 hours |
| Return to work | 5–7 days | 5–7 days |
| Full recovery | 2–4 weeks | 2–4 weeks |
| Signature Clinic price (local) | £2,395 | £2,695 |
| Signature Clinic price (general) | £3,895 | £4,195 |
Recovery: what to expect after blepharoplasty
Whether you have upper, lower, or combined surgery, the recovery process follows a broadly similar pattern. Days 1–4: Expect bruising, swelling, and some tightness around the eyes. Rest, keep your head elevated, and apply cold compresses to reduce swelling. Driving is not permitted immediately after surgery. Days 5–7: Most patients feel comfortable returning to desk-based work within 5–7 days. If your stitches are not self-dissolving, they are removed between 7 and 10 days after surgery. Weeks 2–4: Bruising fades, and residual swelling continues to settle. The majority of patients feel fully confident in social situations within this window. Full recovery is typically complete within 2–4 weeks. It is important to avoid strenuous exercise, swimming, and direct sun exposure for the first two to three weeks following surgery. The aftercare team will provide you with a detailed written aftercare plan at your pre-operative appointment.Can blepharoplasty change the shape of your eyes?
A very common concern, and an important one to address honestly. The goal of blepharoplasty is to remove excess skin and create a fresher, more rejuvenated appearance. In most cases, your eyes will look more open and rested, and you will still look like yourself. However, in some cases, the removal of excess skin may cause the eye shape to look mildly different, simply because tissue that was previously obscuring the eye is no longer there. This is not an alteration; it is the natural eye shape becoming more visible. If deliberate eye shape change is something you’re interested in, a separate procedure, such as lateral canthoplasty or canthopexy, can be discussed with your surgeon. This is distinct from standard blepharoplasty.How to choose the right surgeon for blepharoplasty
The eyes are one of the most delicate and visible areas of the face. Choosing the right surgeon is the single most important decision you will make in this process. At Signature Clinic, all blepharoplasty procedures are performed by surgeons with specialist training and extensive experience in eyelid surgery specifically. During your consultation, your doctor will:- Conduct a thorough examination of your eyelid anatomy
- Review your medical history for any factors that could affect safety or outcomes (including thyroid conditions, dry eye, and cardiovascular health)
- Discuss your goals and set realistic expectations
- Walk you through your surgical options and recommended approach
- Provide a fixed, all-inclusive quote with no hidden costs
FAQs
Is blepharoplasty painful?
How long do blepharoplasty results last?
Am I too young for blepharoplasty?
Can I have blepharoplasty if I wear glasses or contact lenses?
Does blepharoplasty leave visible scars?
If you’re unsure whether you need upper, lower, or combined blepharoplasty, the best starting point is a consultation with one of our doctors. You’ll leave with a clear understanding of your options, realistic expectations, and a straightforward plan if you decide to proceed.
*Disclaimer: This content is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional before undergoing any cosmetic or medical procedure.
