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Upper eyelid surgery, or upper blepharoplasty, is an operation that removes excess skin, and sometimes a small amount of fat, from the upper eyelids. It treats hooded or heavy lids that make the eyes look tired, older or smaller than they are. The incision sits in the natural eyelid crease, so the scar is hidden when the eyes are open. It is one of the most frequently performed facial procedures and, for many people, one of the most rewarding, because the change is visible every time they look in the mirror while still looking entirely like themselves.
Most patients are in their forties or older, but some younger people have naturally heavy lids and seek surgery earlier. Whatever the age, the aim is not to create a different eye shape. It is to restore a clean, visible eyelid fold and remove the heaviness that has built up over time.
Why upper eyelids become heavy
With age, the skin of the upper eyelid loses elasticity and stretches. The thin muscle underneath relaxes, and the fat that cushions the eye can bulge forward, particularly at the inner corner near the nose. The result is a fold of skin that rests on or near the lashes, sometimes called hooding. Some people notice that eyeliner smudges, that the eyelids feel heavy by the end of the day, or that they raise their brows constantly to keep their eyes open.
It is important to separate three problems that can look similar:
- Excess eyelid skin (dermatochalasis): treated with upper blepharoplasty.
- Low brows: the brow sits lower and pushes skin down onto the lid. Treated with an endoscopic brow lift.
- Eyelid ptosis: the eyelid margin itself sits too low because the lifting muscle has weakened. This needs a ptosis repair, not simply skin removal.
Many patients have a combination. Identifying which one is responsible is the most important part of planning, because removing eyelid skin when the real problem is a low brow can make the brow drop further and leave the eye looking crowded.
Who is a good candidate?
You may benefit from upper blepharoplasty if you have:
- skin resting on or close to the eyelashes
- a lost or hidden eyelid crease
- puffiness at the inner corner of the upper lid
- a tired look that persists despite good sleep
- difficulty applying eye make-up
You should be in good general health and free of active eye disease. If you have dry eyes, thyroid eye disease or have had laser eye surgery, tell your surgeon, as these may change the plan or require an eye examination first.
What happens during surgery
Before any injection, the amount of skin to remove is marked carefully with you sitting upright, because the eyelids behave differently when you lie down. The crease line is marked to match your natural fold, and the upper limit of the skin excision is set so that enough skin remains for the eye to close comfortably.
The operation is usually performed under local anaesthesia, often with light sedation. After the eyelids are numbed, the marked skin is removed together with a thin strip of the underlying muscle where appropriate. If the inner fat pad is bulging, a small amount is removed or repositioned. The incision is closed with fine stitches. Both eyelids together usually take between forty-five minutes and an hour and a half.
Removing a small amount of tissue precisely gives a better result than removing a lot. Over-resection is one of the few mistakes in eyelid surgery that is difficult to reverse, so a conservative approach is preferred.
Combining it with other procedures
Upper blepharoplasty is frequently combined with:
- lower eyelid surgery to treat bags and hollows under the eyes
- an endoscopic brow lift when the brows have dropped
- almond eye surgery to change the angle of the outer eye corner
- a facelift as part of a broader rejuvenation
When the brow is lifted in the same operation, the brow is positioned first and only then is the eyelid skin marked, so that the right amount is removed.
Preparing for surgery
Two weeks before the operation, stop aspirin, anti-inflammatory painkillers and supplements that affect bleeding, such as fish oil, vitamin E and ginkgo, after checking with the doctor who prescribed them. Stop smoking and nicotine products at least four weeks before. If you have had botulinum toxin injections around the eyes or forehead, mention the date, as they can temporarily change the position of the brows and eyelids and affect the markings. On the day, arrive without make-up or contact lenses, and bring a pair of sunglasses and someone to accompany you home.
Upper blepharoplasty for men
Men’s upper eyelids usually have a lower, flatter crease and slightly thicker skin. A male blepharoplasty therefore keeps the crease lower and removes less skin, so the eye looks rested rather than feminised or overdone. Brow position is assessed especially carefully in men, because a heavy, low brow is common and removing too much eyelid skin can bring the brow down further. Scars in men heal just as well, and the crease hides them in the same way.
Recovery after upper eyelid surgery
You go home the same day, usually with small strips over the incisions. Cold compresses and keeping your head raised for the first few days help to control swelling.
- Days 1–3: swelling and bruising, eyes may feel tight or gritty; rest and use cold compresses regularly
- Days 5–7: stitches removed; swelling clearly reduced
- Days 7–10: most people return to work and social activities, with sunglasses if needed
- Week 2: eye make-up allowed once the incision has healed
- Weeks 3–4: exercise can resume
- Months 2–3: the scar softens and fades; the final result is visible
Blurred vision in the first days usually comes from ointment or swelling and clears quickly. Avoid screens for long periods at first, as they can make the eyes feel dry. Lubricating drops are often prescribed.
Risks and how they are managed
Serious complications are rare, but you should be aware of them. They include bleeding, infection, dry or irritated eyes, difficulty closing the eyes fully in the early weeks, asymmetry of the crease, visible or thickened scars and, very rarely, a collection of blood behind the eye that needs urgent treatment. Sudden severe pain, increasing swelling or any change in vision after surgery should be reported immediately.
Taking an accurate history, measuring carefully, removing tissue conservatively and following the aftercare instructions keep these risks low.
How long the result lasts
Skin that has been removed does not grow back, so the improvement is long-lasting. Most patients enjoy the result for ten years or more. The eyelids and brows will continue to age slowly, and a small amount of heaviness may return later in life, but it rarely reaches the level it was at before surgery.
Upper eyelid surgery in Istanbul
Upper blepharoplasty is one of the easier procedures to plan from abroad. A stay of five to seven days usually allows for the consultation, the operation and removal of the stitches. Flying is generally fine after the stitches are out, although your eyes may feel dry in the cabin air, so bring lubricating drops.
Dr. Mehmet Özdemir is a plastic, reconstructive and aesthetic surgeon with the EBOPRAS qualification of the European Board of Plastic, Reconstructive and Aesthetic Surgery. He trained in Germany, Poland and Brazil, consults in Turkish, Kurdish, English and German, and practises in Bakırköy, Istanbul. Before recommending eyelid surgery, he always examines the brows and eyelid muscle function, so that the operation you have is the one that actually addresses the cause of your heavy lids.
