Upper and Lower Eyelid Surgery: Surgical Techniques, Potential Risks, and Outcome

Upper and lower eyelid surgery, also known as Blepharoplasty, stands as a cornerstone and one of the most popular procedure in the field of plastic and reconstructive surgery. With its ability to address both aesthetic and functional concerns, this procedure rejuvenates the periocular region (around the eyes) by removing excess skin, fat, and correcting muscle laxity. In this comprehensive article, we delve into the surgical techniques, potential risks & complications, and outcomes of upper and lower eyelid surgery, offering a detailed perspective for those considering this transformative procedure.

The demand for eyelid surgery continues to grow globally, as individuals seek solutions for ageing-related changes or inherited traits that affect the eye area. In Dr. Allen Rezai’s London and Dubai practices, blepharoplasty has been one of the most sought after procedure by his patients. Beyond aesthetics, the procedure can also address functional impairments, such as obstructed vision caused by sagging upper eyelids. In expert hands, this procedure results as an ideal option for patients with correct indications to rejuvenate the eye area, restore a youthful look, and maintain harmony in the face while keeping a natural look. The remarkable results that blepharoplasty offer makes it a unique and valuable option in the realm of plastic and reconstructive surgery for many.

Patients who may benefit from an upper eyelid surgery may have lose skin hanging over their eyes which can obstruct their vision and give them a tired or drowsy appearance. Indications for upper eyelid surgery include both aesthetic and functional concerns. The most common reasons for undergoing this procedure are excess skin or dermatochalasis, which may obscure the natural eyelid crease or cause a tired appearance, and significant skin laxity that obstructs the visual field, impairing daily activities like reading or driving. Patients may also seek surgery to correct ptosis, address fat protrusion that creates a puffy look, or achieve overall facial rejuvenation. Additionally, the procedure is useful for rectifying asymmetry, deformities, or issues like irritation caused by skin folds trapping moisture. For many, upper eyelid surgery complements other facial procedures, contributing to a balanced and refreshed appearance.

| Before and After Upper Eyelid Surgery with Dr. Allen Rezai

The procedure begins with meticulous markings along the natural crease of the upper eyelid. An incision is made following these markings, and excess skin and fat are carefully excised while preserving the orbicularis oculi muscle to prevent functional impairment. Avoiding over-resection of fat is crucial to prevent a hollowed appearance. Closure is performed with fine sutures to ensure an discreet scar and optimal aesthetic results. In some cases, Dr. Allen Rezai may recommend to combine an upper eyelid surgery with other procedures, such as brow lifts, to achieve a more comprehensive rejuvenation of the upper face. This holistic approach can enhance the overall aesthetic balance, particularly in patients with significant brow ptosis.

Lower eyelid surgery addresses concerns such as under-eye bags, puffiness, and dark circles, which often contribute to a tired or aged appearance. This procedure can involve different techniques depending on the patient’s needs.

• Transconjunctival Approach: This technique involves an incision inside the lower eyelid, enabling the removal or repositioning of excess fat without any visible scarring. It is particularly suited for patients with minimal skin laxity. The transconjunctival approach is often preferred for younger patients or those who primarily require fat removal or repositioning without significant skin tightening.
• Subciliary Approach: For patients with significant skin laxity, an incision is made just below the lower lash line. This method allows for the tightening of loose skin, repositioning of fat, and correction of structural irregularities. Maintaining the support structures of the lower eyelid is essential to prevent complications such as ectropion or eyelid malposition. The subciliary approach is versatile and can address a wider range of aesthetic and functional concerns, making it suitable for older patients or those with more pronounced signs of ageing.

| Before and After Lower Eyelid Surgery with Dr. Allen Rezai

Indications for lower eyelid surgery include persistent puffiness or bags under the eyes due to fat prolapse, excess skin or wrinkles in the lower eyelid area, dark circles caused by shadowing from anatomical changes, and conditions like ectropion, where the eyelid turns outward. This surgery also appeals to patients seeking a smoother transition between the lower eyelid and cheek, contributing to a youthful and rested look. By addressing these concerns, lower eyelid surgery significantly enhances the overall harmony and aesthetics of the face.

Advanced techniques, such as fat grafting and skin resurfacing, are increasingly being integrated into lower eyelid surgery to enhance outcomes. Fat grafting can help restore volume in the tear trough area, while resurfacing methods, such as Morpheus8, Laser, or Chemical Peels,  tighten lax skin, improve skin texture, and reduce fine lines.

A successful blepharoplasty with Dr. Allen Rezai begins with a thorough consultation and preoperative assessment. This includes evaluating the patient’s medical history, current medications, and any pre-existing conditions that may impact surgery or healing. A detailed examination of the eyelid anatomy, skin quality, and the presence of any functional impairments is also essential.

Patient expectations play a significant role in surgical planning and choosing the correct surgical technique. Dr. Allen Rezai ensure that his patient’s wishes are considered while maintaining a realistic goal and understand the potential outcomes and limitations of the procedure. Clear communication during the consultation process helps build trust and ensures patient satisfaction following the operation.

Postoperative care is critical to achieving optimal results and minimising complications. Patients are advised to follow specific guidelines, such as keeping the head elevated and avoiding strenuous activities during the initial recovery period. Proper wound care and the use of prescribed medications, including antibiotics and anti-inflammatory drugs, further support the healing process.

Most patients experience mild swelling and bruising, which typically resolve within one to two weeks. Full recovery and the final aesthetic results are usually apparent after several months. Regular follow-up appointments allow Dr. Allen Rezai to monitor healing and address any concerns promptly.

Dr. Allen Rezai firmly believes that any cosmetic or surgical procedure should only be performed when there is a clear medical or aesthetic indication. The rise of online trends often pressures younger individuals to pursue treatments they may not yet require, potentially leading to unnecessary interventions.

For blepharoplasty, strong indications—such as significant skin laxity, vision obstruction, or pronounced fat deposits—are key to achieving optimal results and ensuring the procedure is worthwhile. A thorough assessment by an experienced surgeon, such as Dr. Allen Rezai, ensures that the treatment plan is tailored to address the patient’s specific concerns while avoiding risks like overcorrection or under-treatment.

By focusing on clear indications, patients can achieve safe, effective, and meaningful outcomes, maximising both their satisfaction and the long-term value of the procedure.

While blepharoplasty is generally considered safe, it is not without risks. Potential complications include:

• Infection: Proper surgical techniques and postoperative care minimise this risk.
• Bleeding or Hematoma: Rare but can occur, particularly in patients with underlying health conditions or those taking blood-thinning medications.
• Scarring: Although typically minimal and inconspicuous, scarring can be more pronounced in some patients – especially those who are prone to keloidal scarring.
• Ectropion or Eyelid Malposition: Can result from excessive skin removal or inadequate support of the lower eyelid.
• Dry Eyes: Temporary dryness or irritation is common but usually resolves with appropriate management.

With Dr. Allen Rezai, carefully assessing risk factors and adopting preventive measures to minimise complications are important. Keeping his patients informed on potential risks and early intervention in case of complications are essential components of comprehensive care.

Blepharoplasty remains a fundamental procedure in facial rejuvenation, significantly improving the appearance of the eyes, restoring a youthful look, and enhancing overall facial harmony. By combining advanced surgical techniques with a holistic approach to patient care, Senior Consultant Plastic, Aesthetic, and Reconstructive Surgeon Dr. Allen Rezai ensures natural, lasting, and the best possible outcomes for his patients. Whether addressing aesthetic concerns, functional impairments, or both, this procedure offers a powerful tool for enhancing patients’ lives and restoring confidence.

For information about eyelid surgery and/or eye bag removal in general please visit Eyelid Surgery.

For details about procedures and treatments or for a consultation, advice and prices at our Dubai clinic please call +971 4 431 2396 or use our ONLINE FORM.