Ever look in the mirror and feel your eyes look constantly tired, puffy, or heavy? You’re not alone. Blepharoplasty is one of the most effective ways to refresh your appearance. But what you might not know is that “blepharoplasty” isn’t just one procedure. It’s a spectrum of tailored techniques, each designed to solve a specific problem. Choosing the right one is the key to getting the natural, rejuvenated look you’re after.
This guide will walk you through the different types of eyelid surgery, so you can feel informed and confident about your choices.
What Are the Different Types of Eyelid Surgery?
The first question your surgeon will ask is: “Which area are you looking to improve?” This examination determines the type of blepharoplasty you need and whether you’re a better candidate for a surgical or a non-surgical eyelid lift.
Upper Blepharoplasty
This is the most common procedure for addressing that tired, heavy look. An upper eyelid lift focuses on the fold of skin that droops down from the brow, sometimes even affecting your peripheral vision.
The surgeon removes a precise ellipse of excess skin and, if needed, a small amount of protruding fat. The incision is expertly hidden within the natural crease of your eyelid, meaning once healed, the scar is virtually invisible. It’s a fantastic solution for creating a more open, alert, and youthful appearance.
Learn more about how to treat hooded eyelids in our detailed guide.
Lower Blepharoplasty
This procedure tackles under-eye bags and puffiness that can make you look perpetually worn out. The goal is to smooth the transition between your lower eyelid and cheek, banishing those stubborn bags for good. If you’re exploring different treatment options, our guide on lower blepharoplasty for under-eye bags explains how this surgery compares to other solutions.
The technique here is crucial and depends on your specific anatomy, whether the primary issue is fat, skin, or muscle. We’ll dive into the specific techniques for this below.
Combined Blepharoplasty
Many of our patients opt for a combined upper and lower blepharoplasty procedure. This comprehensive approach ensures a harmonious, balanced rejuvenation of the entire eye area. It means one surgery, one anaesthetic, and one recovery period to achieve a fully refreshed look.
Blepharoplasty Techniques
This is where the art and science of eyelid surgery come together. The technique used for treating under-eye bags differs completely from the one used to correct sagging upper eyelids, as each area requires a precise and tailored approach.
Traditional incision
This common approach involves creating a fine incision within the natural crease of the upper eyelid or just beneath the lower lash line. Through this opening, the surgeon can precisely remove or reposition excess skin, fat, and muscle to achieve a smoother, more youthful eyelid contour.
Transconjunctival Blepharoplasty
This is a brilliant, scarless technique used primarily for lower eyelid surgery. Instead of an external cut, the surgeon makes the incision on the inside of your lower eyelid. It’s perfect for younger patients or those who only need fat removal without any excess skin.
Transcutaneous Blepharoplasty
This is the traditional “external” approach for lower lids. An incision is made just below the lash line. This allows the surgeon to remove or reposition fat, tighten muscle, and remove excess skin all at once. It’s ideal when skin laxity is a significant concern.
Pinch Blepharoplasty
A minimalist technique for the lower eyelids. It involves “pinching” and removing a tiny strip of skin just below the lashes. It’s often combined with a transconjunctival approach to remove fat, offering a subtle lift with minimal downtime.
Laser Blepharoplasty
In this method, a laser is used instead of a scalpel to make the initial incisions. The potential benefits can include more precision and reduced bleeding. The laser cauterizes blood vessels, leading to less bleeding, reduced bruising and swelling, and a faster recovery compared to traditional surgery.
Bilateral Blepharoplasty
This simply means surgery is performed on both eyes. The vast majority of cosmetic eyelid lifts are bilateral to ensure a symmetrical, balanced result.
Unilateral Blepharoplasty
Surgery on only one eye. This is less common and is typically only done if there is a significant asymmetry from birth or due to an injury.
Advanced and Specialised Eyelid Procedures
While the procedures we’ve covered address the most common concerns, eyelid surgery has evolved to include highly specialised techniques for more specific goals or complex cases.
Ptosis Repair
Remember the “heavy” feeling? If your upper lid droops because the muscle itself is weak (a condition called ptosis), a standard upper blepharoplasty won’t fix it. Ptosis surgery specifically tightens the levator muscle that lifts the eyelid, often in combination with an upper blepharoplasty for the best aesthetic and functional result.
Check out our full comparison guide between ptosis Repair and blepharoplasty.
Double Eyelid Surgery (Asian Blepharoplasty)
This procedure creates or enhances the supratarsal crease (the “fold”) on the upper eyelid, which is absent in about 50% of people of East Asian descent. It’s a highly customised procedure that requires a deep understanding of ethnic eyelid anatomy to create a natural-looking result.
Revision Blepharoplasty
This is a corrective surgery for patients who are unhappy with the results of a previous blepharoplasty. It can address issues like hollowed eyes (A-frame deformity), webbing of the inner corner, asymmetries, or eyelid malposition. It is often considered one of the most challenging forms of eyelid surgery due to the presence of scar tissue from the first operation.
Canthopexy & Canthoplasty
These procedures focus on the lateral canthus, the outer corner of your eye. They are crucial for supporting the eyelid’s position and shape. Canthopexy is a milder support procedure that tightens the eyelid’s tendon without cutting it.
Canthoplasty is a more definitive repair that involves cutting and reattaching the tendon to reposition and strengthen the entire eyelid. These are often performed during a lower blepharoplasty to prevent downward pulling or rounding of the eye (scleral show), ensuring a naturally almond-shaped, uplifted result.
Fat Grafting & Fat Repositioning
A standard lower blepharoplasty removes excess fat that causes bags. However, as we age, we also lose volume in our cheeks, creating a highlight under the bag that makes it more prominent.
- Fat Repositioning: Instead of removing the fat, the surgeon re-drapes it down over the cheekbone to smooth the transition and fill the tear trough.
- Fat Grafting: In cases where there is significant hollowness, fat can be harvested from another part of your body (like the abdomen) and carefully injected around the eye to restore lost volume. This technique (also called augmentation blepharoplasty) combats a hollow, aged look that simple bag removal can sometimes accentuate.
Direct Brow Lift
While a traditional brow lift addresses the forehead, a Direct Brow Lift involves removing a strip of skin and tissue directly above the brow, lifting it into a higher position. This is a very powerful lift, often recommended for older gentlemen with heavy brows or patients with significant visual field obstruction.
Reconstructive Eyelid Surgery
This is a highly specialised field focused on restoring the eyelid after trauma or the removal of skin cancers (like basal cell carcinoma). The goal is not just cosmetic but functional as well to protect the eye, maintain moisture, and preserve vision. This often involves complex grafts and flaps to rebuild the eyelid’s structure.
Frequently Asked Questions (FAQs)
The most modern approaches focus on preservation rather than removal. Techniques like fat repositioning and transconjunctival blepharoplasty smooth and tighten the eyelids without removing too much fat or skin, helping maintain a natural contour and reducing the risk of hollowing.
Blepharoplasty is typically divided into upper and lower procedures. Upper blepharoplasty removes excess skin and fat from the upper eyelids to correct hooding, while lower blepharoplasty targets under-eye bags and puffiness for a smoother, rested appearance.
The pinch technique is a conservative lower eyelid method where only a small “pinch” of loose skin is removed without disturbing deeper tissues or fat pads. It’s ideal for patients with mild skin laxity who want subtle tightening and minimal recovery time.
Yes. Upper blepharoplasty is one of the most effective ways to correct hooded eyes by removing redundant upper-lid skin and restoring the natural crease. This opens up the eyes, creating a more refreshed and youthful look.
Look in the mirror. If the concern is droopy, hooded skin on the top lid, you’re looking at an upper procedure. If it’s under-eye bags and puffiness, it’s a lower. If it’s both , then a combined approach is your best bet.
The results are typically long-lasting. Upper blepharoplasty can last a lifetime, as the removed skin and fat won’t grow back. Lower blepharoplasty also provides permanent improvement of under-eye bags, though your skin will continue to age naturally.
Your Journey to Brighter Eyes Starts with a Single Conversation
Navigating the world of Blepharoplasty can seem complex, but you don’t have to do it alone. The best way to know which type and technique are right for you is through a personal, in-depth, free consultation.
Our expert surgeons at Auralia will listen to your concerns, assess your unique anatomy, and recommend a tailored plan to help you achieve your goals.
