Eyelid Surgery
Surgery types, recovery, NHS vs private options, and FAQs
Overview
Eyelid surgery, known medically as oculoplastic surgery, encompasses a range of procedures that address conditions affecting the eyelids, tear ducts, and the tissues surrounding the eyes. These procedures may be performed for medical reasons — to improve vision obstructed by drooping or excess eyelid tissue — or for cosmetic purposes to rejuvenate the appearance of the eye area.
The most common eyelid conditions requiring surgery include ptosis (a drooping upper eyelid that can obstruct the visual field), dermatochalasis (excess, hooded upper eyelid skin), entropion (an inward-turning eyelid that causes the lashes to scratch the eye), ectropion (an outward-turning eyelid that exposes the inner surface), and eyelid lumps, cysts, and lesions such as chalazia and skin cancers.
Oculoplastic surgery is a subspecialty of ophthalmology, and procedures are performed by specialist oculoplastic surgeons who have additional training in both the functional and aesthetic aspects of eyelid and periorbital surgery. Many eyelid procedures are available on the NHS when there is a functional visual impairment, while cosmetic procedures are typically self-funded privately. In the UK, eyelid surgery is one of the most commonly performed oculoplastic procedures, with thousands of operations carried out each year.
Symptoms
- Drooping upper eyelid(s) partially covering the pupil (ptosis)
- Excess hooded skin on the upper eyelids obstructing peripheral vision
- Eyelid turning inward, causing eyelashes to rub on the eye (entropion)
- Eyelid turning outward, causing dryness, tearing, and exposure (ectropion)
- Persistent lumps, cysts, or growths on the eyelid
- Watery eyes due to tear duct blockage or eyelid malposition
- Tired, heavy-feeling eyelids, particularly towards the end of the day
- Skin irritation or infection in the eyelid crease from excess skin folds
When Surgery is Needed
Eyelid surgery is recommended when eyelid conditions are causing functional problems, discomfort, or a risk to eye health. Your ophthalmologist or GP may recommend surgery when:
- Ptosis or dermatochalasis is obstructing your upper visual field, making it difficult to see above or to the sides — this can be measured with a visual field test
- Entropion is causing the eyelashes to scratch the cornea, leading to pain, redness, infection risk, and potential corneal scarring
- Ectropion is causing persistent watering, dryness, irritation, or exposure of the inner eyelid surface
- An eyelid lump or lesion needs to be removed for biopsy, is causing discomfort, or is growing
- Blocked tear ducts are causing chronic watering or recurrent infections
For cosmetic concerns, such as bags under the eyes, wrinkled eyelid skin, or a desire for a more youthful appearance without functional impairment, surgery is available as a private self-pay procedure.
Types of Surgery
Upper blepharoplasty
Removal of excess skin, and sometimes fat, from the upper eyelids. An incision is made in the natural crease of the eyelid, so the scar is well-hidden. The procedure can be performed under local anaesthesia and takes approximately 30-60 minutes. It can be both functional (improving the visual field obstructed by hooded lids) and cosmetic (creating a more open, refreshed appearance).
Lower blepharoplasty
Addresses bags, puffiness, or excess skin beneath the lower eyelids. Fat may be removed or repositioned, and excess skin tightened. The incision is typically made just below the lash line or inside the eyelid (transconjunctival approach). This is predominantly a cosmetic procedure and is usually self-funded.
Ptosis repair
Tightening or reattachment of the levator muscle that raises the upper eyelid. This restores a more normal eyelid position and improves the obstructed visual field. The technique depends on the severity and cause of the ptosis. In adults, the most common approach is levator advancement through an incision in the eyelid crease. In severe cases, a frontalis sling procedure may be used, connecting the eyelid to the forehead muscle.
Entropion and ectropion repair
Surgical correction of eyelids that turn inward (entropion) or outward (ectropion). Various techniques are used depending on the cause, including horizontal lid tightening, retractor reinsertion, and grafting procedures. These operations restore normal eyelid position, relieve symptoms, and protect the cornea. They are typically performed under local anaesthesia and take 30-60 minutes.
Eyelid lesion excision
Removal of lumps, cysts, or growths from the eyelid. This includes chalazia (meibomian cysts), papillomas, and skin cancers such as basal cell carcinoma (the most common eyelid malignancy). The specimen is sent for histological analysis. Reconstruction of the eyelid after larger excisions may be required to maintain proper eyelid function and appearance.
Recovery
Recovery from eyelid surgery depends on the type and extent of the procedure, but most eyelid operations have a relatively quick recovery compared to other surgical procedures.
After blepharoplasty, you can expect bruising, swelling, and some discomfort around the eyes for 1 to 2 weeks. Cold compresses, keeping your head elevated, and using prescribed ointments will help manage swelling. Stitches are usually removed after 5-7 days (or dissolve on their own). Most patients can return to normal activities within 7 to 10 days, though strenuous exercise should be avoided for 2-3 weeks.
For ptosis repair, the recovery timeline is similar to blepharoplasty. There may be some difficulty closing the eye fully in the first few weeks, requiring lubricating drops and ointment to keep the eye moist.
For entropion and ectropion repair, recovery is usually 1 to 2 weeks. A pad may be placed over the eye overnight after surgery, and you will use antibiotic ointment for about a week. Swelling and bruising settle within 2 weeks.
Scarring from eyelid surgery is generally minimal and well-hidden in the natural creases of the eyelid. Final results, including any improvement in the visual field, are typically evident within 4 to 6 weeks.
NHS vs Private
Eyelid surgery is available on the NHS when there is a documented functional impairment. This means the eyelid condition must be demonstrably affecting your vision or eye health — for example, ptosis or dermatochalasis that obstructs the visual field (confirmed by a visual field test), entropion causing corneal damage, or ectropion causing significant symptoms. Your GP or optometrist can refer you to an NHS ophthalmology or oculoplastic service.
NHS waiting times for eyelid surgery vary by region but are typically 8 to 18 weeks. Some NHS trusts have specific criteria for funding blepharoplasty, often requiring evidence that the upper eyelid margin is within a certain distance of the pupil centre.
Cosmetic eyelid surgery is not available on the NHS and must be funded privately. Private costs vary by procedure:
- Upper blepharoplasty: from £2,495 per lid (from £3,495 for both)
- Lower blepharoplasty: from £2,500 to £4,000
- Ptosis repair: from £2,795
- Entropion/ectropion repair: from £1,995
- Eyelid lesion excision: from £795
Frequently Asked Questions
Will eyelid surgery leave visible scars?
How do I know if my drooping eyelids qualify for NHS surgery?
How long do the results of blepharoplasty last?
Can I wear contact lenses after eyelid surgery?
Is eyelid surgery performed under general anaesthesia?
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