Sagging or puffy eyelids can occur with ageing.  The upper eyelids are the most commonly affected, but a major contribution may actually come falling down of the brow. 

There are two elements to sagging or puffy eyelids: excess hanging skin and bulging of the fat from around the eye itself.  Both would be addressed with blepharoplasty (eyelid reduction surgery). 

In the upper eyelid, the excess fold of skin and muscle is excised to re-establish the fold, and the bulging fat is removed to produce a smooth contour.  This opens the eye and can help improve impairment of vision if the upper lids cause obstruction to the visual fields .  Upper blepharoplasty can be done under local, sedation or general anaesthetic.

The lower eyelids are slightly different and care must be taken not to pull the lower lid down (ectropion).  To this end, if the tone of the lower lid is poor, or in the mature patient, a small hitching stitch may be required to help support the lower lid.  This adds little to the operation. Again excess fat, skin and muscle are removed.  I prefer to do lower lids under general anaesthesia.  Of course both upper and lower lids can be done together.

If the main complaint is “crepey” skin with only mild excess in the lower lids then laser resurfacing may be the most appropriate procedure.  The “crow’s feet” at the outer rim of eye are caused by the repeated contraction of the eye muscles and are best treated by injections.

For upper blepharoplasty Medicare and health fund rebates apply if pre-operative perimetry is performed by an Optometrist that demonstrates the presence of visual impairment.  There are no rebates for lower blepharoplasty as this is considered cosmetic surgery.

All patients need to be individually assessed during a comprehensive consultation to determine the most appropriate surgery in their circumstances.

Important Note:

The content on our page in general in nature and does constitute medical advice. Any surgery or invasive surgery carries risks and has a recovery time. Please refer to the procedure page for detailed information.