Blepharoplasty is a surgical procedure that modifies the eyelids by addressing excess skin, muscle tissue, and fatty deposits that may develop due to ageing, genetic factors, skin characteristics, and environmental influences such as sun exposure. The procedure is performed under either local anaesthesia with sedation or general anaesthesia, depending on the extent of surgery and individual circumstances discussed during consultation.

Eyelid surgery in Sydney requires careful assessment of eyelid anatomy, skin quality, fat distribution, muscle tone, tear production, and overall facial proportions. Not all individuals are suitable candidates for blepharoplasty, and individual assessment is required to determine appropriateness.

Upper blepharoplasty addresses excess skin and tissue of the upper eyelids. The procedure involves making an incision within the natural eyelid crease, where excess skin is carefully measured and removed. A portion of the underlying orbicularis oculi muscle may be addressed, and excess fatty tissue may be removed or repositioned. The incision is then closed with fine sutures, which are typically removed approximately one week after surgery.

Upper eyelid surgery may be considered for individuals experiencing heaviness of the upper eyelids, excess hooded skin, or in some cases where advanced upper eyelid skin descent may affect peripheral vision. When functional visual concerns are documented through appropriate assessment including visual field testing, upper eyelid surgery may potentially meet Medicare criteria under specific circumstances. Medicare eligibility depends on individual assessment and documented evidence, and cannot be determined without consultation.

Recovery from upper blepharoplasty typically involves bruising and swelling that gradually resolves over one to two weeks, though individual healing varies. Most patients can return to non-strenuous activities within seven to ten days, with full recovery taking several weeks.

Lower blepharoplasty addresses concerns related to the lower eyelids, including bulging fat deposits (commonly referred to as eye bags), excess skin, and changes in lower eyelid contour. Several surgical approaches may be used for lower eyelid surgery in Sydney, and the appropriate technique depends on individual anatomy, skin quality, and the specific concerns being addressed.

Lower eyelid surgery requires careful evaluation of eyelid position, skin elasticity, cheek-eyelid junction anatomy, tear trough depth, and lower eyelid support structures to minimize the risk of complications such as lower eyelid malposition.

Transcutaneous lower blepharoplasty

Transcutaneous lower blepharoplasty, also called external lower eyelid surgery, involves an incision made just below the lower eyelash line, extending into a natural skin crease. This approach allows the surgeon to address fatty tissue, tighten underlying muscle if required, and remove excess skin. The technique may be appropriate when both fat repositioning and skin removal are indicated.

Transconjunctival blepharoplasty

Transconjunctival blepharoplasty is performed through an incision made inside the lower eyelid, within the conjunctiva (the membrane lining the inner eyelid). This internal approach leaves no visible external scar and allows access to remove or reposition bulging fat deposits. This technique may be suitable for patients with good skin elasticity and minimal excess lower eyelid skin, where the primary concern is fat repositioning rather than skin removal.

Pinch blepharoplasty

Pinch blepharoplasty involves a conservative approach to lower eyelid skin removal. An incision is made just below the eyelash line, and a measured amount of excess skin is removed without extensive dissection of deeper tissues. This technique may be performed in conjunction with transconjunctival blepharoplasty and may reduce the risk of lower eyelid malposition in selected cases.

In some cases, fat may be repositioned into the tear trough area (the groove between the lower eyelid and upper cheek) rather than removed, to address hollowing and create a smoother eyelid-cheek transition.

Eyelid surgery may be considered for addressing the following concerns:

• Excess upper eyelid skin that creates heaviness or hooding over the eyelashes
• In specific cases, upper eyelid skin descent that may impact peripheral visual fields
• Lower eyelid position changes or laxity
• Prominent lower eyelid fat deposits creating a puffy or baggy appearance
• Excess lower eyelid skin and wrinkles
• Deepening of the tear trough area beneath the lower eyelids

Important: Blepharoplasty does not address brow position, forehead lines, crow’s feet wrinkles, or dark circles caused by pigmentation or vascular shadowing. If brow drooping is a primary concern, brow lift surgery may be more appropriate than upper eyelid surgery alone. Individual assessment is required to determine the most suitable approach.

During your eyelid surgery consultation in Sydney, Dr Mohaghegh will conduct a thorough assessment of your eyelid anatomy, discuss your concerns and goals, explain appropriate surgical options, and outline realistic expectations for outcomes, recovery, and potential risks. The consultation process includes examination of eyelid skin quality, fat distribution, eyelid position, muscle tone, tear production, and overall facial proportions.

In accordance with Australian regulations for cosmetic surgery procedures, patients considering blepharoplasty must have at least two pre-operative consultations, with at least one conducted in person with the surgeon who will perform the procedure. Patients are required to undergo psychological screening using validated assessment tools to ensure suitability. A mandatory seven-day cooling-off period applies after consent is provided before surgery can be scheduled.

For patients with functional concerns such as visual field impairment, additional documentation including visual field testing and photographic evidence may be discussed to determine whether the procedure may meet Medicare criteria under item 45617.

Recovery from blepharoplasty varies significantly between patients depending on the extent of surgery performed, individual healing characteristics, and adherence to post-operative care instructions. Typical recovery considerations include:

• First 48 hours: Bruising, swelling, and mild discomfort are common. Cold compresses and head elevation are recommended to minimize swelling.
• First week: Bruising and swelling are most prominent during this period. Sutures are typically removed around day 5-7 for upper eyelid surgery. Most patients can resume light activities and work from home.
• Weeks 2-3: Bruising gradually fades and swelling continues to reduce. Most patients can return to non-strenuous work and social activities with residual swelling often concealed with makeup.
• Weeks 4-6: Significant improvement in appearance, though subtle swelling may persist. Most patients can resume exercise and normal activities as guided by their surgeon.
• Months 3-6: Final contour refinement continues as residual swelling fully resolves and incision lines mature.

Activity restrictions typically include avoiding heavy lifting, strenuous exercise, swimming, and activities that may risk trauma to the surgical area for 2-4 weeks. Specific recovery instructions and timelines will be provided based on the extent of your surgery and individual healing response.

Individual recovery varies. Factors including age, skin quality, surgical extent, technique used, and individual healing capacity all influence recovery duration and experience.

All surgery carries risks. Blepharoplasty is a surgical procedure that carries both general surgical risks and procedure-specific risks that must be carefully considered before proceeding.

General surgical risks

• Bleeding and haematoma formation
• Infection requiring antibiotic treatment
• Adverse reaction to anaesthesia
• Scarring (while incisions are placed to minimize visibility, individual scar healing varies)
• Pain and prolonged discomfort
• Need for revision surgery

Specific risks of eyelid surgery

• Asymmetry between the two eyelids
• Dry eyes or excessive tearing
• Temporary or persistent changes in eyelid sensation
• Difficulty closing eyes completely, particularly in the early recovery period
• Lower eyelid malposition (ectropion or retraction) requiring corrective surgery
• Visible scarring, particularly in individuals prone to abnormal scar formation
• Unsatisfactory aesthetic outcome requiring revision
• Temporary blurred vision or very rarely, serious vision complications
• Hollow or sunken appearance if excessive tissue is removed

These risks will be discussed in detail during your consultation, along with steps taken to minimize complications. Individual risk factors vary based on medical history, eyelid anatomy, and surgical approach.

For comprehensive information about blepharoplasty risks, please visit our detailed risk information page or discuss these matters during your consultation.

The cost of blepharoplasty in Sydney varies depending on several factors including whether upper eyelids, lower eyelids, or both are being addressed, surgical technique required, anaesthesia type (local with sedation versus general anaesthesia), surgical facility fees, and individual case complexity.

When upper eyelid surgery is performed to address functional visual field impairment documented through appropriate testing, a Medicare rebate may be available under item number 45617. Medicare coverage is not available for cosmetic blepharoplasty. Eligibility for Medicare benefits depends on meeting specific criteria including:

• Documented visual field impairment caused by upper eyelid skin descent
• Formal visual field testing demonstrating functional impairment
• Photographic documentation of eyelid position
• Assessment confirming that the functional impairment is attributable to excess eyelid skin rather than other conditions

Private health insurance may provide coverage for hospital and anaesthetic costs when functional criteria are met, though individual policy terms vary. A gap payment typically applies even when Medicare criteria are satisfied.

Detailed cost information specific to your individual circumstances will be provided during your consultation, including a written quote outlining all anticipated fees for surgery, anaesthesia, surgical facility, and post-operative care.

For more detailed information about eyelid surgery cost in Sydney, please visit our comprehensive cost guide.

What is the difference between blepharoplasty and eyelid surgery?

Blepharoplasty and eyelid surgery are the same procedure. “Blepharoplasty” is the medical term, while “eyelid surgery” or “eyelid lift” are commonly used descriptive terms. Both refer to surgical modification of the upper eyelids, lower eyelids, or both.

What is the difference between upper and lower blepharoplasty?

Upper blepharoplasty addresses the upper eyelids by removing excess skin, muscle, and fat through an incision in the upper eyelid crease. Lower blepharoplasty addresses the lower eyelids to modify bulging fat, remove excess skin, or improve lower eyelid contour, and may be performed through an internal incision (transconjunctival) or external incision (transcutaneous) depending on individual anatomy and concerns.

Who may be suitable for eyelid surgery?

Suitable candidates for blepharoplasty are typically adults in good general health with realistic expectations who have concerns about excess upper eyelid skin, lower eyelid bags, or eyelid laxity. Individuals with certain medical conditions affecting healing, severe dry eye, thyroid eye disease, or unrealistic expectations may not be suitable candidates. Individual assessment during consultation is required to determine appropriateness.

Can eyelid surgery help if upper eyelid skin affects vision?

When excess upper eyelid skin causes documented impairment of peripheral vision confirmed through visual field testing, upper blepharoplasty may be considered a functional procedure. In these specific cases, Medicare coverage may be available. Assessment requires formal visual field testing, photographic documentation, and confirmation that visual impairment is attributable to eyelid skin rather than other factors.

Does Medicare cover blepharoplasty in Sydney?

Medicare provides coverage for upper eyelid surgery only when specific functional criteria are met and documented, including visual field impairment caused by excess upper eyelid skin. Medicare does not cover cosmetic blepharoplasty. Lower eyelid surgery is generally considered cosmetic and is not covered by Medicare. Individual assessment and documentation are required to determine Medicare eligibility, which cannot be guaranteed without thorough evaluation.

How much does blepharoplasty cost in Sydney?

Blepharoplasty cost in Sydney varies based on whether upper eyelids, lower eyelids, or both are addressed, surgical technique, anaesthesia type, and facility fees. When functional criteria for Medicare are met for upper eyelid surgery, a Medicare rebate applies but a gap payment is typically required. Cosmetic blepharoplasty costs are not covered by Medicare. Specific cost information will be provided during consultation after individual assessment.

What is recovery like after eyelid surgery?

Recovery from eyelid surgery typically involves bruising and swelling that are most prominent in the first week and gradually resolve over 2-3 weeks. Most patients can return to light activities within 7-10 days and resume normal activities including exercise by 4-6 weeks. Individual recovery varies based on surgical extent, technique used, and individual healing characteristics. Temporary dry eyes, sensitivity to light, and blurred vision may occur in the early recovery period.

What are the risks of blepharoplasty?

Blepharoplasty carries both general surgical risks (bleeding, infection, scarring, anaesthetic complications) and procedure-specific risks including asymmetry, dry eyes, eyelid malposition, difficulty closing eyes, changes in eyelid sensation, and rarely, vision complications. Individual risk factors are discussed during consultation based on medical history and eyelid anatomy.

Will blepharoplasty leave visible scars?

Upper eyelid surgery incisions are placed within the natural eyelid crease where scars typically heal to become very fine and well-concealed. Transcutaneous lower blepharoplasty incisions are placed just below the eyelash line and extend into natural skin creases. Transconjunctival lower blepharoplasty is performed through an internal incision with no external scar. Individual scar healing varies based on skin type, healing characteristics, and genetic factors.

What is transconjunctival lower blepharoplasty?

Transconjunctival lower blepharoplasty is a technique where the incision is made inside the lower eyelid through the conjunctiva (inner eyelid lining), leaving no visible external scar. This approach allows removal or repositioning of bulging lower eyelid fat and may be appropriate for patients with good skin elasticity and minimal excess lower eyelid skin.

What is pinch blepharoplasty?

Pinch blepharoplasty is a conservative lower eyelid technique involving removal of a measured amount of excess skin through an incision below the eyelash line, without extensive deeper tissue dissection. It may be performed in combination with transconjunctival fat removal and may reduce the risk of lower eyelid malposition in selected patients.

Is a brow lift different from upper eyelid surgery?

Yes. Upper eyelid surgery (upper blepharoplasty) removes excess skin from the upper eyelid itself, while brow lift elevates the position of the eyebrow. When brow drooping is the primary concern creating upper eyelid heaviness, brow lift may be more appropriate than upper blepharoplasty alone. Individual assessment is required to determine which procedure, or combination of procedures, may be suitable.

If you are considering blepharoplasty in Sydney, Dr Mohammad Hassan Mohaghegh offers comprehensive consultations to assess suitability, discuss surgical options, and explain realistic expectations for eyelid surgery outcomes, recovery, and risks.

Dr. Mohammad Hassan Mohaghegh
MD, MPhil, FRACS (Plast)
AHPRA Registration Number: MED0001627149
Registered medical practitioner, Specialist Plastic Surgeon
Specialist registration in Surgery – Plastic Surgery

Practice location:
Shop 1/161 New South Head Rd
Edgecliff, NSW 2027

Contact:
Phone: 1300 074 466
Email: hello@drmohaghegh.com.au
Website: drmohaghegh.com.au

To schedule your consultation or learn more about upper eyelid surgery, lower eyelid surgery, or combined blepharoplasty procedures, please contact our practice.