With #undetectableera trending on Tiktok and ‘undetectable small changes(the leave-no-trace type of work) driving the aesthetic trends, you might be surprised to learn that one of the most “no-trace” procedures of all is, in fact, surgery. One so transformative that glossy magazine beauty editors, who can have any non-surgical procedure they like for free, happily choose to pay for surgery.
I know, because I’m one of them – and many my peers have gone before me to get their eyes surgically “pinned” (the medical term is upper eyelid blepharoplasty or “bleph”). The procedure addresses the thinning and drooping that darkens many eyelids with age. Eventually the skin sags over the eye creases and lash lines. And in very advanced cases it can block your vision.
I can’t pretend that my upper eyelids stopped me from seeing properly, so I had no medical reason to have the op: it was pure vanity. With my eyelids looking like deflated balloons by the age of 54, there was no way I was going to get that tired look off my face and I was sick of it.
Makeovers are among my special subjects as a beauty journalist, so I inevitably looked first for some magic scalpel-free solution. But he left disappointed. Many eye modifications, often called “non-surgical blepharoplasty” (involving fillers, neurotoxins, or heat-based “skin reshaping” devices), promise the world but deliver very little, especially if you’re over 50 and your loss of elasticity is advanced.
Some of these “minimally invasive” procedures involve weeks of downtime (think swelling, weeping, scabbing – you can see some of the “damage” for yourself in my article on the truth about non-surgical cosmetic procedures). Knowing that inflammation and irritation actually age the skin and could make things worse in the long run, I had no intention of undergoing either of these options.
But after consulting many top ophthalmologists over many years, I it was fine with cutting my eyelid strips with a scalpel and sewing them back together. Plus, I was happy to pay at least three times the price of the most expensive microplastic eye to get blepharoplasty. Why? And how much money are we talking about here? All the answers, as well as the experiences of some of my fellow beauty editors, are below.
Why is upper eyelid surgery the best option for sagging eyelids?
Many ophthalmologists also perform eye modifications because many patients simply do not want surgery. But all experts agree that surgery is the far superior option if you want real results. Not only will the result be longer lasting (at least ten years, compared to several months to two years, depending on the fit), it is much more reliable, with good surgery achieving highly personalized and precise results, whereas those from minor changes cannot be predicted or guaranteed and in some cases involve more downtime than surgery.
Blephs are among the surgical procedures with the highest success and satisfaction rates, according to the British Association of Aesthetic Plastic Surgeons (BAAPS), and are currently the fourth most popular cosmetic surgery procedure in the UK.
What happens during upper eyelid blepharoplasty?
An upper eyelid lift can be performed under general anesthesia (with full hospital care and an anesthesiologist) or under local anesthesia under deep sedation (where you are asleep) or light sedation (where you are actually awake). I had the latter, so yes, I was awake and asking questions throughout the process. Local anesthesia avoids the risks of general anesthesia and is believed to promote faster recovery.
I had been given medication to stop the bleeding (for the same purpose, I had to avoid ibuprofen, omega 3 oils and other blood thinners for two weeks before the operation) and a sedative diazepam to take before, which meant I was pretty relaxed when I landed on the operating table. The experience was non-traumatic, with my surgeons chatting and reassuring me the whole way through.
Pain wasn’t a problem: the anesthetic injections in my eyelids were done using the world’s thinnest needle and a vibrating massage bar that distracts from the sting – uncomfortable but not horrible. I was completely numb. Soothing music and an aromatherapy diffuser added to the “cool vibe.”
The procedure was done in 30 minutes (I had two surgeons – see below – working at the same time, which speeds up the procedure). In that time, a carefully mapped strip of skin was removed from each eyelid, as well as some loose fat from the inner corners of my eyes. After pulling the lot again, a firm compression pad was applied to my eyes to counteract the swelling and bruising for an hour while I relaxed. I came out with puffy caps with purple stitches in the folds – nothing too dramatic.
What are the risks of blepharoplasty?
The list is long, but in the hands of experienced ophthalmic plastic surgeons, the likelihood is small. Risks include infection, loss of vision, loss of sensation, scarring, shrinkage, inflammation, and worsening of dry eye syndrome (if the eye cannot close properly after surgery).
It’s also possible that you won’t be happy with your new look, which is why it’s so important to choose a doctor who offers extensive pre-op sessions to discuss your exact wishes.
Showing them photos of your eyes when you were younger (ie the ones you hope to claim again) is very helpful for both parties, and soon, many surgeons will be able to offer AI-generated projections of what’s possible for you, taking out a lot of the guesswork.
What is the downtime for upper eyelid blepharoplasty?
It’s a surprisingly minimal seven to ten days, on average. After that, your eyelids will have healed enough to wear eye makeup and contact lenses. But if you don’t mind being seen with pretty puffy eyes, you can be upright and not running around quite right after the op.
My eyelids felt a little tight, but not painful right after the surgery, and I could see normally with my glasses. I was sent on my way with eye drops, antibacterial ointment and an anti-inflammatory eye mask to apply several times a day for five days. I didn’t have to bend over for two days or exercise for ten, to avoid any pressure on the wounds, but I could sleep as I pleased – I didn’t need a seat or special pillows.
The swelling was largely gone in a few days, but two dark blood bruises that appeared on the second day took three weeks to resolve – however, they were easily covered. My stitches were removed on the sixth day, with the scars tucked into the creases of my eyes so that they were barely visible, which was good as they remained quite red and tender for a month. After a few months, they faded to almost invisibility. As for the pain, there never was.
It’s worth noting that lower eyelid blepharoplasty, which deals with eye bags, is a more complicated surgery, involving two weeks of downtime for initial recovery.
