What Is the Typical Cost of Blepharoplasty Surgery?

Blepharoplasty surgery is a common eyelid procedure that can help with the appearance of drooping eyes. The total cost of this surgeon depends on the oculoplastic surgeon you choose, the hospital they work out of, and what kind of treatment you want. Here are the top things to know if you're thinking about this kind of procedure.

Types of Blepharoplasty Surgery

As we age, the fine skin around our eyes stretches and becomes less elastic. This stretchy skin creates a hooded effect on our top eyelids and a sagging effect on the bottom eyelids. Hooded lids can impact your field of vision. Many people also find that sagging lids detract from the beauty of their eyes. There are two types of blepharoplasty that target the top lid and bottom lid. You can also combine these surgeries and have them done at the same time. The surgeries only differ slightly from top lid to bottom lid. The upper eyelids are done with tiny incisions along the crease, and the lower eyelids are done with an incision just under your lash line.

Fixed Price Surgery Costs

There are some general costs for all surgeries. This may include the cost of use of the operating room (theatre), the cost of anesthesia, pharmacy costs, and the costs of post-op care. In the UK, many private hospitals offer what is called fixed-price surgery. This means the amount you are quoted covers all of your care.

Location is a large factor in the total cost. Urban hospitals treat more people and have a greater demand for their equipment. They also spend more on new technology and skillful staff. Expect to pay more if you seek treatment in London versus the provinces. The experience of your doctor may also influence the cost of your treatment. A tenured surgeon will come at a higher cost than a junior plastic surgeon.

Contracts differ from hospital to hospital. One hospital may include all follow-up appointments and pharmacy costs, others may only cover costs incurred within hospital walls. Make sure that you read the fine print to find out about any hidden fee-per-service charges.

Average Cost

The cost of blepharoplasty surgery in the UK ranges from £2,000 to £4,500, and the average cost is just over £3,000. Having both upper and lower eyelids done at the same time will be more expensive than just the top or bottom lid. 

Insurance Coverage and Private Pay

The NHS does not usually cover blepharoplasty surgery. It is considered a cosmetic procedure, and these are generally not covered. Exceptions may be made for drooping eyelids that significantly impact your vision or quality of life. You'll need to work with a doctor to demonstrate this impact. Otherwise, expect to self-pay for this procedure.

Other Procedures

Some people use the chance while already under anesthesia to get multiple procedures. As long as this is approved by your doctor and tolerated by your health, there is no problem performing multiple procedures. Some treatments that people commonly combine with eyelid lifts are Botox and eyebrow lifts. Adding more procedures will increase the total cost of your surgery. However, this may be less than choosing to have a separate operation later and pay hospital fees again.

How to Decide on an Oculoplastic Surgeon

You have lots of freedom to choose your surgeon when paying privately for your operation. At ClinicLoop, your experience starts with the first phone call to our office. You will feel warm and welcomed by our office staff. You can expect to be greeted by Elaine, Florence, or Vicky when you call. Elaine Orchard's job as practice manager is to guide you toward the information you need and help you make an appointment with Dr. Koutroumanos. Vicky Darragh is an expert at identifying the specific needs of each of our clients and answering any questions you have. Florence Barron is our medical secretary and you'll hear her friendly Irish lilt when contacting the office to make appointments or set follow-ups with the doctor.  Florence is in charge of finance. Dr. Koutroumanos is a surgeon with the experience to back up his credentials. You can expect better results from a doctor with an excellent track record than one fresh from college. They may come at a higher cost, but you should not compromise on the quality of your plastic surgeon. Dr. Koutroumanos was awarded three scholarship fellowships all around the world before settling down in his London office. Each surgery is unique to the person it is being performed on, so be wary of one size fits all treatment plans. Dr. Koutroumanos believes that the best kind of cosmetic procedure is one that complements your natural features and is minimally invasive, saving you recovery time and preserving your natural beauty. The professionals at the London Ophthalmology and Ophthalmic Plastics clinic believe that the best outcomes for plastic surgery are those that enhance your existing natural beauty. Dr. Nick Koutroumanos is an oculoplastic surgeon that works with each patient to understand their vision and plans together to make it a reality. Read more

A Day in the Life of an Oculoplastic Surgeon

Have you ever wondered what a day in the life of an oculoplastic surgeon looks like? What about a plastic surgeon that specializes in the area around your eyes? These are doctors that are trained in plastic surgery in the eye area. Dr. Nick Koutroumanos is one such surgeon working in London. Here is a quick look at what he treats and what his daily schedule may look like.

What an Oculoplastic Surgeon Treats

Dr. Koutroumanos targets the area around your eyes. Plastic surgery is not just about how you look. This kind of surgery can be the solution for many medical ailments. Eye surgery can help treat teary eyes and blocked tear ducts. Sometimes eyelids can become misshapen because of other illnesses. Eyelid surgery may address these conditions. Oculoplastic surgeons can also treat cataracts and perform reconstructive surgeries around the eyes. Dr. Koutroumanos is a specialist in addressing cosmetic concerns. Some common cosmetic eye surgeries are brow lifts and eye bag removal. He is also trained to inject fillers and Botox around the eye area. Dr. Koutroumanos has received praise from his patients for their quick recovery times and results from eye bag removal. He will also spend some of his time meeting with patients and making plans for treatment. The other part of his time is spent in surgery. Dr. Koutroumanos splits his time between his private practice clinic, London Ophthalmology and Ophthalmic Plasticsand working for the National Health Service.

Clinic Days

Pre-Op Consults

Before any kind of surgery can take place, Dr. Koutroumanos will get to know you and the reasons for your visit. He will ask about your medical history and any pre-existing conditions. He'll also ask about your desired outcome after surgery. The goal is that your ideas align with Dr. Koutroumanos's practices and that any concerns between both parties are addressed.  Before proceeding with any treatments, you'll also recieve a full eye exam. This is so Dr. Koutroumanos can decide what procedures are best suited for your wishes and to rule out any reasons that surgery may not be suitable. You'll have some clinical photos taken as a reference. Then you and Dr. Koutroumanos will develop a plan for treatment. Dr. Koutroumanos's private practice is based out of The Hospital of St John & St Elizabeth, and he sees his NHS patients at the Royal Free Hospital in Hamstead.

Minor Procedures

These surgeons can do minor procedures like Botox or filler placement. Typically these kinds of appointments will be set for a time that Dr. Koutroumanos is in the clinic rather than the operating room. 

Post-Op Appointments

Dr. Koutroumanos also follows up with patients after their operation. He'll remove sutures and bandages and check to see how patients are healing. He may ask how you're feeling, how the healing process is going, and if any problems have come up since the surgery. Dr. Koutroumanos takes special care to check in with parents of young children since one of his specialties is pediatric oculoplastic surgery. He will also check in at this stage to gauge your reaction to the procedure. This is another chance for you to ask any questions you still have about your surgery or recovery.

Operation Days

Each day spent in the surgery bay will look different depending on what procedures are scheduled. Dr. Koutroumanos employs two secretaries full-time and works with other medical professionals on operation days. He regularly works with Dr. Camilla Davies as his anesthetist. Before each procedure, Dr. Koutroumanos checks in with his patients. He'll ask how you're feeling and explain the procedure once more. He may also draw some pre-operative markings and go over his expectations for your surgery. On the day of surgery, Dr. Koutroumanos will make sure you are comfortable and understand the procedure he's about to perform.  Surgeries last for different amounts of time depending on how complex they are. Simple procedures might be done in under an hour. Complex procedures can take much longer. If it is safe and called for, it may be possible to combine several procedures into one session.  Dr. Koutroumanos specializes in many areas of ophthalmologic surgery. He is an expert in complex tear-duct surgery for pediatric patients and is practiced in reconstructive eyelid and upper facial surgery. Dr. Koutroumanos has also been praised for his skills in aesthetic rejuvenation and cosmetic eye surgeries. 

Training Others

Dr. Koutroumanos also trains other young professionals. He leads a fellowship program that trains surgeons from all over the world. These fellows observe under Dr. Koutroumanos' leadership to better understand this field. He is also a trainer and Royal College Examiner for ophthalmologic plastic surgery, cataract surgery, and general ophthalmology. If you are in need of the services of Dr. Koutroumanos or are interested in learning more about what a day in the life looks like for him, contact our office and set a time to meet. Read more

Bumps on Eyelids: A Guide to Treatment and Prevention

Eyelid bumps can easily go away using home remedies. If the lump interferes with your vision, doesn't respond to home treatment, or is too painful to bear, seek medical treatment. Understanding what causes eyelid bumps can also aid prevention and decision-making as some conditions may require eyelid surgery. Here's an overview of eyelid bumps as well as the different types, symptoms, treatment, and prevention:

What Is An Eyelid Bump?

An eyelid bump is any painful lump at the edge of your upper or lower eyelid. Some appear red and are located where the eyelash meets the eyelid. Bacteria and oil gland blockage are the common causes of most eyelid bumps, and the condition is generally harmless. You don't necessarily require medical treatment as bumps can go away with basic home care. Other cases are severe and call for prompt medical care and diagnosis.

Types of Eyelid Bumps

Before considering treatment for your eyelid issue, you should know the type of bump. Understanding what kind it is and the underlying cause will determine your treatment options. All eyelid bumps can fall into these primary categories: styes, a chalazion, viral papilloma (warts), cysts (sebaceous and apocrine cysts), and xanthelasma.

1.    Styes

A stye occurs when bacteria penetrate the oil glands in your eyelids, Styes are common and round, with a red bump close to the eyelash. It can make you feel sore or itchy around the eyelid and increase sensitivity to light, resulting in teary eyes. A style requires a few days to form, and you can have more than one on the same eyelid.

2.    Chalazion

A chalazion is another common type of eyelid bump stemming from issues with the oil gland. It's an inflammatory lesion that develops when your tear gland or oil-producing glands in the eyelids get blocked. A chalazion can grow to a bigger size than styes and is generally painless. The bump can, however, interfere with your vision, depending on its location and size.

3.    Viral Papilloma (Warts)

Viral papilloma generally occurs in middle-aged or elderly adults. It is benign and painless and appears as a simple skin tag on the eyelid. Standard removal of this eye bump includes excision, where the doctor will surgically remove the wart from the eyelid.

4.    Sebaceous Cysts and Apocrine Cysts

Apocrine cysts are rare but benign cystic tumors of the apocrine sweat glands. These nodules may appear along the eyelid margin. Sebaceous cysts are also benign. Visit your doctor to assess the condition of your eyelid. They will determine whether you have eyelid cysts or a different kind of bump.

5.    Xanthelasma

This eyelid bump stems from fat buildup under the skin. Xanthelasma is generally harmless, yellowish, and occurs more in older people. Such eyelid bumps can also indicate high cholesterol levels. If xanthelasma interferes with your vision or becomes painful, consider medical treatment as this may suggest other issues, such as bacterial infection (stye).

Symptoms of Eyelid Bumps

Eyelid bumps manifest in different symptoms depending on the type. Most lumps are either red or the color of your skin and appear along the edge of the eyelid. The bump may be tender or firm, and others result in watery eyes, gritty, scratchy sensations, and light sensitivity. Eyelid bumps can be mild or harmless, but you should seek medical attention if you experience the following: •    Your eyes become teary/watery •    There’s discharge from your eye •    The white part of your eye changes color •    The bump causes trouble seeing •    Your eyes hurt in low lighting •    The bump grows or gets extremely painful •    You experience eyelid blistering and bleeding in the eyelid bump •    Your eyelid becomes scaly, crusty, or reddish

What Causes Bumps on Eyelid?

Stye eyelid bumps occur when bacteria enter the oil glands in your eyelid, causing inflammation. Those with blepharitis and other eyelid inflammation conditions are more likely to get stye bumps. Chalazion bumps can form when the eyelid oil glands and tear glands are blocked. A style that fails to drain can become a chalazion. Xanthelasma bumps appear when fat collects below the skin surface and may indicate an underlying condition.

Preventing Eyelid Bumps

You can do various things to prevent developing eyelid bumps. Practicing good hygiene is essential in stopping the spread of bacteria and preventing stye eyelid bumps. Make sure you don’t touch your eyes until you’ve washed your hands. If you have blepharitis, rinse your eyelids at least once a day and use a warm compress as soon as you feel irritation. You can also keep xanthelasma bumps at bay by controlling cholesterol levels and eating healthy.

Eyelid Bumps Treatment

Not all eyelid bumps are avoidable or resolved without treatment. If you’re concerned about a stye or chalazion bump becoming bigger or more painful, consult a professional immediately. Some bumps resolve with common home remedies, but others may require advanced procedures like eyelid surgery to restore normal function. Here's a look at popular treatment options for eyelid bumps:

a)    Home Care

A warm compress is a popular home care treatment for eyelid bumps. Holding a warm compress for about ten minutes up to four times a day can help loosen and drain blockages in the glands. Heat and compression can also aid healing, but these homecare practices aren't required for xanthelasma.

b)    Medical Care

If the eyelid bump doesn’t respond to warm compress and routine hygiene, you should involve a medic. The eye is a delicate organ and requires experienced ophthalmologists and eye surgeons to correct. Your doctor will determine whether the bump needs puncturing, draining, antibiotic cream and drops, or eyelid surgery.

Do I Need Eyelid Surgery?

Bumps, such as a large chalazion that doesn't go away on its own, may require surgery. Eyelid surgery will remove the bump and treat the wound to protect your eye from infection. Surgery can also correct fluid drainage and blockage issues. At London Ophthalmology and Ophthalmic Plastics, we specialize in the eyelid, eye socket, and peri-ocular surgery. Contact us today to learn more. Read more

What Are the Symptoms of a Blocked Tear Duct?

A blocked tear duct is common and generally harmless in babies but may signify serious health issues in adults. If you have a blocked tear duct, it's vital to seek immediate medical help. Some cases may resolve with non-invasive treatment, while others will require an oculoplastic surgeon. Here's an overview of the main symptoms of a blocked tear duct and how to fix the condition.

What Is A Blocked Tear Duct?

A blocked tear duct is precisely what the name suggests. When your tear ducts are blocked, the tears can't drain normally. Blocked tear ducts will leave you with a teary eye and irritation and stem from various factors. The prevalent causes include congenital blockage (in infants), age-related changes, infection and inflammation, injury, trauma, tumors, and treatments. Tears come from the lacrimal glands inside the upper lids above your eyes. The tear flows over your eyes and drains into the puncta (openings inside the corner of the eyelids). From the puncta, tears flow to the canaliculi (small canals) then to a lacrimal sac reservoir on the side of the node. The tears then flow to the nasolacrimal duct, from which it drains into your nose and is reabsorbed. Blockage can occur anywhere along the drainage system, from the puncta to the nose. Risk factors such as age, chronic eye inflammation, past surgeries, glaucoma, and cancer treatment increase the likelihood of blockage. A blocked tear duct will affect most drainage system parts, including the conjunctiva (transparent membranes over your eye). The blockage can lead to inflammation or infections.

Symptoms of Blocked Tear Duct

A watery eye or excessive tearing is the main symptom of a blocked tear duct. The condition is almost always treatable and temporary, but some cases require a professional eye doctor to resolve. Apart from excess tears, you may experience the following symptoms: • Redness of the Eye: The white part of the eye may become red and irritated because of excessive tearing and the inflammation of the clear membranes covering it. • Pink Eye: You may experience recurring eye inflammation and infections like conjunctivitis or pink eye. • Blurred Vision: Your vision may become blurry because of excessive tearing,  infections, or inflammation. • Pain and Swelling: Painful swelling is common among those with a blocked tear duct because the blockage puts excess pressure on the glands. The pain and swelling are often near the inside corners of the eye. • Crusting Eyelids: The excess tears and inflammation usually lead to crust forming on or around your eyelids. • Mucus/Pus: You may experience mucus or pus discharge from the eyes and eyelids. Watery eyes may develop alongside a cold, a sinus infection, or an eye infection not related to a blocked tear duct. Symptoms such as swelling and redness may also stem from injuries to the eye, not necessarily affecting the tear ducts. Some teary eyes develop because of bacterial infection, in which case you may experience other symptoms like fever. Exposure to wind, dust, and bright light may also trigger excessive tearing, so professional diagnosis is vital.

Blocked Tear Duct Symptoms in Babies

Babies don't start producing tears until they are a few weeks old. You won't notice the symptoms of a blocked tear duct straightaway. Once they begin producing tears, you may see the following symptoms, which suggest a blocked tear duct: • Redness: The eye surface will become red, usually because your baby is frequently rubbing the eye area. • Unusual Drainage: Tears will drain down the cheek instead of the usual corner of the eye. • No Drainage: Tear may pool near the corner of your baby’s eye without draining. • Discharge: You may notice a yellowish discharge, mucus, or pus in the baby's eye. A blocked tear duct is harmless for babies but may cause distress for you and your baby. If you notice these symptoms in your baby, seek an immediate diagnosis. Popular tests include tear drainage assessment, eye imaging, irrigation, and probing. Treatment may include medication, dilation, probing, flushing, stenting, balloon catheter dilation, and snip punctoplasty.

What to Do For a Blocked Tear Duct

In babies, blocked tear ducts will resolve in a few weeks or months without treatment. As the tear duct and glands mature, they'll naturally remove the blockage. Your post-natal doctor may suggest a special eyelid massage to open the tissues for optimal tear flow. In adults, blocked ducts may resolve naturally or require treatment, such as massage. Other cases may call for surgery from an oculoplastic surgeon. It's vital to wash your hands thoroughly and frequently and avoid rubbing your eyes. If you wear contact lenses or glasses, follow all cleaning recommendations from your eye care specialist. You should also schedule an appointment with your doctor for a professional diagnosis.

When to See an Oculoplastic Surgeon

There’s no home remedy for adults. It’s crucial to seek medical assistance to identify the underlying cause. Conditions arising from bacterial infections can resolve using antibiotic eye drops and pills. If the cause is a narrow punctum, the doctor will use a small probe to increase the opening and irrigate the tear duct with a saline solution. Diagnosis will determine whether you need an oculoplastic surgeon for operations like dacryocystorhinostomy. London Ophthalmology and Ophthalmic Plastics specialize in eyelids, eye socked, and peri-ocular surgery. You can get a professional diagnosis, treatment, and surgery if necessary to restore normal tear drainage. Read more

What Can I Do About My Teary Eyes?

Teary eyes can be uncomfortable and embarrassing. Why it happens vary with age. Some of these problems will go away on their own, some may resolve with medication, and others may require eyelid surgery. Keep reading to learn more about potential causes and treatments for teary eyes.

What Causes Teary Eyes?

Common ailments like allergies or sinus infections can cause watery eyes. This is caused by a narrowing of your tear duct due to infection or swelling. Most people have experienced this kind of watery eyes. Persistent watery eyes are usually attributed to an ongoing problem. Blocked tear ducts are one of the main causes of watery eyes. Tear ducts act as channels to drain tears from your eyes into your sinuses. Tears overflow along your eyelid when these channels become blocked. This causes watery eyes and mucus discharge. Blocked tear ducts are common in infants and young children but happen in adults too. Babies born with a blocked tear duct have congenital nasolacrimal duct obstruction. This usually clears up on its own within the first year of life. However, if it doesn't get better your pediatrician may recommend your child visit an eye surgeon for further evaluation. Watery eyes are due to one of two ailments in older adults. One common problem related to age is the eyelid sagging away from the eyeball, which lets tears leak out. The other common problem is narrowing tear ducts. This is caused by inflammation, injury, or aging. Such narrowing can lead to a blocked tear duct. Ophthalmologists can diagnose these ailments and refer you for further treatment. You may be referred to an eye surgeon, who can provide you with information about eyelid or tear duct surgery.

Less Invasive Solutions for Teary Eyes

Treatment for watery eyes will depend on the route cause. There are some non-invasive methods to repair a blocked tear duct.


For tear ducts blocked due to infection, the first course of treatment will be a prescription to treat the underlying illness. This could be in the form of an eye drop or oral medication. Medication may also be prescribed to relieve blockage from swelling or inflammation.


A special massage technique can encourage a baby's blocked tear duct to open. Parents can be taught this technique to help open their children's blocked tear ducts. Sometimes this works, sometimes not, which is why observation is a critical tool in solving tear duct blockages.


It is important to continue observing tear duct blockages to see if they resolve on their own or will require further medical attention. In infants especially, tear duct blockages often resolve on their own before one year of age. For adults with injuries or swelling that caused their tear duct blockage, you may also be asked to wait and observe if the blockage improves as your injury heals.

Eyelid Surgery and Other Procedures

If you have a severe blockage you may not be a candidate for the procedures in the previous section. Your doctor may recommend other procedures if less invasive methods do not work. Most of these procedures are performed by a surgeon while you are under general anesthesia.

Dilation and Flushing

Your eye surgeon will insert a small probe into your tear duct and dilate it. They will then flush your tear duct with a high-pressure saline solution. You may also see this referred to as irrigation. It is not always a permanent solution but can help clear a blockage.


Another option to help give relief for blocked tear ducts is to place a stent. A stent is another name for a very small tube. These tubes create a passage for tears to drain properly into the sinuses. They are generally not permanent but may cause irritation.

Eyelid Surgery

Eyelid surgery is called dacryocystorhinostomy and is abbreviated as DCR. This surgery makes a shortcut for your tears that bypasses any narrow or blocked passages in your tear ducts. In our practice, more than 90% of patients see a reduction in their watery eyes after the procedure. There are two types of DCR, one called external DCR, and one called endonasal or keyhole DCR. The method your surgeon uses will be based on the severity and location of your blockage. The main difference is the location of the incision. For external DCR your surgeon will make a tiny incision on the side of your nose, and for endonasal DCR your surgeon will make an incision within the nasal cavity. Dr Koutroumanos' practice nearly exclusively uses the endonasal approach which results in absolutely no scarring.

Locating an Opthalmology Office

Start by working with your regular eye doctor and let them know your complaints about watery eyes. They will begin the referral process to get you in touch with an eye surgeon to find you relief. You'll want to work with an expert eye surgeon like Dr. Koutroumanos at London Ophthalmology and Ophthalmic Plastics. You want to work with seasoned experts who can lead you through the process with guidance based on their years of experience. Begin solving your teary eye problem today, and don't suffer any longer. Read more

How Long Should I Rest After Eyelid Surgery?

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4 Important Questions to Ask Your Oculoplastic Surgeon during Consultation

Eyelid surgery is a big undertaking, and there are many questions to ask your oculoplastic surgeon during consultation. The best approach is to prepare a list of questions about everything you need to know about the procedure. After consultation, you should feel ready and adequately informed to decide. Here are four sets of questions to ask: Read more

What Is the Difference Between a Plastic and an Oculoplastic Surgeon?

Plastic and oculoplastic surgeons are closely related but have some distinctions worth mentioning. Oculoplastic surgery mainly deals with the eyelids and structures around the eye, while standard plastic surgery covers the entire body. Here's an overview of the main differences between oculoplastic (eyelid) surgery and general plastic surgery. Read more

How Do Our Eyes Age (Jewish Chronicle, May 2019)

Tired, aged, droopy eyes? This article by London oculoplastic surgeon Dr Koutroumanos, explains the science behind it and what can safely be done for healthier and fresher eyes. Read more

Eyelid Ptosis

Oculoplastics in the News: What is eyelid Ptosis? What is a droopy eyelid and what can be done to correct this in London? Read more