Eyelid lift surgery, also known as blepharoplasty, is a safe and effective way to rejuvenate your appearance and restore a more youthful, rested look without altering your facial features.
When performed by a skilled surgeon, this procedure can produce a subtle, natural-looking result that is virtually undetectable to others. You can achieve a vibrant younger appearance that will boost your confidence in both social and work settings.
In this article, we interview Dr. Nick Koutroumanos about how the eyes change with age, causing a tired look. He explains how eyelid lift surgery (blepharoplasty), both upper and lower, can help to reverse these changes and refresh the eye area.
What happens to the eyelids as we age to make us look tired?
“A lot of the changes that occur with age in the periocular area [area around the eyes], have so many things in common with changes that occur with age in our entire body,” explains Dr Nick. These changes include loss of skin elasticity, the effect of gravity and volume loss.
“With the loss of skin elasticity, the skin stretches and becomes more abundant. The tissues behind the skin also lose volume, and therefore support.” Dr Nick says this results in sagging skin around the eyes.
He goes on to describe the role of gravity.
“Gravity mainly affects the tissues that hold the skin in place. There are tiny little adhesions that effectively support the skin, and everything behind that effectively holds our face on to a bone. So as we age, gravity makes those adhesions weaker. The effect of this on the skin, coupled with loss of elasticity results in wrinkles or extra skin that sags.”
But extra skin around the eyelid isn’t the only characteristic feature that can give you a tired look. Loss of volume also plays a role, as Dr Nick explains.
“Volume loss can create visible tear troughs which can then create shadows and dark circles. Volume loss can also create a difference in how much of the eyelid you can see, which we call the eyelid show. This is one of the main characteristics we address with a blepharoplasty.”
In practical terms, all these changes result in excess skin on the eyelids and a hollowed appearance that results in a characteristic tired look.
When do these changes start happening?
Both men and women can experience changes in the appearance of their eyes as they age. These changes usually start in the mid-20s, but may not become noticeable until later in life, such as in your 40s or beyond.
However, the timing and extent of these changes can vary greatly from person to person. Some people may notice excess skin around the eyelids and hollowing of the eyes in their 30s or earlier. while others may not experience these changes until later in life, or not at all. The shape of a person’s eyes can also influence when and if these changes occur.
How can a blepharoplasty reverse the aging changes?
My cataract and blepharoplasty operations have been a resounding success. With my eyelids lifted, my daughter tells me I look ten years younger. It’s as if I have had a mini facelift.
Catherine S, London-Melbourne, 9th June 20211
Eyelid lift surgery or blepharoplasty may seem like a single procedure, but as Dr Nick explains, there are actually several different surgical techniques and approaches that can be used. The techniques used depend on the specific ageing changes being treated. This allows for a more customised and effective treatment plan.
In upper eyelid surgery (upper blepharoplasty) the primary concern is excess tissues around the eyelids, but that doesn’t mean that every operation is the same. Dr Nick elaborates.
“Every case is designed according to the patient. You don’t just offer a cookie cutter approach. So you either remove skin, or skin and muscle, or skin muscle and fat, and you reposition the crease. All of this is done in a hidden incision which heals within a couple of weeks, you can’t see anything.”
In lower eyelid surgery (lower blepharoplasty), Dr Nick says that the main goal is to smoothen the surface between the eyelid and the cheek.
“In the lower blepharoplasty, you can shrink lower lid bags and smoothen the interface between the lower eyelid and the cheek. This is achieved either by removing or repositioning the orbital fat using different techniques depending on the patient,” says Dr Nick.
Whether your lower eyelid surgery involves removing excess skin or fat or restoring volume for deep tear troughs, creating a smooth, cohesive transition between the eyelid and cheek can drastically improve the overall appearance of the eye area and give a more rested and youthful look.
So, can eyelid lift surgery make you less tired?
In the right hands, absolutely yes. Eyelid surgery can restore a younger look, but it requires an individualised approach to the upper and lower lids.
A surgeon with in-depth Oculoplastic training will be able to create a bespoke surgical plan to essentially sculpt the eyelids to your desired outcome. Importantly, they are able to do this without leaving any scars or other signs that you’ve had any surgery.
To learn more about how successful eyelid lift surgery is, read this article next: How successful is eyelid lift surgery (blepharoplasty)?
About Dr Nick Koutroumanos
Dr. Koutroumanos is a Consultant Ophthalmologist at the Royal Free Hospital in Hampstead, London where he serves as head of the NHS Oculoplastic service. Dr Koutroumanos also has a private practice for both general Ophthalmology and Oculoplastic surgery with locations at The Hospital of St John & St Elizabeth in St John’s Wood.
He has undergone extensive training in eye health and eyelid surgery. Dr Koutroumanos completed a 7-year training program in Ophthalmology, primarily at the esteemed Moorfields Eye Hospital. He then received additional scholarship-funded Oculoplastic fellowships in London, Vancouver, New York, and San Francisco. This extensive training has given him a wide range of expertise in various eyelid surgery techniques. This allows Dr Koutroumanos to consistently achieve natural-looking results for his patients.
I had been considering upper eyelid surgery for some time, but didn’t know who to trust with it. I wanted an oculoplastic surgeon specialising in eyelid surgery rather than a general cosmetic surgeon […] My friends and family were astonished at the results and how amazing they were. I cannot thank Dr Koutroumanos enough. If I was to do this procedure again I would only choose him. My eyes look so young and now applying makeup is not an effort but so flattering.
Sheyda, London February 2022
View more verified patient testimonials on Top Doctors.
All surgical procedures come with risks and should only be done after a thorough assessment by a qualified surgeon. To find out whether you’re suitable for this type of operation, please contact the clinic for an appointment with Dr Koutroumanos.