Eyelid Surgery FAQs


    The procedure to rejuvenate the eyes (eyelids) is called blepharoplasty. Blepharoplasty involves a surgical procedure, performed as an outpatient under twilight sedation or light general anaesthesia, where the excessive skin and bulging fat of the upper and lower eyelids is removed and the youthful stance of the eyelids restored.

    Care must be taken not to overresect tissue but to create a crisp fold in the upper eyelid and not ‘hollow out’ the lid. This outpatient surgical procedure requires precision and experience to rejuvenate your ‘look’.

    eyebrow lift sydney

    Before and 6 years after Browlift, Facelift, Rhinoplasty

    When thinking about facial rejuvenation, it’s important to consider your eyes as well. “Droopy”, “sleepy” upper eyelids and excessive “baggage” on the lower lids are quite common complaints by many patients seeking cosmetic improvement around their eye area. Racial characteristics, excessive expression, allergies and sun exposure all contribute to “droopy” lids where loose skin bends down the eyelashes. Removal of the excessive skin above the eyes and readjustment of crows’ feet can be achieved through eyelid surgery known as blepharoplasty.

    It is important that the surgeon has experience in this procedure as it is of critical importance to remove just enough excess skin and tissue to create a crisp and appealing appearance.  If too much tissue is removed, there is the risk of the patient having too startled a look and worse yet not being able to properly close their eyes which can lead to dry eyes and other ophthalmological issues. In the lower lids, bulging fat is removed alleviating the baggage and reducing the dark rings under the eyelids.

    Facelift with Blepharoplasty (Eyelid lift)

    Not all reasons for cosmetic surgery are wholly aesthetic, as many people also look to rectify things like peripheral vision obstruction via these cosmetic procedures.

    There will be cases that may not benefit from cosmetic surgery and it is always important to receive the correct diagnosis before opting for a cosmetic procedure. The consultation step, the first in Dr. Hodgkinson’s process is the best way to understand your situation and the best path forward.

    If problems via an obstruction to your peripheral vision are the main or sole driver of your research into cosmetic procedures, Dr. Hodgkinson may be able to help. While not all reasons for cosmetic surgery are purely aesthetic, it is essential also to recognise that not all causes of peripheral vision obstruction can be rectified via these procedures.

    There is a range of visual impairment conditions that will not benefit from cosmetic surgery such as glaucoma, a detached retina, and compression of the optic nerve. If a loss in vision is your main or only concern, we strongly recommend that you see an eye doctor first. They will be able to give the correct diagnosis, which will indicate if a cosmetic procedure would be of benefit to you.

    Beauty is subjective, and your idea of beautiful eyes may be different from someone else. During your consultation, Dr. Hodgkinson will work with you to find a look that you love, which also suits your aesthetic and will appear natural. The goal should be an eyelid that suits your unique facial characteristics with a harmonious result.

    A natural symmetric upper eyelid fold is often the priority for most patients, as is a stable supratarsal fold or a dynamic fold which will vary based on eye position. We may also look to remove upper eyelid fat to reduce the appearance of puffiness in the upper eyelid. You can rest assured that Dr. Hodgkinson will assess your unique look to formulate a strategy to enhance your features naturally.

    double eyelid asian eye surgery

    Making eyelid creases symmetrical

    Dr. Hodgkinson will work with you during your consultation to find a natural look that suits the aesthetics of your facial features.

    An upper lid blepharoplasty should remove just enough redundant skin from the upper lids to reveal a nice lid fold. If excessive skin is removed, patients may be unable to close their eyes properly. A well done blepharoplasty will leave enough skin on the lids to allow normal eyelid closure and showing a natural fold on which to apply eye makeup.



    Upper Eyelid Blepharoplasty

    You will be sedated intravenously and locally anaesthetised around the eye area. You will not feel any pain, possibly just a slight pulling sensation. After surgery ice-soaked gauze applied to the eyelid area reduces swelling and bruising.


    Upper Eyelid Blepharoplasty

    Everyone experiences different levels of pain due to their individual threshold; however, we have had a wide variety of patients who claim that eyelid surgery is relatively comfortable. It is quite rare that patients require narcotics or sedatives; however, these are on hand to reduce discomfort should they be required.

    Usually Panadol or sedatives only are needed to reduce discomfort. Ice soaked eye pads reduce swelling and soothing eye drops are used post-operatively. It is also possible to use ice-soaked eye pads to reduce swelling and ease any discomfort that may be experienced post-operatively.

    The duration of surgery is often dependent on the complexity of your specific procedure. Dr. Hodgkinson will need to gain an understanding of whether he is just operating on the eyelids, or if there is a need to also look at the eye bags (often more for aesthetic purposes).

    This will alter the time frame; however, just eyelid surgery is usually performed on an outpatient basis. The procedure involves simply a local anesthetic and an estimated surgery time of one to two hours.

    To understand the exact time frames relevant to you, speak to Dr. Hogkinson during the initial consultation. Once your situation and requirements have been discussed and thoroughly assessed, we will have a clearer understanding of durations. It is important to note that in all cases, you will require someone to drive you home after the procedure.

    It is quite common and no cause for alarm if you experience swelling, bruising, or redness, especially immediately after your procedure. There may be a small chance of watery eyes or light sensitivity, which can be helped by using a cold compress and keeping your head elevated. This will help reduce any swelling while also minimising discomfort. Eye drops may also be used if needed to lessen transient symptoms.

    This information on the appropriate products will be given by our team if necessary.

    Complications with this procedure are very rare, and Dr. Hodgkinson has many years of experience performing these surgeries on an extensive range of patients. However, as with any surgical procedure, there are risks that we make our patients aware of. These can include;

    • Bleeding (very rare)
    • Infection (very rare)
    • Blurred or double vision (exceptionally rare & transitory)
    • Loss of vision (exceptionally rare – Dr Hodgkinson has never had a case.)
    • Lid sagging in the upper or lower region (exceptionally rare)

    These conditions are likely only to be temporary, and our team works very hard to ensure that your procedure and recovery will be as safe as possible.

    In the case of eye bag surgery, it is unlikely that it will be covered by your health insurance provider, depending on your level of cover, as it is deemed an elective surgery. Only those deemed medically necessary are eligible for a rebate. We will have a clearer idea about this during your consultation; however, in most cases, this request is for aesthetic improvements only.

    Cases in which eyelid surgery is covered under an insurance policy need to be deemed medically necessary, usually due to a loss or obstruction of vision. If peripheral vision loss is an issue for you, we will be able to give you a clearer idea about what may or may not be covered by insurance. This will also be the time to receive the exact pricing for your procedure.

    Each patient is different, but some post-surgery outcomes can include;

    • Swelling for an extended period of time
    • Bruising
    • Tearing
    • Dry eyes
    • Conjunctiva
    • Itching
    • Blurring of vision
    • Tightness
    • Small scarring of the upper or lower eyelid area
    • Minor asymmetries in eyelid position

    All these problems are transitory and easily managed if they occur.

    Much like the duration time of your procedure, your recovery time is dependent on how complex your surgery is. In most cases, you will be allowed to go home when our team has confirmed that the local anaesthetic has worn off.

    Even with an understanding of your requirements, it can be challenging to give an exact recovery time due to the different healing abilities of each person. On average, a full recovery is usually seen around the 2-3 week mark.

    Dr. Hodgkinson and his team are well known for their highly skilled aftercare, ensuring that all patients are entirely supported through their recovery process.

    The team is on-hand to assist you at any point should in the very rare occurrence that you experience any difficulty. Dr H. Hodgkinson creates a safe and pleasant experience for all of his patients backed with total support from his experienced team. If you should have an issue during your aftercare process, the team is on-hand to assist you at any point.

    Several factors may require a different technique or render a patient ineligible for this procedure. These can include dry eye syndrome, uncontrolled medical conditions like hypertension, or prominence in the eyeball. The anatomic conditions of eyelids and the quality of the skin can also play a role when selecting this procedure as the best surgical option for a patient.

    It is also important to note that eyelid surgery is not the same as a facelift, despite using a similar technique. Blepharoplasty is only concerned with the eye region, whereas a facelift works with the lower part of the face. These treatments can be combined if that is necessary for achieving the overall goals of the patient.

    The slightest pulling down of the lower eyelid tissues can cause the white of the eye to be over-exposed, resulting in a ‘round eye’ or a severe, ‘hound dog’ appearance. Dr. Hodgkinson will determine who is at risk of developing this problem and use surgical procedures, such as canthoplasty or canthopexy, and temporary tarsorrhaphy to prevent the dragging down of the eyelid. A lazy eye (ptosis of the eyelid) is caused by a weakening of the lid-opening mechanism and can be repaired at the same time as blepharoplasty.  It is important to recognise the lazy eye pre-positioning.

    Yes, it is quite common for a Blepharoplasty to be performed with other procedures such as a face or brow lift. This is dependent upon your aesthetic goals and the recommendations made to achieve them by Dr. Hodgkinson during your consultation.

    As we age, it is common, in both women and men to not only develop droopy upper eyelids but baggy lower eyelids as well.  Eyelid surgery, which is technically know as upper or lower blepharoplasty is used to improve the appearance of the upper and lower eyelids.  For the lower eyelids, a transconjunctival approach is usually used, whereby the incision is placed inside the eyelid and to remove the excess tissue.  This means that there are generally no visible scars whatsoever with lower eyelid surgery.  It is critical that the surgeon has extensive experience in eyelid surgery as if too much tissue is removed or the incision is not appropriately placed, the patient may have resulting problems such as drooping of the lower eyelids known as ectropion.


    Upper and Lower Blepharoplasty

    A relatively straightforward and painless procedure, eye bag reduction is performed under either a local anaesthesia and sedation or general anaesthesia, whichever is deemed more appropriate based on the complexity of your requirements.

    In the transconjunctival approach an incision is made inside the lower eyelid or in the subciliary approach just below the lower lash line, after which the excess skin or fat is removed. These incisions are then closed with sutures or surgical tape with medications or ointment prescribed if required, to assist the healing process and prevent infection.

    Double Eyelid Surgery

    Some Asian patients don’t have an upper eyelid fold when their eyes are open but want to have what is called the “double eyelid” fold. Basic techniques just use a stitch through the eyelid which does not last very long.

    The surgical procedure that creates the best, permanent result involves making an attachment between the levatar muscle that lifts the eyelid and the skin of the eyelid. Caucasian and Asian patients have a natural attachment, but it is usually much lower in Asian eyes, so may not be noticeable when the eyelid is open.

    It is very important to make the fold the correct height. If a Caucasian height is chosen it may look unnatural for an Asian so a midheight is usually best. The procedure involves very carefully making a symmetrical incision, taking a very conservative amount of fat and stitching a connection between the levatar muscle and the skin. Twilight sedation is used so the patient can open their eyes during the procedure to ensure the folds are absolutely symmetrical.

    Blepharoplasty-asianUpper Eyelid Blepharoplasty

    Yes!  Dr Hodgkinson has thirty years’ experience in Asian eyelid surgery and a large percentage of Asian patients in his practice. He has also been a frequent member of the faculty at the Oriental Society of Aesthetic Plastic Surgery (OSAPS) conferences.  Dr. Hodgkinson often has the privilege of lecturing in Asia at cosmetic surgical meetings, as a guest lecturer in China, Taiwan, Thailand, the Philippines, Malaysia, South Korea, and Singapore.

    These opportunities have exposed him to Asian aesthetic surgery, and the top Asian aesthetic surgeons and about 15% of his patients in Sydney are of Asian or of Oriental extraction, or Eurasian. Dr. Hodgkinson enjoys working with these different ethnic subgroups and customising their eyelid and facial surgery to their particular aesthetics while making sure that the operation approximates to their ethnic ideals.

    He uses advanced techniques with permanent results, not the simpler stitch through the eyelid which might be less expensive but is less predictable and does not last long. Dr Hodgkinson is very careful to make sure that the fold/crease in the eyelid is at the correct height and has a natural and attractive Eurasian look.  The procedure is usually performed under twilight sedation to enable the patient to open their eyes during the procedure to ensure that the folds are absolutely symmetrical.


    Oriental Eyelid Blepharoplasty

    As with any surgery, there are some potential risks, however many patients come to Dr. Hodgkinson for his impeccable track record of various cosmetic surgery procedures with minimal complications. It is still essential for all patients to be aware of the potential risks associated with double eyelid surgery, which can include infection, bleeding, or abnormal scarring. The incidences of these complications are very small, and Dr. Hodgkinson’s team has a very effective aftercare process to monitor the progress of your recovery, which will allow for the early detection of potential complications.

    If you have had an unsuccessful double eyelid surgery performed by another surgeon, we can assist with revision double eyelid surgery. You may notice some asymmetry of the upper eyelids or prolonged swelling and puffiness as the result of a previous surgery. If this is the case, Dr. Hodgkinson can assess your situation and apply his comprehensive understanding of Asian eyelid surgery to produce a result that you will be much more comfortable with.

    As double eyelid surgery is performed as day surgery, you will likely be able to return home after the procedure. You may experience some mild discomfort such as swelling and bruising for anywhere between a few days up to two weeks. Every patient experiences a different healing process; however, most patients can return to office-style work after one week and light exercise after two.

    The effects of aging may determine the requirements of your surgery as excess upper eyelid skin caused by age may also need to be addressed. The same applies to a drooping brow that may be found in the older Asian population.

    Regardless of your age, however, Dr. Hodgkinson has the required years of experience and precise skills to achieving a natural look for the upper eyelids. Any complications that may be presented due to your age will be taken into account in the planning phase of your surgery and dealt with accordingly to ensure you receive the best result possible.