Eyelid Surgery (Blepharoplasty)

Blepharoplasty is a surgical procedure that removes or repositions excess skin, muscle and fat around the eyelids. The NHS notes that an upper-lid blepharoplasty involves an incision placed in the natural skin crease above the eye, through which the surgeon removes excess skin and a small strip of orbicularis muscle, with conservative fat removal if needed. Lower-lid blepharoplasty may be performed either through a subciliary incision just below the lash line (transcutaneous) or through the inside of the lower lid (transconjunctival, leaving no visible scar) to remove or reposition orbital fat that creates 'under-eye bags' (NHS). The operation takes between 45 minutes and 2.5 hours depending on whether one or both lids are addressed. Candidates include adults with hooded or heavy upper lids that obstruct vision or the visible eyelid crease, and patients with persistent under-eye bags. Vision impairment from severe upper-lid dermatochalasis is, in some health systems, reimbursed as functional rather than purely cosmetic surgery (NHS). The procedure can be performed under local anesthesia with light sedation as a day case, or under general anesthesia if combined with other surgery. In South Korea, the most commonly performed eyelid operation is double-eyelid surgery (East Asian blepharoplasty), which creates or accentuates a supratarsal crease. Korean surgeons offer two distinct approaches: a non-incisional buried-suture technique, in which fine 7-0 sutures are passed through tiny punctate openings to tether the levator aponeurosis to the skin and form a crease without an open incision, and an incisional technique, in which a continuous 2-3 cm incision is made along the planned crease line, excess skin and small amounts of orbicularis and fat are removed, and the levator is fixed to the dermis. The single-knot continuous buried non-incisional technique has been described in the peer-reviewed Korean plastic-surgery literature as producing natural-appearing creases with reduced suture-related complications and shorter operating time (PMC). International patients typically plan a 5-7 day stay: surgery as a day case, suture removal at 5-7 days, and clearance to fly. Bruising and swelling usually take 2 weeks to fade, and the final crease shape settles at 2-3 months. Two weeks off work is the NHS guidance (NHS).