The eyes are often the first area to reveal the effects of ageing. Droopy lids, puffiness, bags, or dark circles can create a tired or heavy look, even when you feel well-rested. When these concerns begin to appear, patients may pursue eyelid surgery as a way to restore a brighter, more youthful expression. Also known as blepharoplasty, this versatile procedure can refresh and revitalise the facial aesthetic.
Depending on your individual goals, our London Consultant Plastic Surgeon, Mr William Townley, may recommend surgery for the upper eyelids (upper blepharoplasty), the lower eyelids (lower blepharoplasty), or a combination of both. Before moving forward with a tailored plan, Mr Townley believes it is important for patients to understand the distinctions between these approaches.
Upper Eyelid Surgery
Upper blepharoplasty typically involves the removal of excess skin and fat on the upper lids. Incisions are usually placed within the crease of the upper eyelid, which generally results in minimal and discreet scarring. Through these incisions, Mr Townley can remove excess skin, reposition or reduce fat, and tighten the underlying tissue to restore a smoother lid contour.
For patients with moderate to severe brow ptosis (drooping of the eyebrows), upper eyelid surgery alone may not fully correct the heaviness in the upper eye region. In these cases, Mr Townley often recommends combining upper blepharoplasty with brow lift surgery, a strategy which can address both the eyelid and brow position for more balanced rejuvenation.
Furthermore, the benefits of upper blepharoplasty can be functional as well as aesthetic. As the skin loses elasticity and begins to sag, it can hang over the natural eyelid crease; not only can this drooping create a heavy, tired, or even angry appearance, but it can interfere with the patient’s ability to see properly. By removing excess skin and refining the eyelid contour, upper blepharoplasty can restore a clearer field of vision while rejuvenating the overall appearance of the eyes.
Benefits of Upper Eyelid Surgery
When performed by a seasoned Consultant Plastic Surgeon like Mr Townley, upper blepharoplasty can:
- Restore a refreshed, more alert appearance
- Reduce heaviness and puffiness in the upper eyelids
- Improve vision where drooping skin obstructs sight
- Leave little to no visible scarring
Lower Eyelid Surgery
Lower blepharoplasty focuses on rejuvenating the area beneath the eyes. Common concerns include puffy under-eye bags (caused by protruding fat), loose or crepey skin, hollowing at the eyelid–cheek junction, and dark shadows that contribute to a chronically tired appearance.
For lower eyelid surgery, Mr Townley frequently employs a transconjunctival, or “internal,” incision, which is placed inside the eyelid to avoid visible scarring. Through this approach, fat can be sculpted or repositioned to smooth the contour of the lower lid and reduce puffiness. In some cases, Mr Townley may use fat grafting to restore lost volume and create a smoother transition between the eyelid and the cheek. To enhance support and prevent drooping of the lower lid, he may also tighten the ligaments around the eye using a method known as canthopexy.
Benefits of Lower Eyelid Surgery
In the hands of a skilled provider, lower eyelid surgery can:
- Reduce or eliminate puffy under-eye bags
- Smooth the eyelid–cheek junction for a softer effect
- Create a more rested, balanced facial appearance
- Produce minimal scarring (as incisions are often hidden inside the eyelid)
Combining Upper and Lower Eyelid Surgery
For many patients, signs of ageing appear in both the upper and lower eyelids at the same time. Combining the two procedures in a single operation can provide a more comprehensive and harmonious rejuvenation of the entire eye area. This approach can also reduce overall downtime compared with staging surgeries separately.
During consultation, Mr Townley carefully evaluates the anatomy of the eyes, brows, and surrounding facial structures to determine whether a combined procedure is appropriate or whether it is best to address one area first. His goal is always to achieve balance, refreshing the eyes so they look natural, expressive, and in harmony with the rest of the face.
Which One Should You Choose?
The choice between upper vs. lower eyelid surgery (or a combination of both) depends on several factors:
- The specific concerns you wish to correct (e.g. hooded lids, puffiness, hollows, dark circles, or heaviness)
- Your skin quality and elasticity
- How much excess skin is present
- Your overall health and eye condition
- How much recovery time you can allow for
- Your goals for long-term results
Schedule Your Consultation
Mr William Townley is renowned for his knowledge of facial anatomy and record of exceptional cosmetic and reconstructive outcomes. Whether you are considering upper eyelid surgery, lower eyelid surgery, or a combined approach, his goal is always subtle, balanced rejuvenation. Contact our office today to schedule your consultation and begin your journey toward your ideal facial aesthetic.
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