Local anaesthetic or “twilight” (conscious sedation)
Nil required, outpatient procedure
Not required. Daycase surgery
Within natural lines of skin creases in upper lid and crow’s feet wrinkles
Steri- strips for seven days
From £2700 for surgery, anaesthesia, facility fee and follow up
What is an upper blepharoplasty?
On the face of it, upper blepharoplasty (upper eyelid lift) surgery may seem to be a somewhat simple exercise, however, all is deeper than it seems on first view! Eyelid surgery for the upper and lower eyelids is perhaps the most sought-after set of procedures from Jonathan, based on the detail of his analysis and the expertise of his surgery, which includes craniofacial oculo-plastic reconstruction and restoration in very young children to advanced adulthood.Upper blepharoplasty is in fact a ‘family’ of related surgical procedures, the aim of which is to create a natural balance between the eyebrow, the orbit, the upper eyelid crease, and the eyelash line – for a youthful and defined upper eyelid ‘shelf show’.
Some upper eyelids lose definition and comfortable function because of an excess of skin and muscle within the eyelid (intrinsic excess), which drops down like a set of ‘Venetian blinds’ over the upper eyelid shelf. In other upper eyelids, there is no skin/muscle excess, just an intrinsic laxity where the skin and muscle drops down over the eyelash line like ‘a loose pair of socks around the ankles’! The solution to this is not the removal of excess skin/muscle, but the elevation, definition, and stability of the restoration of the upper eyelid crease. Indeed, removal of skin/muscle in this situation would create difficulty in eyelid closure – an adverse event to avoid!
Ageing creates a loss of eyelid definition. However, not all loss of eyelid definition is from ageing. The analysis of the upper eyelids matters. A youthful volume above the eyelid crease is a beautiful feature, whereas an excess of tissue below the eyelid crease leads to a loss of comfort and definition in the upper eyelid. Some loss of definition might be related to ethnicity – an Oriental upper eyelid can be re-crafted to feel less heavy by surgery to make a double fold – which creates an upper eyelid shelf that is more associated with a Caucasian upper lid. The upper eyelid blepharoplasty can therefore be used in a very bespoke way to create the desired upper eyelid shape and volume.
Jonathan knows the human face and the detailed impact of the function and shape of the eyelids on your confidence in appearance. Working with you, your photographs from throughout the years, and observing your natural face in conversation, animation, and in different light, he will restore and rejuvenate for you in a bespoke manner. Jonathan will combine his master craftsmanship of surgery with the artistic principles of light and shadow, definition and shape, to deliver comfortable eyelid function with natural beautiful and youthful appearance.
Some upper eyelid blepharoplasty is “functional” to remove excess weight from the upper eyelids and improve the visual field, whereas some upper eyelid blepharoplasty is requested mostly for appearance. It is very common for upper eyelid blepharoplasty, requested for appearance change, to deliver an unexpected improvement in comfort….At the Jonathan Britto clinic natural bespoke restoration of facial features underlines everything we do. Scars that are well placed, and as controlled in quality as possible. Function that is retained and comfort that is restored. Meticulous analysis, meticulous technique, and meticulous care, but all delivered with a warm smile and a personal welcome.
Time in planning, time in preparation, and time to develop the relationship between patient and surgeon, and with the members of the team, to deliver best care and confident results. Blepharoplasty delivered at the age of 40 is not the same, and does not have the same aims, as blepharoplasty delivered at the age of 75. The principles are timeless, but the indications, aims, alternatives for procedures, and expectations of outcome are bespoke.
We will undertake a comprehensive ‘analysis phase’ based on two or three pre-surgical consultations (as many as required), looking at the structure of the face and eyelids together – today and in comparison to photographs from the past (if available). We will study your skin, offering advice on affordable daily skin health prescribed products that work. Our aesthetician, Karen, will be on hand to mentor and advise your skincare for the best of skin health from season to season. This approach is particularly valuable for the “dark circles” which are a common feature of southern Mediterranean, African, and Asian skin types.
Prepare and repair! Our Lifestyle Medicine physician and consultant anaesthetist, Shyamala, will advise you on how best to prepare for your surgery, and the simple strategies you can incorporate into daily life to facilitate healing in the repair phase of recovery.
Following two consultations with Mr Britto, I was a very nervous patient, he made me feel at ease by the second consultation & explained the procedure & why my eyes always felt heavy, I looked tired all the time. I had upper blepharoplasty, the results are amazing. I can finally look in the mirror and not feel so disheartened as I was really conscious about my eyelids. I cannot thank Mr Britto enough, his expertise, knowledge & caring nature is second to none. I now have confidence in myself. Thank you so much Mr Britto
Verified Patient (Doctify)
Why consider upper blepharoplasty (upper eyelid lift) surgery?
Patients seek Jonathan’s oculoplastic surgery expertise for a variety of reasons. Some patients feel that their upper eyelid is droopy (ptosis), or heavy (dermatochalasis) and they are seeking greater eyelid comfort, or better function with an improved visual field. Other patients feel that the weight and heaviness in the upper eyelids reduces the upper eyelid definition and makes them feel old and look tired. Often, it is the combination of both appearance and function that leads to the request for upper eyelid blepharoplasty.Some patients seek to pre-empt the signs of ageing that they see in the senior members of their family, others seek a confidence boost after a midlife challenge or change of circumstance. All our patients have their story to tell – and they come to Jonathan for the appearance they wish to tell that story.
Both men and women consider upper eyelid lift surgery for many different reasons. It may be to correct an hereditary feature, or familial traits that they have become self-conscious about. They hear comments about “looking tired”, “are you unhappy?” that do not reflect their inner confidence and vitality.
The range of surgical and non-surgical techniques that are currently available offer a perplexing minefield of choices. Jonathan and his team will guide you through the options with clarity. What is your desired outcome? What recovery time is available to you? How do you approach matters of cost, and how do you perceive matters of risk? There are many horror stories about both surgical outcomes and non-surgical therapies. Which are true? What is the balance of risk, reward, recovery time and cost? All these questions will be answered by Jonathan with clarity, in plain and simple language, and backed up with a written report.
Many patients are referred to Jonathan from across the country and internationally who seek restoration from a poor surgical outcome elsewhere. These patients come to the clinic in a state of distress, and regret, and some feel aggrieved because of the costs they have faced. They feel torn between the feeling they cannot continue as they stand, but they are fearful of further surgery and further cost. We are very much aware of the psychological aspects of expectation unmet. Jonathan has worked with psychology teams who are expert in facial appearance from the beginning of his career, and he has built an expert psychology team which is available to all our patients. We never rush our patients, our philosophies and plans are explained in simple language, and we measure our outcomes and are happy to share them.Combination approaches are often considered and requested by patients who have learned of Jonathan’s comprehensive skills. Blepharoplasty techniques come from a ‘family’ of related procedures, many of which Jonathan has had a major hand in developing and presenting to colleagues. Jonathan will often combine blepharoplasty with specialised face and neck-lifting techniques or browlift. The aim is to create a naturally balanced face, at rest and in emotional expression, where each “aesthetic unit” of the face moves seamlessly with its neighbour.
Jonathan’s team has been at the forefront of developing the “twilight technique” of facial surgery, where patients are kept as comfortable and pain-free as can be – throughout the surgery, but without being completely asleep. This allows for a relaxed patient with the ability to open and close the eyes, or smile, with dynamic facial movement during the surgery for bespoke surgical technique. The ‘twilight technique’ also allows rapid recovery, minimal bruising and swelling, and no post-anaesthetic downtime.
We are at the forefront of measuring our results from blepharoplasty surgery. We will ask you to fill out some short pre-operative questionnaires, and then again at set times after the surgery. The ‘QPROM’ questionnaires were developed in the United States and have been recommended by the UK Royal Colleges of Surgeons to be adopted to measure results in aesthetic surgery. Jonathan’s consecutive facelift results are audited independently and ‘blindly’ on a quarterly basis, and are presented in peer review and professional appraisal.
We understand that it is a big step to consider blepharoplasty (eyelid lift) surgery. It is your face, it is on show, it is deeply personal, and it matters.The consultation is usually a 2-3 step ‘analysis phase’ at either our London or Essex clinics. Alternatively we can arrange a video consultation from the comfort of your own home.
1. Discretionary free-of-charge video-call
Jonathan will enjoy introducing himself to you in a free video-call to discuss your request. It would be very useful if you could send us some selfie photographs (to email@example.com; held securely as part of your medical record), which will help inform the conversation.
2. Face-to-face consultation
If you would like to receive a detailed written analysis, with a quote for treatment, Jonathan will meet you in clinic for a face-to-face appointment. You are welcome to bring a friend or family member for support. The medical history and physical analysis in the privacy of the consulting room is an essential part of making the treatment plan. After this meeting you will receive a detailed plan and a written quote, together with a suite of information about our ‘twilight’ surgeries, relevant comments from prior patients, and some insights about the psychology and holistic care that is part of our commitment to you.
3. Face-to-face or remote catch up…
Jonathan recommends that you open a “procedure diary” on your phone, into which you can drop any questions that occur to you throughout the day, and after receiving the clinic letter and information from your face-to-face consultation.
This third conversation is to answer any questions you have, and to allow Jonathan to ask you about any reflections he has had to refine your care.
…. Step 4…..
In truth, our door is always open, and Jonathan will be very happy to see you face-to-face or remotely if you have further questions about your requested procedure.
Consultation fees: £295 is charged prior to Step 2
Please be aware we use a data security software to encrypt any correspondence that we send you which includes your personal data. These emails may fall into your junk folder, so following your consultations please keep a regular check on this folder.
If you wish to receive unencrypted, ‘open’ email to your inbox – please can be requested via an online, ‘one click’ consent form.
After upper blepharoplasty surgery, (depending upon the combinations which may be requested), Jonathan recommends a minimum of 1 week away from work. Many patients in today’s world will work partly from home and remotely and may consider an early return starting with 2 to 3 hours per day. The repair phase is important, and rest is a vital part of this.Swelling and bruising are an inherent part of upper blepharoplasty surgery and are usually not perceptible to regular social contacts after two weeks. Return to driving is at at 1 week. Stitches are dissolving/removed between two and three weeks. Return to the gym is between 1 to 2 weeks with a gentle increase, and return to swimming at six weeks. You can shower at 48 hours. Sleeping position is best on your back with three pillows for gentle elevation to reduce swelling.
Every surgical procedure carries inherent risk, and risk events may happen despite every person in the team performing without error. In the ‘analysis phase’, Jonathan will discuss matters of risk for each type of procedure, backed up with a concise and clearly written document of risk. Jonathan is proud to run a practice that is low risk for patients, and, when a risk event rarely occurs, to provide a comprehensive open – door service to resolve matters.
Yes.Much depends upon how well the original surgery was done, and the aims of the current surgery. This will be discussed with Jonathan in the “analysis phase”. He will point out what the original upper blepharoplasty surgery has achieved well, and what has deteriorated, or has not gone well after the first surgery.
There is impact of all of this on the aims and indications of the proposed secondary upper blepharoplasty, on the alternatives available, and on the risks and responsibilities and expectations of outcome – all of which are comprehensively discussed.
In contemporary practice, about 50% of the patients that seek blepharoplasty/facelift combination surgery from Jonathan have had previous fillers to their faces. With a well conducted “analysis phase” Jonathan will explain how the filler has affected the eyelid function and appearance, and how the filler might affect the proposed surgical plan. If the previous fillers have been done well, with a light touch, in sensible parts of the face, then the risk is reduced. Jonathan will always urge patients to keep a “filler diary” of the product they have received, and the area of the face that has been treated.Other non-surgical therapies such as energy – based topical treatments will also change the way that the skin of the face and eyelids behaves, this may bring challenges during surgery, which is why Jonathan’s experience with a wide range of facelift techniques is particularly valuable for these challenging situations.
Upper blepharoplasty provides both functional benefit in comfort, and appearance benefit in contour. One of the simplest of the aesthetic surgical techniques, it is also one of the most difficult to get right for patients, to give confidence, youthful contour, and hidden scars. It can be undertaken under local anaesthesia as an outpatient procedure or combined with more extensive facial surgeries. Upper blepharoplasty provides very good value, consistently happy patients, and very consistently supportive reviews
A whole face can be changed very effectively but with great subtlety with an upper blepharoplasty surgery. Equally appreciated by men and women, very much technically determined by ethnicity and gender, the upper blepharoplasty is a deceptively simple but challengingly complex operation. It is a delight to achieve consistently happy outcomes for our patients who often go on to develop a long-term relationship with my team in my practice