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.
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 xpertise of his range of oculoplastic surgery from very young children to senior 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 aging. 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.
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 aging 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.
We understand that it is a big step to consider blepharoplasty 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 medsec@jonathanbritto.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
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If you wish to receive un-encryped, ‘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.
All upper blepharoplasty scars are hidden in natural crease lines of the upper eyelid – extending a little into the ‘crow’s feet’ smile lines beyond the corner of the eye. Depending upon the bespoke upper blepharoplasty technique much depends on the detail. Scars are controlled by good planning, good surgical technique, (which Jonathan can control) and the individual patients genetics of healing (which we can modify but cannot control completely). Upper blepharoplasty scars maturing beautifully and are often very well hidden, and the colour balance across the skin above and below the sky becomes increasingly uniform as time goes on.
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.
Immediately after the surgery, the upper eyelid scars will have Steri-Strips placed. These help to see you and dress the surgical incision. The strips will reduce eyelid opening for the period of time (one week) that they are usually in place, and this helps with healing. The visual field is therefore reduced in this early phase. After the surgery the scar of the upper eyelid blepharoplasty is initially tight and non-compliant, becoming softer and softer as the weeks pass. The upper eyelid will open normally, and the visual field will be unaffected. For combination surgery with upper and lower eyelids, artificial tears or topical antibiotics and gels may be used that cause blurry vision – washing away of the gel and blinking to spread the surface drops will solve the problem.
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 Plexr or radio-frequency 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.
The cost of upper blepharoplasty surgery is divided into surgical fee, which includes a schedule of follow-up for one year (in practise unlimited), the anaesthetic fee, and the facility fees (hospital or clinic). A full explanation of terms and conditions, including fees for secondary surgery or return to theatre is provided during the ‘analysis phase’.
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
