Whilst upper eyelid surgery can be carried out under a local anaesthetic, lower eyelid surgery, particularly when the drawn look is addressed, usually requires a general anaesthetic. Excess skin is removed leaving a scar in the lid fold on the upper eyelid and underneath the lashes on the lower eyelid. These scars may extend outwards into the skin creases in the crows foot area.]

The extent depends on the amount of tissue removed.

As well as removing excess skin and fat, modern lower eyelid techniques lift the muscle envelope below the eye to rejuvenate the central or mid-face area, taking away the drawn look and restoring a more youthful appearance.

Surgery to upper or lower eyelids alone is usually carried out as a day case. Where both lids are treated patients are best managed overnight in hospital, where they can be nursed upright to minimise swelling.

At home it is advisable to use extra pillows in bed for a few days to help the swelling settle. As well as swelling, there will be bruising which usually takes 10-14 days to settle. This can often be covered with make-up as the bruising yellows. Any stitches are removed 5 days after surgery.

The eyes are often watery afterwards for a few weeks. This is partly caused by swelling of the white of the eye, (chemosis), and partly because the tear ducts do not drain as well when they are swollen and the tissues stiff. Chemosis may take longer to settle than the swelling of the skin.

Surgery is not usually painful and only simple analgesia is required. Most patients can return to normal day to day activities by 3 weeks. Eyelashes are numb for some months afterwards and the tissues stiff for some weeks. The scars, whilst usually settling very well, are pink to begin with and again can be disguised with makeup.

Impact exercises are best avoided for 4-5 weeks.

Wrinkles in the crows feet area will remain after treatment and, because skin is less elastic with age, there will always be some laxity of the upper eyelids when open.

For patients with laxity of the brow area a brow lift may be required to correct this.

As with all cosmetic procedures, complications from surgery are unusual.

Infection is rare. All patients will have some amount of bruising and black eyes. Larger collections of blood, (haematomas), are rare. The eyelids will be stiff for a number of weeks and may pull slightly. This usually settles without further treatment. The scars in the crows feet area are kept as short as possible. That leaves prominences, which will shrink down. Adjustments may need to be made to the scars to help that process. Artificial tears may be required for the first few weeks if your eyes feel dry.

Sometimes small white cysts can be seen along the line of a scar as it settles. These can be picked out with a needle. Blindness is described in the medical literature. This is associated with the use of adrenaline in local anaesthetic solutions, rough surgery and bleeding afterwards. It is exceptionally rare. Patients are not exposed to the risks.