Blepharoplasty in Switzerland: a more rested look, from eyelids to dark circles

The eyelids are often the first area of the face to betray tiredness and age: skin hanging over the upper eyelid, bags under the eyes, hollow dark circles, eyes that look sad or heavy even when you feel well. Blepharoplasty is the procedure that corrects these changes. It is one of the most frequently performed cosmetic surgeries in Switzerland, among both women and men, and it has the particularity that, in some cases, it can be a functional procedure covered by insurance, when excess skin obstructs vision. This page explains how the eyelids work, which techniques exist, who they are for, how the procedure and recovery go, what the risks are, what insurance covers and where to consult in each of the 26 cantons.

Upper blepharoplasty removes excess skin, and sometimes fat, from the upper eyelid; lower blepharoplasty treats the bags and the junction between the eyelid and the cheek. It is often performed under local anaesthesia, as day surgery, and takes forty-five minutes to two hours depending on the eyelids treated. Bruising and swelling last one to two weeks; the scars become very discreet. An upper eyelid that obstructs the visual field, documented by an eye examination, may be covered by basic insurance. Before any upper blepharoplasty, the position of the eyebrow must be assessed: see our page on brow and temporal-midface lift. The budget, in percentage terms, is on our page on blepharoplasty prices in Switzerland.

The eyelid is a thin and complex structure that protects the eye, spreads tears and contributes to facial expression. It is made up of several layers, each of which can change with age.

The skin

It is the thinnest skin on the body, very supple and almost devoid of subcutaneous fat. It loosens easily and forms folds.

The orbicularis muscle

This circular muscle surrounds the eye and allows the eyelids to close, blink and squint. It plays an essential role in protecting the eye and must be respected during surgery.

The orbital septum

It is a thin membrane that holds back the fat surrounding the eye. With age, it slackens, and the fat bulges forward, forming bags.

Orbital fat

It forms pads, two in the upper eyelid and three in the lower eyelid. Their bulging creates the bags; their shrinking can, on the contrary, make the eyes look hollow.

The levator muscle

It lifts the upper eyelid. When it stretches or detaches, the eyelid drops over the eye: this is ptosis, which is different from simple excess skin.

The tarsus and tendons

The tarsus is a fibrous plate that gives the eyelid its shape. The tendons at the corners of the eye, or canthi, hold it taut against the eyeball. Their slackening, common with age, makes the lower eyelid less firm.

Eyelid or eyebrow?

Before an upper blepharoplasty, the surgeon always checks the position of the eyebrow. If the eyebrow has dropped, it pushes skin onto the eyelid and creates a false excess. Removing skin in this case would bring the eyebrow even closer to the eye and make the eyes look heavier. By gently lifting your eyebrow with your fingers in front of a mirror, you can get a first idea: if the excess disappears, the eyebrow is the cause.

Excess skin or ptosis?

An eyelid that covers the eye can have two causes: excess skin hanging down, called dermatochalasis, or drooping of the eyelid itself due to weakness of the levator muscle, ptosis. In the second case, removing skin is not enough: the muscle must be tightened or reattached. The surgeon distinguishes between the two by measuring the position of the edge of the eyelid relative to the pupil. Both situations can coexist.

When the skin of the upper eyelid hangs down, many people unconsciously raise their eyebrows all day to clear their vision. This constant effort of the forehead muscle can cause fatigue at the end of the day, headaches and marked forehead wrinkles. After blepharoplasty, the forehead often relaxes, and these symptoms decrease. This is also why the surgeon examines the position of the eyebrows with the forehead relaxed, so as not to underestimate their real descent.

Upper blepharoplasty

The surgeon draws the incision in the natural crease of the upper eyelid, sometimes extending slightly beyond the outer corner of the eye into a crow's foot line. They remove the excess skin measured beforehand, possibly a thin strip of muscle, and some of the protruding fat, especially near the nose. They take care to leave enough skin for the eyes to close perfectly. The scar, hidden in the crease when the eyes are open, generally becomes almost invisible.

Lower blepharoplasty through the internal approach

When the main problem is a fat bag without significant excess skin, the surgeon can go through the inside of the eyelid, through the conjunctiva. There is no visible scar. They remove or reposition the fat. This approach, called transconjunctival, is particularly suitable for young patients and firm eyelids.

Lower blepharoplasty through the external approach

When there is also excess skin or muscle, the incision is placed just below the lashes, then extends slightly into an outer wrinkle. The surgeon treats the fat, tightens the muscle and removes a thin excess of skin. They often combine this with tightening of the outer corner of the eye, to prevent the eyelid from being pulled down during healing.

Fat repositioning

Rather than removing all the fat from the bags, which can make the eyes look hollow over time, the surgeon can redistribute it to fill the tear trough, the groove between the eyelid and the cheek. The result is a smoother, more natural transition.

Fat transfer

When the eyes look hollow, a transfer of fat taken from the abdomen or thighs can fill dark circles and the tear trough, alone or combined with blepharoplasty. See our page on facial fat transfer.

Tightening the corner of the eye

When the lower eyelid is lax, the surgeon can tighten the tendon at the outer corner of the eye, with a simple suture or by reattaching it to the bone. This step prevents the eyelid from being pulled down after surgery and improves its firmness.

Ptosis correction

If the upper eyelid droops because of the levator muscle, the surgeon tightens or reattaches this muscle, often through the same incision as the blepharoplasty. This is more delicate surgery, as a few tenths of a millimetre affect the height and symmetry of the eyelids.

Variants

Some practitioners use a laser for the incision or to resurface the skin of the lower eyelid; see our page on laser blepharoplasty. Other requests can be treated without surgery; see our page on medical blepharoplasty.

Blepharoplasty mainly concerns people aged forty to seventy, but hereditary bags can appear in the twenties or thirties.

• Excess skin on the upper eyelid that makes the eyes look heavy or interferes with make-up.
• Bags under the eyes that persist even after a good night's sleep.
• A tired look, with hollow dark circles.
• An upper eyelid that obstructs vision upwards or to the sides.
• Asymmetry of the eyelids, due to laxity.

Precautions

Dry eyes, common with age, with screen use or among contact lens wearers, must be assessed and treated before the procedure, as surgery can make them temporarily worse. A history of refractive eye surgery, glaucoma, thyroid disease or facial paralysis must be reported. A very lax lower eyelid requires supporting steps. Smoking slows healing.

Men

In men, the upper eyelid crease is lower and less marked; the surgeon removes skin in moderation so as not to feminise the eyes. Bags are often the first request. The scars are as discreet as in women.

The interview

The surgeon asks what bothers you, since when, whether your eyes are dry, watery or irritated, whether you wear contact lenses, whether you have had eye surgery, particularly laser vision correction, and which treatments you take.

Examining the eyelids

They measure the excess skin, the position of the crease, the height of the edge of the eyelid relative to the pupil, the strength of the levator muscle, the protrusion of the bags and the depth of the tear trough.

The eyebrow

They assess the position of the eyebrow, at rest and when lifted, to distinguish excess skin from brow descent.

Lower eyelid firmness

They gently pull the eyelid down and observe how quickly it returns to place. A slow or very lax eyelid requires combined tightening.

Closure and dryness

They check that the eyes close completely and may assess tear production. Significant dryness may require prior treatment or an ophthalmological opinion.

Visual field

If the upper eyelid seems to obstruct vision, a visual field test at the ophthalmologist's documents the impairment, which is useful for a coverage request.

An eye examination before blepharoplasty is recommended in many cases: dry eyes, glaucoma, previous eye surgery, reduced vision, or when the procedure is requested for visual impairment and a visual field test is needed for insurance. This examination also allows an eye disease that would change the treatment plan to be detected.

Upper blepharoplasty is usually performed under local anaesthesia, sometimes with light sedation. Lower or four-eyelid blepharoplasty can be performed under local anaesthesia with sedation or under general anaesthesia. The procedure takes from forty-five minutes for upper blepharoplasty to about two hours for all four eyelids, and is generally performed as day surgery.

The markings

With you sitting up, eyes open and then closed, the surgeon precisely marks the skin to be removed, taking symmetry into account.

Local anaesthesia

It is given by small injections into the eyelid, after anaesthetic eye drops. They sting briefly, then the area is numb.

The procedure

The surgeon makes the incision, removes the skin, treats the fat and other structures according to the plan, then closes with very fine stitches.

The end

Cold compresses are applied. You go home after a short period of monitoring, accompanied, wearing sunglasses.

Cold

Cold compresses, applied without pressing, several times a day for two or three days, markedly reduce swelling and bruising.

The eyes

The eyes may be dry, watery, sensitive to light or slightly blurred because of the ointment. Artificial tears bring relief. A significant drop in vision or intense eye pain requires immediate medical attention.

Screens and reading

Possible in moderation from the first few days; the eyes tire quickly and become drier. Take breaks.

Contact lenses

These generally have to wait one to two weeks, according to the instructions.

Make-up

It generally resumes after the stitches have been removed and the scars have fully closed, with new products to limit the risk of infection.

Sun and sport

Sunglasses, a hat and sunscreen on the scars for several months. Gentle exercise resumes after two weeks, intense sport after three to four weeks.

Dry eyes

Common and usually temporary, dryness is treated with artificial tears. It may last longer in people who already had dry eyes.

Incomplete closure

If too much skin is removed, or while swelling persists, the eyes may not close completely for a few days. Lasting incomplete closure, which is rare, can expose the cornea and require correction.

Downward pulling of the lower eyelid

After an external approach, the lower eyelid may be pulled down, showing white below the iris, or even turn slightly outwards. Tightening the corner of the eye and cautious skin resection prevent this risk; massage or a correction may be necessary.

Asymmetry

Slight asymmetry is common at first. Persistent asymmetry can be addressed with a touch-up.

Hollowing

Excessive fat removal can make the eyes look hollow and older. That is why fat is often preserved or repositioned.

Haematoma behind the eye

A rare but serious complication: intense pain, an eye that swells and becomes hard, or a drop in vision in the hours following the procedure require immediate treatment. Call 144 or go to the emergency department without delay.

Scars and small cysts

Small white cysts may appear along the scar; they are easily removed.

These complications are rare, but they require very rapid treatment. In the first few hours after the procedure, keep your head raised, avoid exertion and apply cold as instructed. If in doubt, call without delay.

After blepharoplasty, especially lower blepharoplasty, the white of the eye may swell and form a small transparent pouch, called chemosis. It looks alarming but is generally benign; it reflects a build-up of fluid under the conjunctiva. It usually disappears within a few days to a few weeks, with eye drops, cold compresses and sometimes a light compressive dressing. If it persists or prevents you from closing your eye, contact the surgeon.

The result of an upper blepharoplasty is generally lasting: the excess skin removed does not come back, even though ageing continues. Many patients never need another procedure, or only ten to fifteen years later. The result of a lower blepharoplasty that treats bags is often very long-lasting. The eyes look rested and open, without any change in expression when the procedure is measured.

A successful blepharoplasty gives a more open, rested look while preserving the expression and identity of the face. People close to you often notice that you "look well" without identifying what has changed. It does not correct crow's feet, pigmented dark circles or a drooping eyebrow; these require other treatments, possibly combined.

The result of an upper blepharoplasty generally lasts many years, but the skin continues to age and the eyebrows may drop. A second procedure, often lighter, may be considered ten to fifteen years later. The result of a lower blepharoplasty is often very long-lasting, as fat bags rarely recur. A healthy lifestyle, sun protection and not smoking prolong the result.

A blepharoplasty performed to rejuvenate the eyes is cosmetic and remains at the patient's expense. But some situations are medical and may be covered by compulsory health insurance, according to the usual criteria.

Excess skin that obstructs vision

When the skin of the upper eyelid hangs down to the point of hiding part of the visual field, particularly upwards and to the sides, upper blepharoplasty may be considered functional. The impairment is documented by a visual field test at the ophthalmologist's, often performed with the eyelid free and then lifted, and by photos.

Ptosis

Drooping of the eyelid due to weakness of the levator muscle, which obstructs vision, is in principle a matter for medical treatment.

Lower eyelid malpositions

An eyelid that turns inwards, with lashes rubbing the eye, or outwards, with watering and irritation, also calls for functional surgery.

The process

The surgeon or ophthalmologist sends a prior cost approval request to your insurer, with the medical report, the visual field test and the photos. The decision rests with the insurer. If accepted, you pay your usual deductible and co-payment.

Combinations

If a cosmetic lower blepharoplasty is performed at the same time as a functional upper blepharoplasty, the two parts are billed separately.

In Switzerland, blepharoplasty is performed by plastic surgeons and by ophthalmologists specialising in eyelid surgery, sometimes called oculoplastic surgeons. Some maxillofacial surgeons and ENT specialists also perform it. Plastic surgeons are natural contacts for a cosmetic request or one combined with other facial procedures; oculoplastic surgeons for functional situations, ptosis and eyelid malpositions, or when there is an associated eye problem. University ophthalmology departments and the Lausanne eye hospital (Hôpital ophtalmique Jules-Gonin) treat complex situations. In all cases, check the practitioner's title in the MedReg register.

Because blepharoplasty is performed by many plastic surgeons and ophthalmologists, often under local anaesthesia, provision is closer to home than for many other procedures. For 52 cities, this table shows the usual place of consultation, the travel time, how easy stitch removal is around the fifth to seventh day and the usual price difference compared with Geneva for a cosmetic blepharoplasty.

The price depends on the number of eyelids treated, the technique, the anaesthesia and the city. The following table positions the procedures relative to one another, taking as a base of 100 a cosmetic upper blepharoplasty of both eyes under local anaesthesia.

Between cities, the differences follow the general trend: Geneva and Zurich at the top of the scale, medium-sized towns 10 to 20% lower. Details on our page on blepharoplasty prices in Switzerland.

These profiles are fictitious, inspired by common situations in Switzerland. They show the diversity of requests and responses.

Monique, 68, Sion: difficulty seeing

Monique had to lift her chin to read signs. The ophthalmologist found a clear upward reduction in her visual field, which disappeared when the eyelid was lifted. Her insurer agreed to cover the upper blepharoplasty, performed under local anaesthesia in Sion.

Thomas, 34, Zurich: hereditary bags

Thomas had had bags since adolescence, like his father. As his skin was firm, the surgeon proposed a lower blepharoplasty through the internal approach, with no visible scar, repositioning part of the fat.

Claire, 52, Lausanne: eyebrow or eyelid?

Claire wanted an upper blepharoplasty. The examination showed a dropped eyebrow. The surgeon proposed a temporal lift combined with a very measured upper blepharoplasty, explaining that blepharoplasty alone would have brought the eyebrow closer to the eye.

Hans, 61, St. Gallen: unrecognised ptosis

Hans thought he had too much skin. The examination revealed bilateral ptosis due to slackening of the levator muscle. Correction of the ptosis, combined with moderate skin removal, was covered by his insurance.

Sofia, 45, Lugano: hollow eyes

Sofia had hollow dark circles without real bags. The surgeon advised against a conventional blepharoplasty, which would have accentuated the hollow, and proposed fat transfer to the tear trough instead.

Peter, 57, Bern: all four eyelids

Peter had excess skin above and bags below. A four-eyelid blepharoplasty was performed under sedation, with tightening of the outer corners of the eyes. He returned to his office job after ten days.

"It changes the shape of the eyes"

Performed well, it lightens the eyes without changing the shape of the eye or the expression.

"The more skin removed, the better"

Removing too much skin prevents the eyes from closing. Caution is the rule.

"The fat in the bags must always be removed"

Removing too much makes the eyes look hollow; it is often preserved or repositioned.

"It removes crow's feet"

Wrinkles at the corner of the eye require other treatments.

"It lifts the eyebrows"

No; if the eyebrow has dropped, it must be treated separately.

"The scars are visible"

They are hidden in the crease or inside the eyelid and become very discreet.

"It is never reimbursed"

Documented visual impairment or ptosis may be covered by basic insurance.

"General anaesthesia is needed"

Upper blepharoplasty is usually performed under local anaesthesia.

The visual field is the extent of space that the eye can see without moving, upwards, downwards and to the sides. When the skin of the upper eyelid hangs down, it can hide the upper part of this field. To document this impairment, the ophthalmologist carries out a simple test: you stare at a point in the centre of a screen or dome and press a button as soon as you see a small light in your peripheral vision.

The test is often performed twice: with the eyelid free, then with the eyelid held up with adhesive tape. The comparison shows how much of the reduction is due to the eyelid. Together with the photos, this document is the central element of a coverage request. The test is painless and takes a few minutes per eye.

Dry eyes are very common in Switzerland, encouraged by screen work, dry air from heating in winter, air conditioning, contact lens wear, age and certain treatments. They cause a gritty sensation, burning, eye strain and sometimes, paradoxically, watering.

Why it matters

After blepharoplasty, blinking may be temporarily less effective and closure less complete, which worsens dryness. In someone who already has dry eyes, the discomfort may last longer.

Before the procedure

The surgeon looks for dryness, sometimes with a simple tear production test, and may ask for an ophthalmological opinion. Prior treatment with artificial tears, a night-time gel or eyelid margin care improves comfort after the procedure.

During recovery

Preservative-free artificial tears several times a day, ointment or gel at night, regular breaks from screens, humidifying the air.

Adapting the procedure

In people with dry eyes, the surgeon removes skin with extra caution and strengthens the support of the lower eyelid.

The term "dark circles" covers different realities that do not call for the same treatments.

Blepharoplasty effectively treats hollow dark circles and bags. It has no effect on pigmented or vascular dark circles, which require dermatological care or camouflage. A good diagnosis avoids a disappointing procedure.

Geneva

There is a wide choice between plastic surgeons, specialist ophthalmologists and the university ophthalmology department. Stitch removal and check-ups are just a few minutes away by public transport.

Vaud

The Lausanne eye hospital, plastic surgeons and ophthalmologists throughout the canton provide extensive coverage, including on the Riviera, in Yverdon and in Nyon.

Neuchâtel

Local plastic surgeons and ophthalmologists handle routine blepharoplasties; complex cases can be referred to Lausanne or Bern.

Jura

Local ophthalmologists perform visual field tests; the procedure can be carried out locally or in Basel, Biel/Bienne or Bern.

Fribourg

Local provision is bilingual; Lausanne and Bern are close for a wider choice.

Valais

Sion, Martigny, Monthey and Visp have practitioners; Upper Valais also looks to Bern.

Bern

The university ophthalmology clinic, plastic surgeons and many ophthalmologists offer a wide choice; Biel/Bienne offers bilingual provision.

Zurich

The widest choice of practitioners in the country, both plastic surgeons and oculoplastic surgeons.

Lucerne

Substantial local provision for the whole of Central Switzerland.

Uri

Uri residents consult in Lucerne; plan stitch removal.

Schwyz

Lucerne or Zurich depending on the part of the canton, with a few local practitioners.

Obwalden

Lucerne, about twenty minutes away.

Nidwalden

Lucerne, a quarter of an hour away.

Glarus

Zurich or St. Gallen; some tests can be done locally.

Zug

Local provision, supplemented by Zurich and Lucerne.

Solothurn

Solothurn and Olten have practitioners; Bern, Basel and Zurich are close by.

Basel-Stadt

The university clinic and many practitioners offer a complete choice.

Basel-Landschaft

Local provision and the proximity of Basel.

Schaffhausen

Local provision; Zurich and Winterthur for complex cases.

Appenzell Ausserrhoden

St. Gallen, close by.

Appenzell Innerrhoden

St. Gallen, about three-quarters of an hour away.

St. Gallen

Substantial local provision, the reference for Eastern Switzerland.

Graubünden

Chur has practitioners; from the valleys, stitch removal sometimes requires a long journey.

Aargau

Aarau and Baden have solid provision; Zurich is close by.

Thurgau

Frauenfeld, Kreuzlingen, St. Gallen and Winterthur offer several options.

Ticino

Lugano, Bellinzona and Locarno have practitioners; consultations in Italian.

The relationship between the eyebrow and the upper eyelid is the most important point to assess before upper blepharoplasty. With age, the tail of the eyebrow drops and pushes the eyelid skin down, creating an excess that does not originate in the eyelid. Patients often compensate by unconsciously raising their eyebrows, which etches wrinkles into the forehead.

If eyelid skin is removed without taking the eyebrow into account, the eyebrow, no longer held up, may drop further, and the eyes look heavier than before. This is one of the classic causes of dissatisfaction after blepharoplasty. A good surgeon therefore always examines the eyebrow, at rest and when lifted. If the eyebrow is the cause, they propose a brow lift, alone or combined with a more measured blepharoplasty. See our pages on brow and temporal-midface lift and on Endotine endoscopic lift.

Causes

In adults, ptosis is most often due to slackening or detachment of the levator muscle tendon, with age, after prolonged wear of rigid contact lenses or after eye surgery. More rarely, it is due to a neurological or muscular disease, which must be looked for when it appears quickly, varies during the day or is accompanied by other symptoms.

Diagnosis

The doctor measures the distance between the edge of the eyelid and the light reflex on the pupil, the excursion of the levator muscle and the position of the crease. They compare both sides.

Treatment

Correction involves shortening or reattaching the levator muscle tendon, often through the crease incision, sometimes from inside the eyelid. The procedure is delicate: a few tenths of a millimetre change the height. Local anaesthesia sometimes allows the height to be checked by asking the patient to open their eyes during the procedure.

Coverage

Ptosis that obstructs vision is in principle covered by basic insurance, once documented.

Lower blepharoplasty is more delicate than upper blepharoplasty, as the lower eyelid is subject to gravity and contributes to tear drainage. A lower eyelid pulled down after surgery exposes the eye, causes irritation and watering, and gives a rounded look to the eye.

Assessing firmness

Gently pulling the eyelid down and observing how it returns shows how firm it is. A lax eyelid almost always requires tightening of the outer corner.

Choosing the approach

The internal approach avoids any visible scar and preserves the supporting structure. The external approach allows excess skin to be removed, but requires great caution.

Treating the fat with restraint

Removing, reducing or repositioning fat according to the relief of the bags and the depth of the tear trough.

Caring for the skin

Fine wrinkles of the lower eyelid can be treated with a peel or laser rather than excessive skin removal.

During lower blepharoplasty, particularly in people whose lower eyelid is lax, the surgeon can strengthen the outer corner of the eye with a supporting stitch, called canthopexy, or by shortening the tendon, called canthoplasty. This step prevents the lower eyelid from dropping after the procedure and sometimes improves the shape of the eye.

It is assessed at the consultation with a simple test: the surgeon gently pulls the lower eyelid down and observes how quickly it returns to place. An eyelid that returns slowly indicates laxity that warrants support.

A feared complication of lower blepharoplasty is lowering or retraction of the eyelid, which shows the white of the eye below the iris and can give a sad look or cause dryness. It is encouraged by removing too much skin, an already lax eyelid and contracting scars. Current techniques, which remove little skin and support the outer corner, greatly reduce how often it happens.

During the first few weeks, slight lowering due to swelling is common and often corrects itself with upward massage recommended by the surgeon. If it persists, surgical correction may be proposed after a few months.

In people with bags but no excess skin, often younger, the fat of the lower eyelid can be removed or repositioned through an incision inside the eyelid, with no visible scar. This approach reduces the risk of the eyelid dropping. When the skin is a little loose, it can be combined with laser resurfacing or a peel to tighten it slightly. See our page on laser blepharoplasty.

One to two months before

Have any dry eyes treated. If functional coverage is being considered, have the visual field test done and wait for your insurer's reply. Stop smoking.

Two weeks before

On medical advice, suspend products that encourage bleeding. Avoid alcohol. If you wear contact lenses, have your glasses ready.

The day before

Prepare cold compresses or small cold packs, artificial tears, sunglasses and pillows. Remove your make-up carefully and do not apply any cream around the eyes on the day of the procedure.

On the day

Come without make-up or contact lenses, accompanied. Take your usual treatments according to the instructions you have received.

Before blepharoplasty, report all your medicines, including food supplements. Anticoagulants, aspirin, certain anti-inflammatories and supplements such as fish oil or ginkgo increase the risk of bleeding, which can be dangerous around the eye. Any decision to stop them is always made with the doctor who prescribed them. Glaucoma eye drops must be continued.

Well-controlled diabetes allows blepharoplasty to be performed in good conditions. Poorly controlled diabetes slows healing and increases the risk of infection. Review the situation with your doctor before the procedure, and report any retinopathy, which may require a prior ophthalmological opinion.

Well-controlled glaucoma does not contraindicate blepharoplasty. It is important to continue the drops, inform the surgeon and ophthalmologist, and check the eye pressure after the procedure. Some patients who have had glaucoma filtration surgery require particular precautions so as not to damage the operated area; the ophthalmologist gives their opinion before the procedure.

Before the procedure, prepare at home compresses or gel masks in the fridge, artificial tears, extra pillows, sunglasses, simple meals and a few activities that do not tire the eyes, such as podcasts or music. Reading and screens are possible in moderation, but they increase dryness. Also arrange your journey home, as you will not be able to drive on the same day.

Smoke irritates the eyes and eyelid skin, increases dryness and slows healing. Stopping smoking for several weeks before and after the procedure is strongly recommended. In the long term, stopping smoking also preserves the quality of the skin around the eyes and prolongs the result.

The markings

Sitting up, with your eyes open and then closed, you let the surgeon mark the excess skin to be removed. This step is essential for symmetry.

Anaesthesia

Anaesthetic eye drops, then small injections into the eyelids. Light sedation can help you relax. For all four eyelids, deeper anaesthesia is sometimes offered.

During the procedure

You may feel sensations of touch, see the theatre light through your eyelids, and sometimes be asked to open your eyes to check the height, particularly in cases of ptosis.

Discharge

After a short period of monitoring with cold compresses, you go home accompanied, wearing sunglasses, with your instructions and eye drops.

Around the surgeon, the nurse prepares the procedure, explains the care, accompanies you in the recovery room and gives you the written instructions. After discharge, the secretariat or nurse answers your practical questions about compresses, eye drops or bruising. Do not hesitate to contact them: questions in the first few days are very common.

Day 1

Swollen eyelids, tightness, slightly stinging eyes. Cold every hour, without pressing, rest with your head raised.

Days 2 and 3

Swelling and bruising at their peak, sometimes eyes slightly closed in the morning. Eye drops and ointment as instructed.

Days 4 and 5

Bruises turn yellow, swelling decreases. Short outings with sunglasses are possible.

Days 5 to 7

Stitch removal. The eyes already look more open, even if slight swelling persists.

The stitches of the upper eyelid, often placed in the crease, are generally removed after five to seven days. This quick step is painless or almost painless. With some techniques, absorbable stitches are used and fall out on their own. For a lower eyelid operated on from the inside, there are no visible stitches. After stitch removal, the scar is still pink; it gradually becomes very discreet in the eyelid crease.

Applying cold to the eyelids, through chilled compresses or gel masks wrapped in a cloth, reduces swelling and bruising during the first forty-eight hours. Sessions last about ten minutes, several times a day, without pressing on the eye. After the third day, cold brings less benefit; keeping your head raised and gentle walking take over.

In the weeks following blepharoplasty, the eyelids sometimes close less well at night and the eye can dry out, with a gritty or burning sensation. Preservative-free artificial tears during the day and a gel or ointment at night protect the surface of the eye. This dryness is generally temporary. Tell the surgeon if it persists beyond a few weeks.

During the first two weeks, limiting salt, alcohol and highly processed foods reduces water retention and eyelid swelling. Drinking plenty, sleeping with your head raised and walking regularly help the swelling to subside.

For the first few nights, sleep on your back with your head raised on two pillows to limit swelling. Avoid sleeping on your side or front for one to two weeks so as not to press on the eyelids. If the eyelids do not close completely during sleep, which is common at first, an ophthalmic gel or ointment protects the eye at night.

In the first few days, the operated eyelid may feel stiff or difficult to close completely because of the swelling. Blinking deliberately, without forcing, and gently closing your eyes several times a day help maintain good mobility. Grimacing, vigorous movements and rubbing your eyes should be avoided for the first few weeks. Normal mobility returns within a few days to a few weeks.

Eyelid bruising turns from purple to green and then yellow over one to two weeks. To hide it, wait for the surgeon's permission before applying make-up to the area, then use a peach concealer on purple and a yellow concealer on green. Tinted sunglasses are often the simplest solution during the first week.

Eyelid make-up is not advised for about ten days, until healing and stitch removal. Foundation can be applied earlier, avoiding the operated area. To hide residual bruising, a peach or yellow concealer is effective. Use new products for mascara and pencils, and remove make-up without rubbing.

• Are the swelling and bruising progressing normally?
• Is my lower eyelid properly in place?
• When can I resume contact lenses, make-up, sport?
• Should I massage the scar or eyelid, and how?
• Is the dryness I feel normal?
• Will the asymmetry I see fade?

Front photos, with eyes open and then closed, and profile photos, taken before the procedure and then at one week, one month, three months and six months, in the same light, help judge the result objectively. During the first few weeks, swelling and bruising are often worrying; the photos then clearly show the progress.

In most people, the upper eyelid scar becomes almost invisible, as it is placed in the natural crease and eyelid skin heals remarkably well. Its outer end, sometimes extended into a crow's foot line, may remain visible a little longer.

Bruising and swelling are most visible during the first week. Many patients resume a discreet social life after ten to fourteen days, possibly with sunglasses and a little make-up. For an important event, such as a wedding or a presentation, allow at least three to four weeks between the procedure and the date.

It is common for one eyelid to be more swollen or more bruised than the other during the first few weeks. This temporary asymmetry is due to bleeding and swelling, which are not always evenly distributed. It gradually fades. Asymmetry in the shape or height of the crease can only be judged after three to six months, once the swelling has gone.

Tingling, pulling, a feeling of heavy or, conversely, numb eyelids, watering eyes, sensitivity to light: these sensations are common during the first few weeks. They reflect the healing of tissues and small nerve endings, and gradually disappear. Increasing pain, reduced vision or spreading redness, however, require you to contact the team.

Many patients work at a screen and wonder when they can resume. Reading and screens are possible from the first few days, but the eyes, somewhat dry and swollen, tire quickly. Set the screen brightness to a comfortable level, enlarge the text, place the screen slightly below eye level so that you open your eyelids less, take a break every twenty minutes by looking into the distance, and use artificial tears. For office work, a return after a week is often possible, possibly working from home for the first few days.

A heavy upper eyelid can interfere with prolonged reading on screen, by slightly reducing the upper visual field and tiring the forehead. After blepharoplasty, many patients report more comfortable reading. During recovery, screens are allowed in moderation, with regular breaks and artificial tears.

Prescription glasses can be worn from the first few days, provided they do not rub the incisions; a light frame is more comfortable while swelling persists. Contact lenses generally have to wait one to two weeks, because inserting them requires pulling the eyelids apart and they can increase dryness. If you have worn contact lenses for a long time, particularly rigid lenses, tell the surgeon: prolonged wear can encourage slackening of the levator muscle, and therefore ptosis.

Prescription glasses can generally be worn from the next day, making sure that the frame does not rest on the scar or on a swollen lower eyelid. Light frames are preferable. Contact lenses generally have to wait one to two weeks, so as not to pull on the eyelids when putting them in and taking them out.

Men make up a large proportion of patients. Their requests often concern bags, which make them look tired, and excess skin that makes the eyes look heavy. In men, the upper eyelid crease is naturally lower, and the eyebrows lower and more horizontal: the surgeon removes skin in moderation so as not to create an overly open or feminised look. Male skin, which is thicker, sometimes stays swollen a little longer. The scars remain very discreet. Many men return to work after a week.

In men, the eyebrows are naturally lower and more horizontal, and the eyelid crease less high. A male blepharoplasty removes less skin and preserves this appearance, to avoid a feminised or surprised look. When the eyebrows are very low, the surgeon discusses it, but a brow lift is less often proposed in men, particularly in cases of baldness, because of the position of the scars.

In older people, upper blepharoplasty is often functional: the skin hides part of the visual field, forces them to lift their chin to see and causes tiredness at the end of the day. Once documented by a visual field test, it may be covered by basic insurance. The procedure, often under local anaesthesia, is well tolerated. Points to watch are dry eyes, which are more common, anticoagulant treatments, to be managed with the doctor, and thinner skin. The benefit to quality of life is often considerable.

Brow lift

When the eyebrow has dropped, it is treated at the same time, often before the upper blepharoplasty, to avoid removing too much skin. See our page on brow and temporal-midface lift.

Facelift

Blepharoplasty is frequently combined with a neck and face lift or a deep plane facelift, for harmonious rejuvenation. See our pages on neck and face lift and deep plane facelift.

Fat transfer

It fills hollow dark circles and temples. See our page on facelift and facial fat transfer.

Skin treatments

Peels or laser for fine wrinkles of the lower eyelid, botulinum toxin for crow's feet, performed during or after the procedure.

Botulinum toxin injections for forehead lines or crow's feet change the position of the eyebrows and the tension around the eyes. Before blepharoplasty, it is useful to wait until their effect has worn off, or at least to tell the surgeon, so that they can assess the real position of the eyebrows. After the procedure, injections can resume once healing is complete, generally after a month.

Hyaluronic acid injections

They can fill a hollow tear trough without significant bags. They require great experience, as eyelid skin is thin and the product can show or swell. See our page on medical blepharoplasty.

Botulinum toxin

It softens crow's feet and can slightly lift the tail of the eyebrow, without acting on excess skin or bags.

Surface technologies

Radiofrequency, lasers and peels improve skin texture and can tighten it slightly.

Limitations

None of these techniques removes significant excess skin or a pronounced fat bag. They are suitable for early-stage situations or as a complement.

• Does my problem come from the skin, the fat, the levator muscle or the eyebrow?
• Which technique do you propose for my lower eyelids: internal or external approach, removal or repositioning of fat?
• Do the corners of my eyes need tightening?
• Are my eyes moist enough for the procedure?
• Which anaesthesia, and can I go home the same day?
• Could my situation be covered by insurance?
• Can you show me results in comparable patients?
• What happens if a small excess of skin remains or asymmetry appears?

Check the practitioner's title in the MedReg register and their experience in eyelid surgery. Be wary of a proposal for upper blepharoplasty without an examination of the eyebrow.

A second opinion is useful if you are offered lower eyelid surgery, which is more delicate, or if different practitioners' proposals diverge, for example on whether a combined brow lift is worthwhile. Bring your photos, the visual field test if it has been done, and your questions.

Before the procedure, you sign a document that specifies the planned steps, the scars, the risks — including dry eyes, asymmetry, eyelid retraction and rare but serious complications — and the after-effects. Read it at home and ask your questions. You can withdraw up to the last moment.

For cosmetic blepharoplasty, a deposit is often requested on booking. Ask about the conditions for postponement in the event of conjunctivitis, a stye or a health problem, and about cancellation conditions. For a covered procedure, wait for the insurer's written reply before setting the date.

Upper blepharoplasty is often performed under local anaesthesia, in an equipped practice or clinic; lower blepharoplasty and combined procedures are more often performed in a clinic, sometimes under sedation or general anaesthesia. Check the facility's authorisation, the presence of an anaesthetist if sedation is planned, and the arrangements in case of complications outside opening hours.

Ignoring the eyebrow

An upper blepharoplasty that ignores a dropped eyebrow often disappoints.

Neglecting dryness

Untreated dry eyes make recovery uncomfortable.

Wanting all the bags removed

Excessive removal makes the eyes look hollow over the years.

Resuming make-up too soon

Wait until the scars have fully closed and use new products.

Ignoring intense pain

Severe eye pain with reduced vision is an absolute emergency.

Blepharoplasty. Eyelid surgery.

Canthopexy. Tightening of the outer corner of the eye.

Visual field. The extent of space perceived by the still eye.

Conjunctiva. The mucous membrane lining the inside of the eyelids and the white of the eye.

Dermatochalasis. Excess eyelid skin.

Ectropion. A lower eyelid turned outwards.

Entropion. An eyelid turned inwards, with lashes rubbing the eye.

Lagophthalmos. Incomplete closure of the eyelids.

Milium. A small, benign white cyst.

Levator muscle. The muscle that lifts the upper eyelid.

Orbicularis. The muscle that closes the eyelids.

Ptosis. Drooping of the eyelid due to weakness of the levator muscle.

Orbital septum. The membrane that holds back the fat around the eye.

Tear trough. The groove between the lower eyelid and the cheek.

Pollen

People with allergies often have itchy, red, watering eyes during the pollen season. Rubbing your eyes after blepharoplasty must be avoided at all costs. Schedule the procedure outside your allergy season, or have the allergy treated beforehand.

Sun and altitude

Recent scars and operated eyes are sensitive to light. In the mountains, summer and winter, the light is intense: wraparound sunglasses, a hat and sunscreen are essential for several months.

Skiing

Ski goggles press around the eyes. They can generally be worn again after a few weeks, once the scars have fully closed and the swelling has resolved. Ask the surgeon's advice.

Winter and heating

Dry air from heating worsens dry eyes. A humidifier and artificial tears make recovery more comfortable.

The upper eyelid crease scar, still pink in the first few months, can become pigmented in the sun. Wraparound sunglasses, a hat and, once the skin has closed, a sunscreen suitable for the eye area protect it. Sunglasses are also appreciated during the first few weeks to hide bruising and protect light-sensitive eyes.

In the mountains, intense light and reflection off the snow irritate eyes that are still sensitive. Good-quality, wraparound sunglasses are essential during the first few months. Stays at altitude pose no particular problem after blepharoplasty, but avoid intense exertion and skiing during the first few weeks.

Step 1: document the impairment

See an ophthalmologist, who performs a visual field test with the eyelid free and then lifted, and takes front photos. Depending on your insurance model, a referral from your family doctor may be needed.

Step 2: the cost approval request

The surgeon sends your insurer a coverage request with the medical report, the visual field test and the photos. They specify the planned steps.

Step 3: the reply

The insurer, often after consulting its medical adviser, accepts or refuses. If refused, you can ask for an explanation and, if necessary, send additional information.

Step 4: your contribution

If coverage is accepted, you pay your deductible, if not yet reached, and the 10% co-payment, capped annually.

Associated cosmetic procedures

A cosmetic lower blepharoplasty or brow lift performed at the same time is billed separately and remains at your expense.

• Do you cover upper blepharoplasty when the visual field is reduced?
• Which documents must be attached to the cost approval request?
• How long do you take to reply?
• If only one eyelid is covered, how is the other billed?
• Does supplementary insurance cover part of the cosmetic procedure?

Exertion that increases pressure in the head, such as carrying loads or bending over for long periods, should be avoided for the first two weeks, as it encourages bleeding and swelling.

Working from home is often possible after three to five days, limiting screen time and taking regular breaks. Returning to the office generally takes place after ten to fourteen days, once the bruising has clearly diminished. Physical jobs, those exposed to dust or involving carrying loads, require two to three weeks. The sick note does not state the nature of the procedure.

Your family doctor can prescribe the pre-operative check-up, review your treatments, particularly anticoagulants, and refer you according to your insurance model. The ophthalmologist assesses the health of your eyes, looks for dryness, glaucoma or another problem, and performs the visual field test for a functional request. After the procedure, both can provide local follow-up, in liaison with the surgeon.

In the first few days, your eyelids will be swollen and discoloured, and you will need rest and cold. Someone close to you must take you home after the procedure, as you will not be able to drive. Their help is invaluable for preparing cold compresses and reminding you not to rub your eyes. Also tell them about the one sign that requires immediate action: intense eye pain with reduced vision, which requires calling 144.

Young children who want to be carried or who touch your face can complicate recovery. Arrange help for the first week, avoid carrying them and explain that they must not touch your eyes for a few days. Quiet games and reading stories allow you to spend time together safely.

The eyelids are not just part of how the eyes look. With each blink, they spread the tear film over the surface of the eye, clean it and protect it from dryness and dust. At night, their complete closure prevents the cornea from drying out. The lower eyelid, held closely against the eyeball, guides tears towards the small drainage channels at the inner corner of the eye. That is why any eyelid surgery must preserve these functions: leaving enough skin for complete closure, respecting the muscle that allows blinking and keeping the lower eyelid in a good position. A good aesthetic result is only of value if it preserves the health of the eye.

Entropion

The eyelid, usually the lower one, turns inwards, and the lashes rub the eye. This causes irritation, redness, watering and a feeling of something in the eye. Surgical correction, generally simple, is indicated and is covered by basic insurance.

Ectropion

The lower eyelid turns outwards, exposing its inner surface. The eye waters, becomes irritated and can dry out. It occurs with age, after facial paralysis or sometimes after surgery. Correction tightens the eyelid and is also a medical matter.

The link with blepharoplasty

A lax lower eyelid must be supported during lower blepharoplasty to avoid ectropion after the procedure.

Some thyroid diseases, particularly autoimmune ones, can affect the tissues around the eyes: the eyes look more prominent, the eyelids retract and show the white of the eye, bags appear, and dryness and irritation are common. These changes are not a matter for conventional cosmetic blepharoplasty. They first require management of the disease by an endocrinologist and an ophthalmologist, then, once the situation has been stable for several months, possible specific surgery carried out by specialist teams. If you have thyroid disease, always mention it before eyelid surgery.

After facial paralysis, the upper eyelid may no longer close completely, and the lower eyelid may become lax, with a risk of the cornea drying out. Management is a matter for medicine and reconstructive surgery: protecting the eye with artificial tears and gels, then surgical steps to help closure or tighten the lower eyelid. These situations are followed by specialist ophthalmologists and surgeons, and are in principle covered by basic insurance.

Watering can seem paradoxical in someone with dry eyes: the irritated eye produces poor-quality reflex tears. It can also come from a lax lower eyelid that no longer guides tears into their channels, a blocked tear duct, an allergy or an infection. After blepharoplasty, temporary watering is common, due to swelling. Persistent watering warrants an eye examination, both before and after surgery.

Bags under the eyes are not always linked to age. In many people, they are hereditary and appear in the twenties or thirties, often like a parent's. They depend neither on sleep nor on lifestyle, although lack of sleep, salt or alcohol accentuate them in the morning. In these young patients with firm skin, a lower blepharoplasty through the internal approach, with no visible scar, often gives a very long-lasting result with a quick recovery. The fat is often repositioned rather than removed, to avoid hollowing years later.

Some people seek advice after a first blepharoplasty whose result does not satisfy them: residual excess skin, eyes hollowed by excessive fat removal, a lower eyelid pulled down, asymmetry or incomplete eye closure. Correction depends on the problem: further skin removal, fat transfer to fill a hollow, tightening of the lower eyelid, or even a skin graft where too much skin was removed. These revision procedures are more delicate and are a matter for practitioners experienced in eyelid surgery. They are generally discussed several months after the first procedure.

A touch-up is sometimes wanted to correct slight asymmetry, a small residual excess of skin, a widened scar or a persistent bag. It is discussed after six months, once healing is complete, and is often performed under local anaesthesia. The financial conditions should be known before the first procedure. Acting too early risks correcting a defect that would have disappeared on its own.

Some requests concern the shape of the eyes, particularly eyes that are more elongated towards the temples, sometimes called "fox eyes". Conventional blepharoplasty does not change the shape of the eye; it removes what weighs it down. Elongating the eyes calls for other procedures, such as a temporal lift or a change to the outer corner of the eye, which have their own limitations and risks. See our page on fox eyes.

• Check that the gaze is directed at the same point and that the lighting is identical: front lighting erases bags.
• Also compare the position of the eyebrows, which greatly influences the appearance of the upper eyelid.
• Look at the result after several months, once the swelling has gone.
• Note whether the eyes look natural, without a rounded outer corner or hollows under the eyes.

Here is the fictitious but realistic account of the recovery of a 58-year-old patient who had all four eyelids operated on under sedation.

Day 1

"Home by late morning. Eyelids swollen, a feeling of tightness. I apply the small cold packs every hour."

Day 2

"Swelling at its peak, eyes slightly closed on waking. Purple bruising under the eyes. I sleep sitting up on three pillows."

Day 4

"Feeling better. The bruises are starting to turn yellow. I read a little with artificial tears."

Day 6

"Stitches removed, almost painless. My eyes already look more open."

Day 10

"Back to work from home. A little concealer under my eyes and nobody notices anything on video calls."

Month 3

"The scars are almost invisible. My eyes look rested, without having changed. It's exactly what I wanted."

Every patient progresses differently; this diary illustrates a typical recovery.

The eyes are the part of the face to which other people's attention goes first. Heavy eyelids or pronounced bags give an impression of tiredness, sadness or lack of sleep, often at odds with how the person actually feels. That is why blepharoplasty has a major effect on the image projected, even though it changes very little. It does not change identity or expression: it removes what was blurring the message. Many patients say that people no longer ask them whether they are tired.

Observe

Note what bothers you: hanging skin, bags, dark circles, visual impairment, eyebrows.

Do the mirror test

Gently lift the eyebrow: if the excess disappears, the eyebrow is the cause.

Consult

A plastic surgeon or a specialist ophthalmologist assesses the eyelids, eyebrow, dryness and firmness.

Check insurance

If you have visual impairment, have a visual field test done and request cost approval.

Organise

Allow one to two weeks, cold compresses, artificial tears and sunglasses.

Cosmetic blepharoplasty is never urgent. Taking time to understand the examination, to compare two opinions if necessary, to choose the right period and to organise recovery avoids disappointment. A reputable practitioner does not push you to decide on the day and answers all your questions, including about what the procedure cannot correct.

• A front view, looking straight ahead, eyes open normally.
• A front view, eyes gently closed.
• A front view looking upwards.
• Two profiles and two three-quarter views.
• Close-ups of each eye, open and closed.
• An older photo, if possible, to compare the position of the eyebrows.

Take the photos in natural light, without make-up or glasses. Say whether you have dry eyes, wear contact lenses or experience any visual impairment, and give your eye history.

One year after blepharoplasty, the scars are practically invisible and the result is stable. Most patients no longer need any particular follow-up. Ageing continues, and some people consider a new, often lighter procedure ten to fifteen years later. Regular sun protection, care of the skin around the eyes and, if you wish, maintenance treatments such as botulinum toxin for crow's feet help preserve the result.

Many patients who have had eyelid surgery say they were first surprised by how much swelling and bruising there was in the first week, then by how quickly it disappeared. They then report a more rested look, comments from those around them on how well they look and, for those who had visual impairment, a wider field of vision and a less tired forehead at the end of the day. The rare disappointments mainly concern expectations about wrinkles or dark circles, which surgery alone does not correct.

These accounts are a reminder of the importance of a thorough consultation that clearly sets out what the procedure can achieve. They also show that preparing recovery well, with help, cold compresses and free time, makes the first week much calmer. Finally, they stress the need for patience: the final look emerges after a few months, once the last swelling has resolved and the scar has become discreet in the eyelid crease.

Beyond the price of the procedure, allow for the initial consultation, often charged for a cosmetic request, any eye examination, eye drops, artificial tears and ointments, good-quality sunglasses and days off work. For a procedure covered by insurance, your contribution is limited to the deductible and co-payment, plus any costs not covered.

If you live alone, arrange for a relative or friend to be with you for the journey home and the first night, as your vision may be blurred and your eyes swollen. Prepare cold compresses, eye drops and simple meals in advance and keep everything within reach. Most patients are independent from the next day. In the event of intense eye pain, call 144.

Before 35

Requests mainly concern hereditary bags or constitutional excess skin. The skin is firm and recovery quick.

Between 35 and 50

The first signs of laxity appear: skin of the upper eyelid starting to hang down, bags more visible in the morning, a deepening tear trough. The tail of the eyebrow may start to drop.

Between 50 and 65

Excess skin becomes clear, bags become established, and the eyes look tired. This is the age at which blepharoplasty, often of all four eyelids, is most common.

After 65

Excess skin can obstruct vision, the lower eyelid becomes lax and dry eyes are common. Upper blepharoplasty often becomes functional.

For a long time, blepharoplasty involved removing a large amount of fat from the bags. In the short term, the result was clean. But over the years, many patients saw their eyes become hollow, look sunken and their face age faster, as the fat around the eyes naturally decreases with age.

Today, most surgeons take a more conservative approach. They remove only the fat that genuinely protrudes, and often reposition the rest to fill the tear trough. In patients whose eyes already look hollow, they may even add volume with fat transfer. The aim is no longer just to remove what sticks out, but to restore a smooth, youthful transition between the eyelid and the cheek.

Measuring the skin

The surgeon gently pinches the excess skin to determine the amount to remove, always leaving a sufficient margin for the eyes to close completely. They measure each side separately.

Position of the crease

The crease is placed at a natural height, higher in women and lower in men, and symmetrically.

The muscle

A thin strip of the orbicularis muscle may be removed to define the crease better, but many surgeons preserve it, especially in patients with dry eyes.

The fat

The small fat pad near the nose is often reduced; the central fat is treated with caution so as not to create hollowing.

The lacrimal gland

In some people, the lacrimal gland, located under the outer part of the eyelid, descends and creates a bulge. The surgeon can put it back in place rather than remove it.

Closure

A very fine thread, often a continuous stitch, closes the incision. It is removed around the fifth to seventh day.

Many patients want as much skin as possible removed for a dramatic effect. The surgeon is cautious, as enough skin must be kept for the eyelid to close completely, particularly during sleep, and to avoid a hollow or surprised look. A measured amount gives a rested, natural look. If a small amount of excess skin remains, a touch-up is easy; removing too much skin, by contrast, is difficult to correct.

The eyelid contains several fat compartments. The inner corner pad, near the nose, often becomes more visible with age and contains whiter, more fibrous fat. It is treated with care during blepharoplasty, as there are many blood vessels there. In the upper eyelid, moderate removal avoids a bulge near the nose; in the lower eyelid, it can be repositioned to fill a hollow rather than removed.

Many patients are apprehensive about being awake during eyelid surgery. In practice, local anaesthesia is very well tolerated. Eye drops first numb the surface of the eye, then small injections are given into the skin of the eyelids; they sting briefly. After that, you no longer feel pain. A shield is placed over the eye, and you keep your eyes closed most of the time. Light sedation can help you relax. The advantage is a quick recovery, without the effects of general anaesthesia, and the possibility for the surgeon to ask you to open your eyes to check height and symmetry, particularly in cases of ptosis.

The two halves of our face are never identical. One eyebrow is often slightly higher than the other, one eye slightly more open, one bag slightly more marked. These differences, sometimes only noticed after a procedure, often existed beforehand. The surgeon notes them at the consultation and adapts the procedure to each side to improve symmetry, without being able to make it perfect. Pre-operative photos allow you to check, after the procedure, what was already there.

Before the procedure

Well-hydrated, non-irritated skin heals better. Avoid harsh products, such as retinoids, around the eyes in the days beforehand, according to the surgeon's advice.

The first few weeks

Clean the eyelids with saline or the prescribed products, without rubbing. Do not apply any cream to the scars before they have fully closed.

After healing

A moisturiser suitable for the eye area, sun protection and sunglasses preserve the quality of the skin. Gentle scar massage may be recommended after a few weeks.

Removing make-up

Use a gentle product and remove make-up without pulling on the skin, particularly on the lower eyelid.

Eyelid skin, which is very thin, reacts easily to cosmetics, nail varnish, eye drops or pollen, with redness, swelling and flaking. Eyelid eczema must be calmed before blepharoplasty, as it increases inflammation and can interfere with healing. A dermatologist can identify the allergen involved. After the procedure, favour fragrance-free hypoallergenic products.

Inflammation of the eyelid margins, or blepharitis, is common: red eyelids, crusts at the base of the lashes, stinging eyes. It is treated with daily hygiene: warm compresses, gentle massage and cleaning of the eyelid margins. Active blepharitis must be calmed before blepharoplasty, as it increases the risk of irritation and infection.

After healing, the eyelid skin may feel dry or slightly tight for a few weeks. A simple, fragrance-free moisturiser suitable for the eye area improves comfort. Active products such as retinoids or acids should wait about a month, and be introduced gradually on well-healed skin, watching for redness or stinging, a sign to slow down a little.

"Will your eyes look different?"

They will look more rested, but the expression and shape of the eyes remain the same.

"Does it hurt?"

Not much. The discomfort mainly comes from swelling and a feeling of dry eyes.

"Will you be off work for long?"

One to two weeks in general.

"Is it reimbursed?"

Only if the eyelid obstructs vision, documented by an examination, or in cases of ptosis.

For many older patients, functional upper blepharoplasty changes daily life: they no longer need to lift their chin or raise their eyebrows to see, their eyes tire less at the end of the day, and reading and driving become more comfortable. The forehead, which was constantly working to lift the eyelids, relaxes. These benefits fully justify the procedure when the impairment is documented, which is why basic insurance can cover it.

• Before upper blepharoplasty, always have the eyebrow examined.
• Mention dry eyes, contact lenses, eye surgery or thyroid disease.
• Bags are increasingly treated by preserving or repositioning fat.
• Documented visual impairment or ptosis may be covered by basic insurance.
• Intense eye pain with reduced vision after the procedure is an emergency: call 144.

In some situations, collaboration between a plastic surgeon and an ophthalmologist provides additional safety: significant dry eyes, previous eye surgery, glaucoma, thyroid disease, or blepharoplasty combined with a facelift. The ophthalmologist assesses and prepares the eye, the surgeon performs the procedure, and follow-up is shared. This coordinated approach is particularly useful in older people and in functional situations.

When both procedures are being considered, it is generally advisable to have refractive surgery, such as LASIK, before blepharoplasty, or to leave a sufficient interval between the two. Both procedures can temporarily increase dry eye, and combining these effects is undesirable. The ophthalmologist and the eyelid surgeon coordinate the timetable. See our page on LASIK.

In older people, cataracts and drooping eyelids often coexist. Cataract surgery is generally performed first, or at least well apart from the blepharoplasty, to limit the risk of infection and allow the eye to heal. An eyelid that obstructs vision can also make cataract surgery less comfortable; the ophthalmologist advises on the most suitable order.

In some people, whatever their origin, the upper eyelid crease is naturally low, barely visible or even absent, and the eyelid looks full. This characteristic is part of the identity of the eyes. When someone wants a more defined crease, surgery involves creating or slightly raising this crease, possibly removing a little fat. The surgeon takes care to respect the proportions of the face and not to create a crease that is too high, which would look artificial. As with any procedure around the eyes, listening to the request and preserving identity are essential.

The tear trough is the groove that runs from the inner corner of the eye and slopes down towards the cheek. It results from a strong attachment between the skin and the bone at this point, which becomes more marked as the cheek loses volume and the eyelid fat bulges above it. The contrast between the bag and the hollow creates the shadowed look.

Fat repositioning

During lower blepharoplasty, the fat from the bags is slid under the groove and secured, which removes both the bag and the hollow.

Fat transfer

Small amounts of purified fat are injected along the groove. This is a worthwhile solution when the hollow predominates, without a significant bag.

Hyaluronic acid injections

They fill the groove temporarily. The procedure requires experience, as the skin is thin and the product can show or retain water.

The choice

It depends on the size of the bag, the depth of the hollow, the quality of the skin and your preferences.

Bags that appear mainly on waking and diminish during the day are often due to water retention, encouraged by a salty meal, alcohol, lack of sleep, allergies or sleeping position. They do not always justify surgery. Conversely, bags present all the time, even at the end of the day, generally reflect fat herniation, which blepharoplasty corrects.

A bulge in the outer part of the upper eyelid, near the temple, is not always fat. It may be the lacrimal gland, which produces some of the tears and descends with age. It must on no account be removed, as this would encourage dry eyes. The surgeon simply puts it back in place and secures it under the bony rim. This is an example of the anatomical precision that eyelid surgery requires.

Xanthelasmas are small, soft, flat yellowish plaques, often located at the inner corner of the eyelids. They are linked to fat deposits in the skin and warrant a cholesterol test, although they also appear in people with normal results. They can be removed surgically, sometimes during blepharoplasty, or treated by laser. They can recur.

Small benign lesions often appear on the eyelids: white spots called milia, small skin-coloured bumps called syringomas, small cysts. They can be removed by a dermatologist or during blepharoplasty. Any lesion that bleeds, ulcerates, grows or causes lashes to fall out must, however, be examined, as some skin cancers can affect the eyelids.

In the first few days after blepharoplasty, anything that increases pressure in the blood vessels of the face encourages bleeding: exertion, carrying loads, bending with the head down, coughing hard, constipation, alcohol, very hot baths. Poorly controlled high blood pressure also increases the risk of haematoma. That is why rest, keeping the head raised and blood pressure control are recommended for at least a week. If you are being treated for high blood pressure, take your treatment as instructed, including on the day of the procedure.

For initial guidance, your family doctor or ophthalmologist are ideal contacts. For a cosmetic request, you can consult a plastic surgeon or an oculoplastic surgeon directly. After the procedure, keep the practice's number within reach. In the event of intense eye pain, sudden swelling or reduced vision, call 144 without delay. For a question about coverage, your health insurer can advise you. And for a first opinion, you can send us your request using the form on this page.

Fine wrinkles of the lower eyelid and crinkled or slightly loose skin do not always justify skin removal, which risks pulling the eyelid down. Laser or peel resurfacing, alone or in addition to a lower blepharoplasty through the internal approach, can tighten the skin slightly and improve its texture. The skin reddens and then peels for a few days, and strict sun protection is essential afterwards, especially on olive skin, which is more prone to dark marks. See our page on laser blepharoplasty.

Eyelid bruising follows a characteristic colour change, linked to the breakdown of blood under the skin. Red or purplish for the first two days, it becomes bluish, then greenish and finally yellow, before disappearing within ten to fifteen days. It may move down towards the cheeks under the effect of gravity. Its intensity varies greatly from one person to another, depending on the fragility of the blood vessels, the treatments taken and the extent of the procedure. Cold, keeping the head raised, stopping blood-thinning products beforehand and avoiding exertion limit it. Bruising that suddenly increases, with pain and tension in the eye, however, requires emergency medical attention.

If you have a tattooed eyeliner or permanent eyebrow make-up, tell the surgeon. Blepharoplasty generally does not change the eyeliner line, which sits at the edge of the lashes. However, if a brow lift is combined, the position of eyebrow make-up may change. It is better to wait until healing is complete, a few months, before redoing permanent make-up around the eyes.

Blepharoplasty is one of the most rewarding procedures in facial surgery, because a relatively simple procedure profoundly changes the impression the eyes give. It nevertheless requires precise analysis: the eyelid, the eyebrow, the fat, the skin and the health of the eye must be assessed together. Finally, it must remain measured, as a rested look is always more attractive than a transformed one. With an experienced practitioner, careful preparation and a little patience during recovery, the vast majority of patients are satisfied with their result for many years.

Budget

Price differences between cities and cantons, the quote breakdown and ways to save are detailed on our page Blepharoplasty: prices in Switzerland.

All pages in this section

• Laser blepharoplasty in Switzerland
• Medical blepharoplasty in Switzerland
• Fox eyes in Switzerland

Related procedures

• Ethnic rhinoplasty in Switzerland
• Septoplasty in Switzerland
• Ultrasonic rhinoplasty in Switzerland

Our guides

• Cosmetic surgery in Switzerland

Answers to the questions most often asked by patients living in Switzerland about blepharoplasty. Budget questions are detailed on our page on blepharoplasty prices in Switzerland.

Understanding blepharoplasty

What is blepharoplasty? It is eyelid surgery that removes excess skin and treats fat bags, to rejuvenate and refresh the eyes. It can involve the upper eyelids, the lower eyelids or all four. Depending on the situation, it is cosmetic or functional, when the skin obstructs vision. It is one of the most frequently performed procedures in cosmetic facial surgery.

What is the difference between upper and lower blepharoplasty? Upper blepharoplasty treats the top eyelid: overhanging excess skin, a small fat pad near the nose. Lower blepharoplasty treats the bottom eyelid: bags, excess thin skin, the transition with the cheek. The steps, incisions and recovery differ slightly. Both can be performed in the same session.

Where are the scars placed? For the upper eyelid, in the natural crease, hidden when the eyes are open. For the lower eyelid, either inside the eyelid, with no visible scar, or just below the lashes. In both cases, they become very discreet within a few months. Their progress is monitored at the check-ups.

Does blepharoplasty change the shape of the eyes? It should not change the shape of the eye or the expression. It removes what weighs the eyes down. A poorly performed lower blepharoplasty can round the outer corner of the eye; tightening of the outer corner and cautious resection prevent this risk. A measured approach preserves the expression of the eyes.

Can just the upper eyelids be treated? Yes, it is the most common procedure. It is often performed under local anaesthesia, with a quick recovery. The result is often striking for a relatively simple procedure.

Can just the bags be treated? Yes, with a lower blepharoplasty, often through an internal approach when the skin is still firm, with no visible scar. Recovery is generally quick.

What is the transconjunctival approach? It is access from inside the lower eyelid, through the conjunctiva, which allows bags to be treated with no visible scar. It is suitable when there is no significant excess skin. The conjunctiva heals quickly and without marks.

What is fat repositioning? Instead of removing the fat from the bags, the surgeon moves it to fill the groove between the eyelid and the cheek. The transition becomes smoother, and the eyes do not become hollow over time. It is an increasingly used approach.

What is the tear trough? It is the groove that runs from the inner corner of the eye and slopes down over the cheek. When hollow, it gives a shadowed, tired look. It can be filled with fat from the bags, fat transfer or injections. It often deepens with age and fatigue.

What is a canthopexy? It is tightening of the tendon at the outer corner of the eye. It supports the lower eyelid and prevents it from being pulled down after a lower blepharoplasty, especially if the eyelid was lax. This step is particularly useful in older people.

What is ptosis? It is drooping of the upper eyelid due to weakness or slackening of the muscle that lifts it. It is distinct from simple excess skin and is corrected by tightening or reattaching this muscle. The diagnosis is made at the examination.

How can I tell whether I have ptosis or excess skin? With ptosis, the edge of the eyelid itself drops and covers part of the iris, or even the pupil. With excess skin, the edge is in place, but the skin hangs over it. Only an examination can tell; the two often coexist. Treatment of both is then combined.

Does blepharoplasty treat dark circles? It treats dark circles linked to a hollow or a bag, by repositioning the fat. Pigmented dark circles, linked to skin colour, or vascular ones, linked to the skin's transparency, require other treatments. An accurate diagnosis avoids a disappointing procedure.

Does blepharoplasty remove crow's feet? No. Wrinkles at the outer corner of the eye are due to the orbicularis muscle and the quality of the skin. They are treated with botulinum toxin, laser or peels. Botulinum toxin is often combined to soften them.

Does blepharoplasty lift the eyebrows? No. If the eyebrows have dropped, a brow lift may be necessary, alone or combined. Removing skin from the eyelid has no effect on the position of the eyebrow. That is why examination of the eyebrow is essential.

How long does the procedure take? Forty-five minutes to an hour for the upper eyelid, an hour to an hour and a half for the lower, and about two hours for all four eyelids. The exact duration will be given at the consultation.

What anaesthesia is used for blepharoplasty? Upper blepharoplasty is usually performed under local anaesthesia, sometimes with light sedation. Lower blepharoplasty or all four eyelids can be performed under local anaesthesia with sedation or under general anaesthesia. The choice is made with you, according to your comfort and the duration.

Is local anaesthesia painful? The injections sting briefly, after anaesthetic eye drops. After that, you no longer feel pain, only sensations of touch and pulling. Many patients are surprised at how comfortable they are during the procedure.

Can other procedures be combined? Yes: brow lift, facelift, fat transfer, rhinoplasty or skin treatments. The surgeon assesses whether the combination is reasonable. A single recovery period is then enough.

Is laser blepharoplasty different? The laser can replace the scalpel for the incision or be used to resurface the skin of the lower eyelid. The principles remain the same. Our page on laser blepharoplasty details this approach. The choice of instrument matters less than the practitioner's experience.

Who is it for?

At what age is blepharoplasty performed? Usually between forty and seventy, but hereditary bags can justify a procedure from the thirties onwards. The examination of the eyelids matters more than age.

Can hereditary bags be operated on at a young age? Yes. In young people with firm skin, a lower blepharoplasty through an internal approach treats the bags with no visible scar and a lasting result. The result is often very long-lasting.

Is blepharoplasty suitable for men? Yes, very often. The surgeon respects a lower eyelid crease and removes skin in moderation to preserve a masculine look. The aim is a rested look, not a transformed one.

I have dry eyes: can I have surgery? Yes, but the dryness must be assessed and treated beforehand, as the procedure can temporarily make it worse. The surgeon can also adapt the amount of skin removed and strengthen the support of the lower eyelid. Prior treatment clearly improves comfort.

I have had laser eye surgery: is that a problem? Mention it. Refractive surgery can encourage dry eyes for a while. An interval between the two procedures and an assessment of dryness are often recommended.

I wear contact lenses: what should I plan for? Contact lenses are removed for the procedure and only resumed after one to two weeks. Have glasses ready. Prolonged contact lens wear can also encourage dryness or ptosis. Arrange a way to see during this period.

Is thyroid disease a contraindication? Some thyroid diseases change the eyelids and the eye socket. They must be stabilised and assessed by a specialist before eyelid surgery. Stability of the disease is essential before any surgery.

Is glaucoma compatible? Yes, generally, but mention it, along with your eye drops. The ophthalmologist can be consulted before the procedure. Bring the list of your eye drops.

Are anticoagulant treatments an obstacle? They increase the risk of bleeding, including haematoma behind the eye, which is rare but serious. Their management is decided with the prescribing doctor; never stop them on your own. Never change a prescribed treatment without medical advice.

Is smoking an obstacle? It slows healing and encourages eye irritation. Stopping is recommended before and after the procedure. Nicotine replacement products should also be discussed.

My eyelids are asymmetrical: can they be corrected? Asymmetry due to excess skin or bags can be improved. Asymmetry due to ptosis on one side requires a specific correction. Perfect symmetry is not always possible. The surgeon will show you what is realistic.

Can I have blepharoplasty if my eyebrow has dropped? Yes, but the eyebrow often needs to be treated as well, otherwise the result will be disappointing. The surgeon will explain whether a brow lift alone, blepharoplasty alone, or both would be better. The right procedure depends on the examination.

Is blepharoplasty suitable for olive or dark skin? Yes. Eyelid scars generally heal very well, but temporary pigmentation is possible. Strict sun protection is recommended.

Can blepharoplasty be performed after 75? Yes, in a person in good health. It is often in this age group that visual impairment justifies a functional procedure. General health matters more than age.

What expectations are realistic? A rested look, lighter eyelids, reduced bags. Blepharoplasty does not change the shape of the eyes, does not remove all wrinkles and does not lift the eyebrows. A simulation in the mirror helps set expectations.

Should I see an ophthalmologist beforehand? It is useful in cases of dryness, vision problems, glaucoma or a request for functional coverage. Some surgeons ask for it routinely. The ophthalmologist can also document visual impairment.

Can I get a first opinion from photos? Yes. A front view with eyes open and then closed, two profiles and close-ups of the eyelids allow a first opinion. An examination remains essential to measure and assess the eyes. This opinion is a useful step in preparing the consultation.

Do young women often ask for blepharoplasty? Requests from young people mainly concern hereditary bags or constitutional excess skin. Changes to the shape of the eye are a different type of request, such as fox eyes, and must be discussed with caution. The surgeon will explain the limitations of each approach.

Can I have blepharoplasty and rhinoplasty at the same time? It is possible, depending on your health and the total duration. Both procedures add to the bruising, but a single recovery period is enough. The combination is decided according to your health.

Can blepharoplasty correct eyes that droop at the sides? If the drooping comes from the skin, yes, in part. If it comes from the eyebrow or the outer corner of the eye, a temporal lift or canthopexy will be more effective. The surgeon assesses the precise cause of this drooping.

Recovery and results

How long is recovery? Generally seven to fourteen days before normal social life. Swelling and bruising peak around the second or third day, then decrease. The scars continue to fade for several months. Working from home often allows a quicker return.

Will I have bruising? It is common, especially after lower blepharoplasty. Bruises turn from purple to yellow and disappear within ten to fifteen days. Cold and keeping the head raised limit them. A suitable concealer hides them once the scars have closed.

Is it painful? Pain is generally mild. You feel tension, a gritty sensation in the eyes or slight burning rather than pain. Simple painkillers are enough. Intense eye pain requires emergency medical attention. Report any pain that increases.

When are the stitches removed? Generally between the fifth and seventh day. Some surgeons use absorbable stitches or a continuous stitch that is easy to remove. Removal is quick and painless.

Can I read and look at screens? Yes, in moderation from the first few days. The eyes dry out and tire quickly; take breaks and use artificial tears. Screens on a soft brightness setting are more comfortable.

When can I go back to work? Often after seven to ten days for office work, longer if you are in contact with the public or exposed to dust. For a covered functional procedure, a certificate of incapacity for work can be issued. Jobs exposed to dust require more precautions.

When can I wear make-up? Generally after the stitches have been removed and the scars have fully closed, about ten days. Use new products and remove make-up very gently. Avoid products opened before the procedure.

When can I resume wearing contact lenses? Usually after one to two weeks, depending on the instructions and how comfortable your eyes feel. Resume them gradually, according to your comfort.

When can I resume sport? Gentle exercise resumes after about two weeks, intense sport after three to four weeks. Swimming has to wait until the scars have fully closed and the surgeon agrees. Contact sports have to wait longer.

Should I wear sunglasses? Yes, to protect the eyes from light, which can be bothersome in the first few days, and the scars from the sun. They also help hide the bruising. Choose lenses that filter ultraviolet light well.

How should I sleep? On your back, with your head raised, for about a week. Avoid sleeping on your front or rubbing your eyes against the pillow. A U-shaped pillow helps keep you in position.

My eyes do not close completely: is this normal? In the first few days, swelling may prevent perfect closure. A protective ointment is often prescribed for the night. If closure remains incomplete beyond a few weeks, talk to the surgeon. The night-time ointment protects the eye during this period.

My vision is blurred: is this normal? Slightly blurred vision is common in the first few days, because of the ointment, tears or swelling. A significant, sudden drop in vision is an emergency. Do not drive while your vision remains blurred.

When is the result visible? The result can be seen as soon as the swelling goes down, around the second or third week. It stabilises within two to three months; the scars continue to fade for six months. Compare with your starting photos to judge objectively.

How long does the result last? Upper blepharoplasty gives a lasting result; some patients consider a new correction ten to fifteen years later. Treatment of the bags is often permanent. Regular sun protection helps preserve the result.

Can the bags come back? Rarely. Fat that has been removed or repositioned does not re-form, but the tissues continue to age. Weight gain or water retention can make the eyelids look more swollen. A healthy lifestyle contributes to the stability of the result.

Are the scars visible? They are pink for a few weeks, then become very discreet. The upper eyelid scar is hidden in the crease; the lower internal approach scar is invisible. Sun protection for several months helps keep them discreet.

My eyes water a lot: is this normal? Watering eyes are common in the first few days, due to swelling that impedes tear drainage or to irritation. This usually disappears on its own. Report watering that persists beyond a few weeks.

Will those close to me notice the procedure? In the first few days, yes, because of the swelling and bruising. After that, they will mainly notice a more rested look, without necessarily identifying what has changed. That is the sign of a natural result.

Should I do massages? After a lower blepharoplasty, the surgeon may recommend gentle upward massage of the eyelid after a certain time, to prevent it from being pulled down. Only start on their advice. Follow the surgeon's instructions precisely.

Risks and safety

What are the main risks? Dry eyes, often temporary; incomplete closure of the eyes while swollen; downward pulling of the lower eyelid; asymmetry; a hollowed look; small cysts along the scar; and, more rarely, a haematoma behind the eye, which is an emergency. The surgeon will explain the risks relevant to your situation.

What is a retrobulbar haematoma? It is a collection of blood behind the eye, very rare, which can compress the optic nerve. It appears in the hours following the procedure as intense pain, an eye that swells and hardens, and a drop in vision. It is an absolute emergency: call 144 or go to the emergency department immediately. Speed of treatment is decisive.

Can the lower eyelid be pulled down? Yes, after an external approach, especially if the eyelid was lax or too much skin was removed. Tightening the corner of the eye and cautious resection prevent this risk. Massage or a small correction may be necessary. A touch-up is possible if necessary.

Can too much skin be removed? This is the main risk of upper blepharoplasty. Removing too much skin prevents the eyes from closing completely. That is why the surgeon measures the excess precisely and prefers to remain cautious. Measuring the excess skin beforehand is therefore essential.

Can the eyes look hollow? Yes, if too much fat is removed. Current techniques favour preserving or repositioning fat to avoid this hollowing, which ages the eyes. Hollow eyes are difficult to correct afterwards.

Can dry eyes last? They are usually temporary. They can last longer in people who already had dry eyes. Artificial tears and suitable treatments relieve them. Preservative-free artificial tears are often the best tolerated.

Is infection possible? It is rare, thanks to the good blood supply of the eyelids. Increasing redness, discharge or fever require medical attention. The eyelids have a very good blood supply.

Can asymmetry persist? Slight asymmetry is common at first, due to uneven swelling. If it persists after three to six months, a small touch-up may be offered. Allow time for the swelling to resolve before judging.

Can vision be affected? Damage to vision is exceptional and mainly linked to haematoma behind the eye. Following the instructions, particularly avoiding exertion and controlling blood pressure, and seeking immediate help in case of intense pain reduce this risk. Keep the practice's number to hand.

Can there be cysts? Small white cysts, called milia, may appear along the scar. They are benign and easily removed during a consultation. They pose no danger.

Can the result look artificial? Yes, if too much skin or fat is removed, or if the shape of the eye is changed. A measured approach gives a natural, rested look. Reference photos help judge objectively.

Which signs should alert me? Intense eye pain, sudden swelling, a drop in vision, increasing redness, fever or discharge. In case of intense pain with reduced vision, call 144 without delay. Do not stay alone with any doubts.

Do I need to stop certain medicines? Yes. Aspirin, anti-inflammatories and certain blood-thinning supplements are generally suspended one to two weeks beforehand, on medical advice. Anticoagulants are managed with the prescribing doctor. Your surgeon will give you a precise list.

Does smoking increase the risks? Yes, it slows healing and irritates the eyes. Stopping is recommended. Stopping also improves eye comfort in the long term.

Is a touch-up common? It concerns a minority of patients, for example for a small residual excess of skin, asymmetry or a cyst. It is generally performed under local anaesthesia. It is generally simple and quick.

Are complications covered? For a covered functional procedure, related care is covered under the usual rules. For a cosmetic procedure, the after-effects may not be covered. Check with your insurer in writing.

Who should perform the procedure? A plastic surgeon or an ophthalmologist specialising in eyelid surgery, or a maxillofacial surgeon or ENT specialist trained in this procedure. Check the title in the MedReg register. The practitioner's experience in eyelid surgery is essential.

Is blepharoplasty riskier in older people? The risks are not fundamentally different, but thinner skin, dry eyes and anticoagulant treatments are more common and require particular attention. A careful prior assessment limits these risks.

What if I am not satisfied? Wait until the swelling has gone, generally two to three months, before judging. If a defect persists, talk to the surgeon; a touch-up is often possible.

How can I reduce my risks? Mention your eye history and treatments, stop smoking, apply cold, sleep with your head raised, avoid exertion in the first week, use the prescribed eye drops and attend your check-ups. These simple precautions make a big difference.

Organising your blepharoplasty in Switzerland

Is blepharoplasty reimbursed in Switzerland? Not when it is cosmetic. When excess skin of the upper eyelid obstructs vision, documented by a visual field test, or in cases of ptosis, it may be covered by basic insurance after a prior request. The file must be complete for a quick answer.

How do I obtain coverage? The ophthalmologist performs a visual field test, with the eyelid free and then lifted, and takes photos. The surgeon sends a cost approval request to your insurer with these documents. The decision rests with the insurer. Keep a copy of all documents.

How much does cosmetic blepharoplasty cost? There is no official fee. Upper blepharoplasty is the least expensive; lower blepharoplasty and all four eyelids cost more. Differences between cities reach 10 to 20%. Our price page details them. Compare complete quotes.

Should I see a plastic surgeon or an ophthalmologist? Both perform blepharoplasty. An ophthalmologist specialising in eyelid surgery is particularly suitable for ptosis, an eye problem or a functional request; a plastic surgeon for a cosmetic request or one combined with other facial procedures. The choice depends on your situation.

Where can I have surgery? In all major cities and many medium-sized towns, by plastic surgeons or ophthalmologists. The procedure is often performed in an equipped practice or clinic, as day surgery. Many practices are equipped for the procedure under local anaesthesia.

Do I need a referral from my family doctor? For a covered functional request, it depends on your insurance model. For a cosmetic request, you can consult directly. Check the conditions of your insurance model.

How many days off should I plan for? Generally one to two weeks. For a functional procedure, a certificate of incapacity for work can be issued. Working from home can shorten the absence.

What is the best time of year? Autumn and winter are popular: less sun on the scars and eyes. If you are allergic to pollen, avoid your season, as itchy, watering eyes interfere with healing. Winter is also convenient for sun protection.

Are waiting times long? For cosmetic blepharoplasty, often a few weeks. For functional coverage, you need to add the time for the visual field test and the insurer's reply. Allow time for the administrative process.

Do I need someone with me? Yes, to get home, as you must not drive on the same day and your vision may be blurred. Organise your journey home in advance.

What should I prepare at home? Cold compresses or small cold packs, artificial tears, sunglasses, pillows to sleep with your head raised and screens set to a soft brightness. Have everything within reach before the procedure.

Can my family doctor help me? Yes, with the pre-operative check-up, managing treatments and local follow-up, in liaison with the surgeon. Give them a copy of the report.

Can I be treated in my own language? Yes, provision exists in all language regions, and many practitioners also consult in English. State your preferred language when booking.

What should the quote contain? The practitioner's name and title, the eyelids treated, the technique, anaesthesia, theatre or clinic costs, check-ups, VAT and, where applicable, the separation between functional and cosmetic parts. A vague quote should prompt you to ask for details.

Should I consult several practitioners? It is useful to compare the analysis, particularly regarding the eyebrow and fat, and the proposals. Write down the answers so you can compare with a clear head.

How many check-ups should I plan for? A check-up for stitch removal around the fifth to seventh day, then one or two check-ups during the first few months. Some check-ups can be done using photos.

I live far away: how can I organise stitch removal? Plan the journey for around the fifth to seventh day, or ask whether your family doctor can do it following the instructions. Absorbable stitches sometimes avoid this appointment and are an alternative to discuss.

Which documents should I keep? The operative report, prescriptions, instructions, the invoice and, for covered procedures, the insurer's reply. They will be useful in the event of a touch-up.

Can a brow lift be combined? Yes, it is a common combination when the eyebrow has dropped. See our page on brow and temporal-midface lift. The two procedures often complement each other.

How can I get a personalised opinion? Fill in the form on this page with photos — front view with eyes open and then closed, profile and close-ups of the eyelids — and say whether you experience any visual impairment. We will direct you to appropriate care and an estimate. Free and without obligation. You generally receive a reply within twenty-four hours of receipt of a complete file.

Send us photographs — front view with eyes open and then closed, profile and close-ups of the eyelids, in natural light — and say whether you experience any visual impairment. We will direct you to appropriate care and an estimate. Free, no obligation, no administration fees.