Eyelid surgery (blepharoplasty)

The eyes are the first channel of our emotions, but time, tiredness or genetics can dull their freshness. Excess skin, drooping eyelids, bags under the eyes or a sagging brow tail often give a tired or stern look that does not reflect your inner vitality.

The operation corrects unsightly changes of the upper and/or lower eyelids and the position of the brow, by removing excess skin, redistributing or removing herniated fat and tightening the muscle and fascial layers. The aim is a lasting improvement while preserving the eyelid’s protective function.

As a maxillofacial surgeon, Dr Yousefpour knows the complex three-dimensional anatomy around the eye in depth: every procedure is tailored to restore harmony, preserve the shape of the eye and the blink, and rejuvenate the eyes without ever freezing the features.

The protocol, step by step.

1. Step 1

   Analysis of the eye area

   Assessment of the balance between the brow and the upper eyelid, eyelid tone and tear quality: this balance is essential for a natural result.

2. Step 2

   Pre-operative marking

   Drawn with you standing, taking into account symmetry and the natural eyelid crease in which the scar will be hidden.

3. Step 3

   Surgery

   Millimetre-precise skin removal, targeted removal of the inner fat pad if needed, muscle tightening and moderate re-tensioning of the skin.

4. Step 4

   Follow-up

   Stitch removal around day 6 to 7, a check-up at six weeks, then follow-up of scar maturation.

Regular expertise in eyelid surgery

Blepharoplasty is one of the procedures Dr Afshin Yousefpour performs regularly, and he has carried out many. It is a full part of his maxillofacial practice, alongside jaw surgery and facial reconstructive surgery.

Qualified in stomatology in Brussels in 1997, Consultant Specialist in maxillofacial surgery in the United Kingdom since 2006 and a Fellow of the Royal College of Surgeons of Edinburgh (FRCSEd), he approaches the eyes with the same anatomical rigour as the rest of the face: preserving the function of the eye, respecting the blink and achieving a discreet scar.

A comprehensive, personalised approach to the eyes

• Upper blepharoplasty: correction of dermatochalasis (excess skin “hooding” the eyelid) and, if needed, targeted removal of the inner fat pad. Much of the scar is hidden in the natural eyelid crease.

• Lower blepharoplasty: treatment of fat bags and loose skin, through the inside of the eyelid (transconjunctival, with no external scar) when the skin is firm, or through an incision just below the lashes with muscle tightening.

• Brow and forehead lift: essential when a drooping brow weighs down the upper eyelid; it repositions the tail of the brow to open up the eyes lastingly.

• Combined surgery: joint harmonisation of the eyelids and brows for complete facial rejuvenation.

Your most frequent questions

At what age should blepharoplasty be considered? As soon as there is an aesthetic or functional concern. Genetic fat bags can be treated from the age of 25 to 30; age-related skin laxity is usually treated from 40 to 45.

Is the operation painful? Blepharoplasty is only mildly painful. A temporary feeling of tightness or dry eyes may occur, well relieved by simple painkillers and artificial tears.

What anaesthesia? An isolated upper blepharoplasty is done under simple or enhanced local anaesthesia as a day case. Lower blepharoplasty and combined procedures (four eyelids, brow lift) are usually done under conscious sedation or light general anaesthesia.

When can the result be seen? The eyes open up as soon as the stitches are removed. The near-final result can be judged at six weeks and the scars are fully mature between three and six months.

Normal recovery

• Swelling and bruising of varying extent for 7 to 15 days. Sunglasses allow you to return to social life within the first few days.

• Watery eyes, increased sensitivity to light and temporary dry eyes.

• Temporary inability to close the eyes completely for the first few days (moderate reactive lagophthalmos).

Possible risks and complications

• Haematoma or bleeding: rare, but may require prompt drainage. Retrobulbar haematoma is an exceptional complication requiring emergency treatment.

• Infection: exceptional in the eyelids, thanks to their rich blood supply.

• Abnormal healing: hypertrophic scars, pigment changes or small cysts at the stitches, usually temporary.

• Temporary eye problems: conjunctivitis, exposure keratitis due to dryness, chemosis (swelling of the conjunctiva).

• Ectropion or lower eyelid retraction: the lower lid turns outwards; prevented by millimetre-precise skin removal and treated if needed with massage or a secondary canthopexy.

• Ptosis or residual asymmetry: partial drooping of the upper eyelid (very rare) or a pre-existing asymmetry revealed once swelling settles.

Legal and tax framework, revision surgery

Under Belgian tax law governing medical and surgical procedures (VAT Code, art. 44, § 1, 2°), any procedure or part of a procedure with a purely aesthetic purpose is subject to 21 % VAT, charged in addition to the fees and any hospital costs.

Final healing takes 12 to 18 months: no definitive surgical touch-up can be undertaken before the tissues have fully stabilised.

If revision surgery is needed later, all costs (clinic or hospital stay, anaesthetist’s fees, consumables, theatre equipment and surgical fees) are paid in full by the patient. The initial procedure is in no way a package that includes possible further operations.

Under Belgian law and medical ethics, purely aesthetic procedures do not entitle the patient to a certificate of incapacity for work: the recovery period must be planned by the patient as personal leave.

Informed consent

• The surgeon explains in detail the aims, technical aspects, recovery and inherent risks of blepharoplasty and eye-area surgery.

• Enough time to reflect is always given so that you can ask all your questions and receive clear answers.

• The patient undertakes to follow the pre- and post-operative instructions strictly: stopping smoking, stopping anticoagulants or aspirin according to protocol, prescribed local care.

• The patient acknowledges that any touch-ups are at their own expense, that aesthetic services are subject to 21 % Belgian VAT and that no sick note will be issued.

Frequently asked questions