Eyelid surgery, or blepharoplasty, removes excess skin and repositions or reduces fat around the eyes to soften heavy upper lids and puffy lower eyelid bags. Because the eyes are the focal point of the face, even a modest change can make you look less tired and more like yourself. At her Harley Street practice in London, female plastic surgeon Ms Anna De Leo performs upper, lower and four-lid blepharoplasty with a delicate, conservative approach that respects the natural shape of your eyes.
Eyelid surgery is one of the most rewarding operations in facial aesthetics, and one of the most frequently requested. Yet the skin of the eyelid is the thinnest on the body, and the balance between too little and too much is fine. That is why careful assessment, precise planning and meticulous technique are essential. Ms De Leo will explain exactly what blepharoplasty can achieve for you, and what it cannot, before you make any decision.
01What Is Eyelid Surgery (Blepharoplasty)?
With age, the skin of the eyelids loses elasticity and stretches, while the thin membrane that holds the fat around the eye weakens, allowing fat to bulge forwards. In the upper lid, this creates hooding that can make the eyes look heavy and, in some cases, even weigh on the eyelashes and narrow the field of vision. In the lower lid, it creates bags and a shadowed hollow beneath them that can make you look tired however well you have slept.
Blepharoplasty addresses these changes directly:
- Upper blepharoplasty removes excess skin, and sometimes a small strip of muscle and fat, to restore a clean, defined upper lid crease.
- Lower blepharoplasty reduces or repositions the fat that forms eye bags, smooths the transition between the lid and the cheek, and, where needed, removes a small amount of skin.
- Four-lid blepharoplasty treats upper and lower lids together for a balanced result.
It is important to be realistic. Eyelid surgery is not designed to remove crow's feet or pigment-related dark circles, and it does not lift low-set eyebrows. These concerns can be improved with complementary treatments, which Ms De Leo will discuss with you.
02Who Is Suitable for Eyelid Surgery in London?
Patients seeking eyelid surgery on Harley Street come from a wide range of ages, from their thirties, when inherited eye bags can appear, to their seventies and beyond. You may be a good candidate if:
- Folds of excess upper eyelid skin make your eyes look heavy or tired
- Hooding touches your lashes or makes applying eye make-up difficult
- You have persistent bags under the eyes that do not improve with rest
- You are in good general health and have no significant untreated eye conditions
- You have realistic expectations about what surgery can achieve
Before surgery, it is important to mention any dry eye, glaucoma, thyroid disease, previous eye surgery or laser vision correction, as these influence planning. In some cases, an eye examination by an ophthalmologist is recommended first. If the brow has descended significantly, removing upper lid skin alone may not give the result you want, and this will be discussed openly at consultation.
03Your Eyelid Surgery Consultation on Harley Street
Your consultation with Ms Anna De Leo takes place at 64 Harley Street in Marylebone. She will ask about your general health, your eyes and any medication, then examine the eyelid skin, the position of the brows, the strength and tone of the lower lid, the fat pads and the relationship between the lid and the cheek. Photographs help you both to focus on the details that matter to you.
Ms De Leo will explain which form of blepharoplasty is appropriate, where scars will lie, the choice of anaesthetic and how recovery will fit around your commitments. She will tell you honestly if your goals would be better served by another treatment, or if your expectations are more than surgery can deliver.
The cost of eyelid surgery depends on whether one or both lids are treated, the technique, the anaesthetic, any combined procedures and your aftercare programme; you will receive a clear, personalised written plan. Under GMC guidance, a cooling-off period of at least two weeks applies between consultation and cosmetic surgery, giving you time to reflect and ask further questions.
04Upper and Lower Blepharoplasty Techniques
Most eyelid surgery is performed as a day case in an accredited London hospital. Upper lid surgery can often be carried out under local anaesthetic, with or without sedation, while lower lid or four-lid surgery may be done under sedation or general anaesthesia.
Upper blepharoplasty
The incision is placed precisely in the natural crease that forms when your eyes are open, so that once healed the scar is concealed within the fold. Excess skin is removed conservatively, preserving enough to allow full, comfortable closure of the eye, and protruding fat may be gently reduced. The wound is closed with very fine sutures.
Lower blepharoplasty
There are two main approaches. In the transcutaneous approach, a fine incision is placed just beneath the lashes, allowing excess skin to be removed and fat to be trimmed or repositioned. In the transconjunctival approach, used when there is fat but little excess skin, the incision is placed on the inside of the lower lid, leaving no visible scar. Fat may be repositioned into the tear trough hollow to soften the shadow between the lid and the cheek, and the lower lid may be supported with a canthopexy to maintain its shape.
Blepharoplasty can be combined with a facelift, fat grafting or skin rejuvenation as part of a broader plan.
Great eyelid surgery should never change who looks back at you in the mirror; it should simply let you look as awake as you feel.
ADLSynergy · Harley Street
05Blepharoplasty Recovery Time
Recovery from eyelid surgery is usually comfortable, with more of a sensation of tightness, grittiness or watering than pain. You will be asked to rest with your head elevated and to use cool compresses regularly for the first few days.
- Days 1–3: swelling and bruising are at their peak; vision may be slightly blurred from ointment or swelling.
- Days 5–7: stitches are removed, and bruising begins to fade.
- Days 7–14: most people return to desk work and social life; tinted glasses help, and light concealer can be used once the wounds have healed.
- Weeks 3–4: contact lenses and full exercise can usually be resumed, on advice.
- Months 3–6: scars mature and soften, and the final result is seen.
At ADLSynergy, your recovery is supported by our team, with gentle lymphatic techniques to help swelling settle, guidance on scar care, and nutrition advice that supports healing. Where appropriate, red light therapy or oxygen therapy may be included in your programme. Ms De Leo and the team in London remain available throughout.
06Eyelid Surgery Risks and Honest Expectations
Blepharoplasty is a common and generally well-tolerated procedure, but it is still surgery and carries risks, which are discussed in full at consultation:
- Bruising, swelling and temporary blurred vision
- Dry, gritty or watery eyes, usually temporary
- Difficulty fully closing the eyes for a short period
- Asymmetry, or visible or thickened scars
- Infection or bleeding, including, very rarely, bleeding behind the eye, which is a surgical emergency
- Pulling down or rounding of the lower lid (ectropion or scleral show), which may need further treatment
- Under- or over-correction, occasionally requiring revision
Looking at blepharoplasty before and after photographs can help you visualise the possibilities, but results vary between individuals. Upper eyelid surgery generally lasts many years; lower eyelid fat removal is often very long-lasting. Your eyes will continue to age naturally, and sun protection and good skin care help to preserve your result.
07Why Choose Ms Anna De Leo on Harley Street
Ms Anna De Leo is a GMC-registered Plastic, Reconstructive and Aesthetic Surgery Consultant, a Fellow of the European Board of Plastic, Reconstructive and Aesthetic Surgery (FEBOPRAS) and a member of BAPRAS. Her training in microsurgery, a discipline built on magnification and precision, is particularly relevant to the fine tissues of the eyelids, where millimetres matter.
As a female plastic surgeon, she brings a considered, detail-focused eye to eyelid surgery and an emphasis on preserving each patient's natural expression and character. Patients searching for the best blepharoplasty surgeon in London often value exactly this: precision combined with restraint.
Learn more about Ms De Leo or arrange a consultation at our Harley Street practice to discuss eyelid surgery.
