Eyelid Surgery (Blepharoplasty) in Istanbul
The eye area shapes first impressions more than any other facial region. With age, tissue quality, muscle tone, and the distribution of fat compartments around the lid margin and lid–cheek junction change. Upper-lid skin excess can make lids look heavy; lower lids may show “bags” from protruding fat and fine wrinkles. Upper and/or lower blepharoplasty aims not for a uniform “done” look but for an alert, friendly expression that fits your natural facial dynamics.
In our Istanbul work we start with precise analysis: photo documentation at rest and during eyelid closure, assessment of the lid–cheek contour and brow position, evaluation of skin quality and tear-film stability. This lets us distinguish true upper-lid skin excess from brow ptosis that only imitates hooding. Depending on the findings, we plan an upper-lid, lower-lid, or combined correction and define which tissues should be carefully removed, redistributed, or stabilised.
Upper-lid surgery uses the natural crease as the incision. Excess skin is reduced millimetre-precisely; a thin strip of muscle or medial fat can—if sensible—be conservatively adjusted to smooth the contour without creating a hollowed look. Lower-lid surgery is performed either transconjunctivally (inside the lid, no external scar) or subciliarly just beneath the lashes when there is additional skin excess and mild muscle laxity. Modern concepts favour fat repositioning to harmonise the lid–cheek transition rather than removing volume across the board. Lateral canthopexy prevents lid margin descent when pre-existing laxity is present. These scar-sparing approaches and minimally invasive precision are now standard and serve a natural result.
Regarding the peri-operative setting, our team works with three proven anaesthesia options: pure local anaesthesia, local plus twilight sedation, and general anaesthesia. Which is appropriate depends on findings, extent (one/both sides; upper and lower combined), individual sensitivity, and any adjunct procedures. Upper lids are often very comfortable under local or local + sedation; lower lids—especially in combined corrections—may benefit from sedation or general anaesthesia.
The procedure itself usually takes 30–60 minutes per region, depending on technique and combinations. Most cases are outpatient with a short observation period; with extended procedures (e.g., brow/forehead lift) an overnight stay can make sense. Most patients are socially presentable after a few days; sports and heavier physical activity should pause a bit longer.
For a balanced overall result, eyelid surgery can be combined with complementary measures—from temporal/brow lift and laser/peel for skin refinement to autologous fat transfer for soft-tissue contour and smoother transitions. A combined setting has the benefit of a single anaesthetic and a consolidated recovery; whether this is sensible for you we discuss individually.
Who is a candidate?
Suitable for functional or aesthetic upper-lid skin excess, a “tired look” from hooded lids, lower-lid bulging/“bags,” and pronounced tear-trough grooves. Younger patients with genetic predisposition can also benefit when conservative measures do not sufficiently improve contour. Co-factors such as dry eyes or allergies are incorporated into planning to protect ocular surface stability.
Methods for upper and lower lids
- Upper lid: incision in the natural crease; precise skin reduction, optional fine muscle tightening and conservative fat adjustment. Goal: a clearly defined crease without over-correction.
- Lower lid (transconjunctival): inside-lid approach without external scar; ideal when fat protrusion dominates and skin excess is minimal; repositioning rather than mere removal to smooth the lid–cheek junction.
- Lower lid (subciliary): fine skin incision under the lashes when skin quality/laxity requires additional tightening; optional lateral canthopexy for support.
Anaesthesia options
- Local anaesthesia enables very targeted, gentle correction—often sufficient for upper lids.
- Local + twilight sedation increases comfort without switching off spontaneous breathing; excellent for bilateral or combined procedures.
- General anaesthesia is chosen selectively for complex lower-lid work, longer combined operations, or on explicit request. All options are monitored by experienced anaesthetists.
Technique and workflow
After consent and photo markings in a seated position, sterile preparation follows. We use delicate, low-bleeding dissection to avoid heat or traction injury to sensitive structures. Fat is returned to its original compartment or redistributed in micro-portions, depending on the zone; closure is tension-free. Cooling and head elevation begin immediately; a brief stay for circulation and haemostasis checks concludes the day. Outpatient management is standard—you leave the clinic after short observation with an escort.
Aftercare – thorough and practical
In the first days rely on gentle (not icy) cooling, head elevation, and consistent wound care. Lukewarm water is sufficient for compresses; very cold temperatures promote bruising and prolong swelling. Prescribed eye drops and ointments stabilise the surface, reduce irritation, and support scar maturation. If non-absorbable, sutures are removed after about one week; camouflage is possible shortly thereafter. Sports, sauna, and sweat-inducing activities should pause 2–4 weeks; SPF 50+ is essential for the first months. Check-ups in weeks 2/3 and later as needed ensure progress and fine-tuning.
