Rejuvenating the eye region while preserving its natural shape, fullness and support.
The eyelids do not age in isolation. Brow position, skin excess, orbital fat, lid support, facial volume and the transition between the lower eyelid and cheek all influence how the eye region appears.
My approach is therefore conservative and anatomically directed rather than simply removing skin and fat.
Several structures need to be considered together before deciding what, if anything, should be treated.
Brow descent can contribute to apparent upper-eyelid excess. Treating the eyelid without recognising this may produce an incomplete or unbalanced result.
Loss of volume around the orbit and upper cheek can make the eyes appear more hollow and exaggerate the lid–cheek transition.
Lower-lid tone, position and lateral canthal support influence both the operative plan and whether additional support is appropriate.
Upper blepharoplasty can address genuine excess skin and selected fullness while preserving a natural upper-lid contour.
The brow is assessed first. In some patients, brow position contributes substantially to upper-lid hooding and should be considered as part of the same aesthetic unit.
I favour conservative tissue removal rather than creating a deep or skeletonised upper eyelid.
For the lower eyelid, I generally prefer a transconjunctival approach to address orbital fat without creating an unnecessary external incision through the lower-lid retractors.
Fat is treated conservatively—repositioned or removed selectively according to the anatomy rather than routinely excised.
Where skin excess remains, a limited lateral subciliary incision can be used for pre-orbicularis skin elevation and conservative trimming.
The lower eyelid should not be assessed as a separate strip of tissue above the cheek.
Age-related volume change and the relationship between orbital fat, the tear trough and upper cheek can create a visible transition that makes the eye appear tired even when the eyelid itself is not markedly lax.
Where appropriate, conservative fat repositioning and selective facial fat grafting can soften this transition.
Not every lower blepharoplasty requires canthal surgery.
Can provide additional lateral support where the lid requires reinforcement without more extensive reconstruction.
May be appropriate where greater correction of lateral canthal position or lower-lid support is required.
I use fat grafting around the face when it improves the overall result.
Around the eyes, this may include the lid–cheek junction, upper cheek or selected areas of periorbital hollowing.
It is usually an adjunct to eyelid or facial surgery rather than a standalone treatment.
Recovery varies with the combination of upper-lid, lower-lid and adjunctive procedures performed.
Swelling and bruising around the eyes are expected. Cold compresses, head elevation and postoperative eye care are important.
Bruising and swelling generally improve substantially, although the eyelids may still feel tight or look mildly swollen.
The eyelid contour progressively softens. Residual swelling and scars continue to mature over the following months.
The risks relevant to the particular procedure and individual anatomy are discussed carefully during consultation.
A consultation begins with careful assessment of the brow, eyelids, lid support, facial volume and the lid–cheek junction. From there, we can determine which components—if any—would genuinely improve the eye region while preserving its natural character.
Arrange a consultation →Written and reviewed by Dr Constant van Schalkwyk, Specialist Plastic Surgeon ·
