Aesthetic surgery · consultation first

Eyelid Surgery

Upper lids, lower lids, or both — performed by a plastic surgeon certified by the Royal College, at North Shore Plastic Surgery down the hall. Half of the consultation is working out whether the eyelid is the thing that changed, because often it is the brow or the midface.

Surgery
1–2 h
Stitches out
5–7 d
Visible bruising
1–2 wk
Consultation room at MMC Wellness North Shore — a desk and two chairs by the window

What the decision involves

An upper lid operation removes a strip of skin, and sometimes a little fat or muscle, so the lid stops resting on the lashes. A lower lid operation moves or removes the fat that makes a bag, and tightens the lid if it has loosened. Neither of them lifts a brow, and neither lightens the pigment that makes an under-eye look dark. Those are two of the most common reasons someone books an eyelid consultation, which is why the examination comes before any talk of technique.

Royal College certified

Your surgeon is FRCSC and operates at Lions Gate Hospital.

The cause, then the operation

Brow position, lid laxity, fat and pigment are assessed separately, because they need different answers.

One team afterwards

Scar care and skin work after the operation happen in the same building.

Usually a reasonable candidate

  • Upper lid skin that folds onto the lashes or hides the lid crease
  • Lower lid bags that are there in the morning and stay all day
  • Healthy eyes, or an eye condition your ophthalmologist has under control
  • In good general health and a non-smoker, or willing to stop well before surgery
  • Able to spend one to two weeks with visible bruising

We would ask you to wait

  • Dry eye that already troubles you — this surgery can make it worse
  • Heaviness that comes from the brow rather than the lid; the operation for that is a different one
  • Darkness under the eye caused by pigment or a hollow, which surgery does not lighten
  • Thyroid eye disease that is not stable, or blood pressure that is not controlled
  • An event in the next month

Before surgery

  • Consultation, eye examination and photographs
  • Visual field testing where the upper lid may be obstructing your vision
  • Stop smoking and certain medications — you will get a written list
  • Arrange a driver, and have ice packs and clean gauze at home before the day

The day

  1. 01MarkingSitting upright with your eyes open, before any anaesthetic. The marks decide the result.
  2. 02SurgeryOne to two hours, usually under local anaesthetic with sedation.
  3. 03RecoveryYou go home the same day, with the eyes lubricated and written instructions for the first night.

Recovery

  • Ice for the first forty-eight hours, and sleep with your head raised
  • Bruising and swelling for one to two weeks; stitches out at five to seven days
  • Blurred vision from the ointment, and dryness or grittiness for a few weeks
  • No lifting, bending or straining for two weeks; sunglasses outdoors
  • The scars sit in the crease and along the lash line, and go on fading for months

Risks worth understanding before you decide

This is surgery on the eyelid — thin, constantly moving, and directly in front of the eye. Your surgeon will go through each of these with your own eyes in front of them.

  • Bleeding, infection, and the risks of anaesthesia or sedation
  • Dry, gritty or watering eyes, usually temporary and occasionally lasting
  • Asymmetry between the two sides, sometimes needing a second, smaller operation to adjust
  • Too much or too little skin removed — one leaves a lid that does not close fully, the other leaves the fold you came in about
  • The lower lid pulling down or away from the eye, which may need correction
  • Visible scarring, which varies between people and cannot be predicted exactly
  • Numbness of the lid or the lashes for a period afterwards
  • Changes in vision and, very rarely, bleeding behind the eye with permanent loss of sight

Questions we get

Can I book the surgery online?

No. You can book a consultation. There is no way to schedule an operation from this website — the date is agreed with the surgeon who will operate, after an examination and a written quote.

Does MSP cover it?

A cosmetic eyelid operation is self-pay. Where upper lid skin genuinely obstructs the field of vision, that is assessed against MSP's criteria with visual field testing and handled by North Shore Plastic Surgery, who bill MSP directly.

Upper, lower, or both?

The examination answers that. People often come asking about the lower lids and leave having been shown that the upper lid is what changed the look of their eyes.

Will it get rid of the lines beside my eyes?

No. Those are movement lines in the skin at the outer corner. Different problem, different treatment — and worth knowing before the operation rather than after it.

How long before I look normal in photographs?

Two to three weeks for most people. The fine scar keeps settling for months after that.

I only want the bags gone. Is that a smaller operation?

Sometimes. And sometimes what looks like a bag is a hollow below it rather than fat above it, in which case surgery is the wrong tool. Separating those two is what the consultation is for.

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