Dr Scott J Turner | Specialist Plastic Surgeon (FRACS) | Sydney
Ask most people to point to the first place they notice ageing on their own face, and they point to their eyes. The skin there is the thinnest on the face — it loses elasticity earlier, shows fatigue more readily, and changes in ways that are difficult to hide. Fat pads that were once held neatly in place begin to push forward. Upper eyelid skin descends. The result is a face that reads as tired or older than the person actually feels, and it’s a change that no amount of sleep or skincare reliably reverses.
Dr Scott J Turner is a Fellow of the Royal Australasian College of Surgeons (FRACS) with specific training in eyelid and facial surgery. He consults at his Sydney clinics in Bondi Junction and Manly, with surgery performed at Bondi Junction Private Hospital and Delmar Private Hospital, Dee Why.
What Is Blepharoplasty?
The word comes from blepharon, Greek for eyelid. The procedure itself has been around in various forms for over a century — the underlying principle hasn’t changed, even if the techniques have evolved considerably.
In plain terms, blepharoplasty is eyelid surgery. It addresses the excess skin, herniated fat, and weakened tissue that accumulate around the eyelids over time. It can be performed on the upper lids, the lower lids, or both, depending on what the patient’s anatomy actually requires.
What it isn’t — and this is worth saying upfront — is a procedure that changes the fundamental shape of the eye or produces a dramatically different appearance. The goal is more specific than that. It’s to remove what age has added to the eyelids, so the eyes look like themselves again.
Upper vs Lower Blepharoplasty
These are different procedures addressing different concerns, and it’s worth understanding them separately.
Upper Blepharoplasty
This is the more common of the two procedures, and for many patients the more straightforward.
What happens with age: the skin of the upper eyelid loses elasticity and descends over the eyelid crease. In milder cases this creates hooding — the crease becomes less visible, the eyelid looks heavier. In more significant cases, the overhanging skin begins to physically push the eyelid margin downward, restricting the upper visual field. This is called mechanical ptosis, and it’s the basis on which Medicare rebates can apply.
The incision goes within the natural eyelid crease. Precisely measured skin and any herniated fat are removed, the incision is closed with fine sutures, and the scar sits within the crease — not visible when the eyes are open, barely visible when they’re closed. Sutures come out at approximately one week.
For full details, see upper blepharoplasty Sydney.
Lower Blepharoplasty
Lower blepharoplasty is a different conversation — more complex anatomy, always performed under general anaesthetic in hospital, and not covered by Medicare.
The concern is usually under-eye bags. Fat that was previously held neatly in place by the orbital septum has pushed forward as that membrane weakened. Sometimes there’s also excess lower eyelid skin, or a visible hollow below the bag where the lid meets the cheek.
Two approaches exist, and the choice comes down to the anatomy. The transconjunctival approach — incision inside the lower eyelid, no external scar — suits patients where fat prolapse is the main issue and the skin is still in reasonable condition. The transcutaneous approach, with an incision just below the lower lash line, is used where excess skin also needs to come out.
For full details, see lower blepharoplasty in Sydney.
What Can Blepharoplasty Achieve?
It’s worth being honest about what eyelid surgery does and doesn’t do.
What it can address:
- Hooding of the upper eyelids from excess skin
- Visual field obstruction from significant upper eyelid skin descent
- Under-eye bags from herniated fat
- Excess lower eyelid skin
- Tear trough deformity where fat repositioning is appropriate
- The persistently tired appearance caused by these structural changes
What it cannot address:
- Crow’s feet and dynamic wrinkles around the outer eye — these are caused by repeated muscle movement and are not addressed by blepharoplasty
- Dark circles from pigmentation — where darkness results from melanin deposition rather than structural shadowing, surgery does not help
- Brow descent — a descended brow creates apparent upper eyelid hooding, but removing upper eyelid skin to compensate can anchor the brow in a lower position. Where the brow has dropped, a brow lift may address more of the concern
- Eye shape changes — blepharoplasty does not move the corners of the eye or change its fundamental shape
Is It a Brow Problem or an Eyelid Problem?
This is the most important clinical question before upper blepharoplasty — and the most commonly missed.
The brow and the upper eyelid are connected. When the brow descends with age, it pushes skin downward toward and over the eyelid crease. From the outside, this looks like excess upper eyelid skin. In some patients, much of the apparent hooding is actually coming from the brow having dropped, not from true eyelid skin excess at all.
Operating on the eyelid in this situation without addressing the brow can produce a flat result at best — and can actually make the brow look heavier, because removing skin from the eyelid anchors the brow lower. Where brow descent is significant, a brow lift may need to be part of the plan, either alongside or instead of blepharoplasty.
Dr Turner assesses brow position at every upper blepharoplasty consultation. It’s a conversation that happens before any surgical plan is made.
Who Is Blepharoplasty Suitable For?
There’s no single ideal candidate profile, and there’s no right age. The appropriate time for blepharoplasty is when the structural changes are significant enough to warrant it — and that varies considerably from one person to the next.
Generally, surgery may be appropriate where you have excess upper eyelid skin causing hooding or affecting your visual field, or under-eye bags from fat prolapse that haven’t responded to anything else. Good general health, stable eye health, and realistic expectations are the other key factors. Dry eye, thyroid eye disease, and previous eye surgery all need to be discussed before any procedure is planned.
Smoking is a meaningful risk factor. Patients are asked to stop at least six weeks before surgery.
The Procedure
Upper Blepharoplasty
Performed under local anaesthesia with sedation or general anaesthetic as a day procedure. Operating time is typically 45 to 60 minutes.
The amount of skin to be removed is precisely marked with the patient upright before surgery. The incision is made within the natural eyelid crease, excess skin and fat are removed, and the incision is closed with fine sutures removed at approximately one week.
Lower Blepharoplasty
Always performed under general anaesthetic in a private hospital as a day procedure. Operating time is typically 45 minutes to 1.5 hours depending on the approach and whether both upper and lower procedures are combined.
Transconjunctival: incision inside the lower eyelid, no external scar, fat removed or repositioned. Transcutaneous: incision below the lower lash line, skin and fat addressed through this approach.
Combined Upper and Lower
Where both procedures are appropriate, they are performed in the same operation. One anaesthetic, one hospital admission, one recovery period.
Recovery
Upper blepharoplasty. Sutures are removed at approximately one week. Visible bruising resolves over two to three weeks. Most patients return to work and social settings within one to two weeks. Final result in three to six months.
Lower blepharoplasty (transconjunctival). Return to normal activities within five to seven days. No sutures to remove externally. Final result at three to six months.
Lower blepharoplasty (transcutaneous). External sutures are removed at five to seven days. Return to normal activities within ten to fourteen days. Final result at three to six months.
For a full week-by-week guide to recovery, see recovery after blepharoplasty.
Medicare and Cost
Upper blepharoplasty may attract a Medicare rebate where excess skin causes a documented visual field obstruction confirmed by formal visual field testing. A GP referral is required.
Lower blepharoplasty is not covered by Medicare.
| Procedure | Cost |
|---|---|
| Upper blepharoplasty | From $6,000 |
| Lower blepharoplasty | $9,000–$14,000 |
| Consultation | $450 |
For full pricing detail, see the blepharoplasty cost guide.
AHPRA Regulatory Requirements
Under AHPRA cosmetic surgery guidelines (effective 1 July 2023), the following apply before cosmetic blepharoplasty can proceed:
- A referral from your GP or a specialist physician
- A minimum of two consultations with Dr Turner before surgery is booked
- A psychological evaluation to confirm suitability
- A mandatory cooling-off period before formal consent is given
Where upper blepharoplasty is performed for documented functional vision obstruction, a different pathway applies. Dr Turner’s team will confirm which requirements apply at consultation.
Frequently Asked Questions
What is blepharoplasty?
Blepharoplasty is surgery to address excess skin, fat, and muscle around the eyelids. It can be performed on the upper eyelids, lower eyelids, or both. Upper blepharoplasty removes excess skin and fat that creates hooding and, in significant cases, restricts vision. Lower blepharoplasty addresses under-eye bags from herniated fat, excess lower eyelid skin, and tear trough deformity. The goal is to address the structural causes of a tired or aged appearance around the eyes while maintaining natural expression.
What is the difference between upper and lower blepharoplasty?
Upper blepharoplasty removes excess skin and fat from the upper eyelids, addressing hooding and, where significant, visual field obstruction. It may attract a Medicare rebate where functional criteria are met. Lower blepharoplasty addresses under-eye bags, fat prolapse, and excess lower eyelid skin. It is always performed in hospital under general anaesthetic and is not covered by Medicare. Both can be performed together in a single operation.
How long does blepharoplasty last?
Upper blepharoplasty results typically last five to ten years before further skin descent may prompt consideration of a repeat procedure. Lower blepharoplasty results tend to be longer-lasting — often ten to fifteen years or more — because the causes (fat prolapse, orbital septum weakening) do not recur at the same rate as skin laxity. Individual results vary based on genetics, skin quality, and lifestyle factors, including sun exposure.
What is the recovery from blepharoplasty?
Upper blepharoplasty: sutures removed at one week, visible bruising resolves over two to three weeks, most patients return to work within one to two weeks, final result at three to six months. Lower blepharoplasty (transconjunctival): return to normal activities within five to seven days. Lower blepharoplasty (transcutaneous): return to activities within ten to fourteen days. Combined upper and lower follow the longer of the two timelines.
Can blepharoplasty fix dark circles?
Blepharoplasty can address dark circles caused by structural issues — specifically fat prolapse creating shadows, or tear trough hollowing. Fat repositioning can reduce these structural shadows. However, dark circles caused by pigmentation, melanin deposition, or thin skin revealing underlying blood vessels cannot be corrected with blepharoplasty. Dr Turner will assess the cause at the consultation and advise on what surgery may and may not achieve.
Related Procedures and Resources
Related procedures:
Helpful guides:
- Blepharoplasty Cost Sydney 2026
- Brow Lift vs Blepharoplasty: What’s the Difference?
- Recovery After Blepharoplasty
- Will Medicare Cover My Eyelid Surgery?
- Risks and Complications of Blepharoplasty
Consult with Dr Scott J Turner
Dr Turner consults for blepharoplasty in Sydney at Bondi Junction and Manly. He also sees patients in Brisbane, Canberra, Newcastle, and the Gold Coast. Surgery is performed in Sydney at Bondi Junction Private Hospital and Delmar Private Hospital, Dee Why.
Contact the practice to arrange a consultation, or read more about Dr Turner’s background and training.
