Dr Scott J Turner | Specialist Plastic Surgeon (FRACS) | Sydney
Blepharoplasty is surgical correction of excess skin, herniated fat, and weakened tissue around the eyelids. The word comes from blepharon, the Greek term for eyelid. The procedure can be performed on the upper eyelids, the lower eyelids, or both, depending on what the patient’s anatomy requires. The purpose is to address the structural changes that develop with age in this part of the face, not to alter the fundamental shape of the eye. For commercial information and surgical pricing, see the blepharoplasty in Sydney information hub.
The eyelids show structural change earlier than most parts of the face because the skin there is the thinnest on the body. It loses elasticity sooner, the underlying tissue weakens, and the orbital septum (the membrane holding fat behind the eye) gradually allows fat to push forward. The result can be a tired or aged appearance that no amount of sleep or skincare reliably reverses.
Dr Scott J Turner is a Fellow of the Royal Australasian College of Surgeons (FRACS), registered with AHPRA (MED0001654827), 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?
Blepharoplasty is eyelid surgery. It addresses the excess skin, herniated fat, and weakened tissue that accumulate around the eyelids over time. The procedure has been performed in various forms for over a century, and the underlying principle has not changed, although the techniques have evolved considerably.
The operation can be performed on the upper lids, the lower lids, or both, depending on what the patient’s anatomy actually requires. What blepharoplasty is not is a procedure that changes the fundamental shape of the eye or produces a dramatically different appearance. The goal is more specific than that: 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. It is worth understanding them separately.
Upper Blepharoplasty
Upper blepharoplasty is the more common of the two procedures, and for many patients the more straightforward. With age, the skin of the upper eyelid loses elasticity and descends over the eyelid crease. In milder cases this creates hooding, where the crease becomes less visible and 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 is the basis on which Medicare rebates can apply.
The incision is placed 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. It is not visible when the eyes are open, and barely visible when they are closed. Sutures come out at approximately one week.
For full procedure detail, see the upper blepharoplasty page.
Lower Blepharoplasty
Lower blepharoplasty involves more complex anatomy, is always performed under general anaesthetic in hospital, and is 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 is also excess lower eyelid skin, or a visible hollow below the bag where the lid meets the cheek (the tear trough).
Two approaches exist, and the choice comes down to the anatomy. The transconjunctival approach uses an incision inside the lower eyelid with no external scar. It suits patients where fat prolapse is the main issue and the skin is still in reasonable condition. The transcutaneous approach uses an incision just below the lower lash line and is used where excess skin also needs to come out.
For full procedure detail, see the lower blepharoplasty page.
What Can Blepharoplasty Achieve?
The following outlines what eyelid surgery does and does not address.
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 anatomically. 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. The assessment happens before any surgical plan is made.
Who Is Blepharoplasty Suitable For?
There is no single ideal candidate profile, and no specific right age for blepharoplasty. The appropriate time for surgery is when the structural changes are significant enough to warrant it, which varies considerably from one person to the next.
Generally, surgery may be appropriate where excess upper eyelid skin is causing hooding or affecting the visual field, or where under-eye bags from fat prolapse have not responded to non-surgical approaches. 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, 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 cooling-off period between the first consultation and the formal consent
- A psychological evaluation to confirm suitability
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 and Canberra. 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.
