Understanding Blepharoplasty
The eyelids age differently from the rest of the face. Skin in the periorbital area is among the thinnest on the body and loses elasticity relatively early. Fat compartments shift over time. The orbicularis muscle weakens. The combined effect produces the familiar signs — heaviness of the upper lids, skin that folds over the lash line, puffiness or hollowing beneath the eyes, and a tired appearance that may not reflect how a person actually feels.
Blepharoplasty addresses these changes surgically. Upper blepharoplasty removes excess skin and, where indicated, fat from the upper eyelid. Lower blepharoplasty addresses the under-eye area — repositioning or removing herniated fat, and tightening or excising redundant skin where present. The two procedures can be performed together or independently, depending on what the anatomy indicates.
This is not a procedure to approach casually. The eyelids are functional structures as much as aesthetic ones. Surgical technique, conservative tissue management and an accurate pre-operative assessment all matter significantly to the quality of the outcome and the avoidance of complications. Over-resection of upper eyelid skin in particular is not correctable — which is why measurement, marking and conservative excision are central to the operation.
For comprehensive technical detail, see the main procedure pages: Upper Blepharoplasty, Lower Blepharoplasty and the Eyes procedures overview.
Upper Blepharoplasty Brisbane
Upper blepharoplasty may be considered for patients with excess upper eyelid skin, eyelid heaviness, or skin that sits on or folds over the upper eyelid crease. In some patients this affects appearance only; in others, the upper eyelid skin contributes to functional symptoms such as upper visual field obstruction or eyelid heaviness late in the day.
Upper eyelid assessment must also include brow position. Some patients who initially ask about upper blepharoplasty have brow descent contributing to the upper eyelid hooding — in these cases, removing eyelid skin alone may not address the underlying cause. Dr Turner assesses brow position alongside upper eyelid anatomy and may discuss whether endoscopic brow lift Brisbane is relevant, either instead of upper blepharoplasty or in combination with it. This is covered in more detail in the Upper Blepharoplasty and Brow Lift section below.
The appropriate plan depends on upper eyelid skin, fat, brow position, eyelid margin position, facial anatomy, medical history and whether a functional component is present.
Lower Blepharoplasty Brisbane
Lower blepharoplasty may be considered for patients with lower eyelid bags, puffiness, lower eyelid skin excess, or contour change around the lower eyelid and cheek junction. The surgical plan depends on whether the primary contributor is fat prominence, skin laxity, muscle laxity, eyelid position or midface support — and these often coexist in different proportions across patients.
Lower blepharoplasty does not replace facelift surgery. In some patients, lower eyelid concerns occur together with midface descent, jowls or broader lower-face ageing. Where that is the case, Dr Turner may assess whether lower blepharoplasty should be planned alongside a broader procedure such as deep plane facelift Brisbane or vertical restore facelift Brisbane. This is covered in more detail in the Lower Blepharoplasty and Facelift Procedures section below.
Transconjunctival vs Transcutaneous Lower Blepharoplasty
Lower blepharoplasty can be performed through different approaches depending on anatomy. The choice of approach is one of the more significant surgical planning decisions in lower eyelid surgery and is made based on examination findings, not patient preference.
| Approach | Incision | Generally considered when |
|---|---|---|
| Transconjunctival lower blepharoplasty | Inside the lower eyelid, through the conjunctiva | Lower eyelid fat prominence is the main concern and skin removal is not required |
| Transcutaneous (subciliary) lower blepharoplasty | External incision just below the lower lashes | Skin excess, muscle laxity or additional lower eyelid support need to be addressed |
Transconjunctival lower blepharoplasty avoids an external skin incision, which means no visible scar. It allows direct access to the lower eyelid fat compartments for repositioning or removal. It is not suitable for every patient — where skin excess or muscle laxity also need to be addressed, the transconjunctival approach alone cannot do that work.
Transcutaneous lower blepharoplasty uses an external incision placed just below the lower lash line — also referred to as a subciliary incision. The incision matures over months and is generally inconspicuous once healed, but it does create a small external scar. The transcutaneous approach allows direct access to all the relevant layers (skin, muscle and fat) and is the approach used where skin removal, muscle repositioning or canthal support are part of the surgical plan.
In some patients, the lower lid may benefit from additional support procedures such as canthoplasty or canthopexy to maintain lid position and reduce the risk of ectropion. This is discussed at consultation where relevant.
Upper Blepharoplasty and Brow Lift
Upper eyelid heaviness is not always caused by eyelid skin alone. Brow descent — particularly lateral brow descent affecting the outer corners — can push tissue downward toward the upper eyelid and create or worsen hooding. If brow position is not assessed, upper blepharoplasty alone may not address the underlying cause of the concern, and the patient may be left with persistent heaviness despite a technically successful operation.
During consultation, Dr Turner assesses:
- Brow position relative to the orbital rim
- Forehead muscle activity (frontalis function)
- Upper eyelid skin excess and its position relative to the lash line
- Eyelid crease position and symmetry
- Eyelid margin position (looking for any ptosis component)
Based on this assessment, some patients are appropriately treated with upper blepharoplasty alone. Others may be more appropriately treated with endoscopic brow lift Brisbane — particularly where the brow has descended significantly and the apparent eyelid heaviness is largely a brow position issue. A third group has both brow descent and eyelid skin excess and is appropriately treated with both procedures combined in a single operation.
The distinction matters because the operations address different anatomy. Doing the wrong operation produces a disappointing result regardless of how technically well it is performed.
Lower Blepharoplasty and Facelift Procedures
Lower blepharoplasty is often assessed in the context of the midface and lower face rather than as an isolated eyelid procedure. Some patients have lower eyelid bags or tear-trough contour changes without significant facial descent. Others have lower eyelid concerns together with midface descent, jowls, jawline laxity or neck changes.
Where lower eyelid and midface concerns occur together, Dr Turner may assess whether lower blepharoplasty should be planned alongside one of the following Brisbane procedures:
- Endoscopic Ponytail Facelift Brisbane — where temple and upper midface support is part of the picture
- Deep Plane Facelift Brisbane — where midface, jowls and neck are also affected
- Vertical Restore Facelift Brisbane — for multi-zone facial ageing involving brow, midface and lower face together
- Neck Lift Brisbane — where neck laxity is contributing to overall facial ageing
This does not mean combined surgery is required for every patient. The decision depends on anatomy, cumulative surgical risk, recovery considerations and patient goals. Some patients benefit from staging procedures; others benefit from combining them into a single operative session.
Are You a Suitable Candidate?
Blepharoplasty may be considered for patients with one or more of the following:
- Excess skin on the upper eyelids that creates visual heaviness or — in more advanced cases — affects the upper field of vision
- Fat deposits beneath the upper lids contributing to a puffy appearance
- Persistent under-eye bags caused by herniated fat (distinct from fluid retention or pigmentation, which surgery does not address)
- Loose or crepey lower eyelid skin
- Lower eyelid contour changes amenable to surgical correction
General suitability also depends on overall health, the absence of uncontrolled medical conditions affecting healing, realistic expectations and a clear understanding of what the procedure can and cannot achieve. Certain eye conditions — dry eye, glaucoma, thyroid-related eye disease — require careful evaluation before surgery is appropriate, and may affect the surgical plan or rule blepharoplasty out entirely.
Suitability is properly assessed at consultation after clinical examination. No assumptions should be made prior to physical assessment.
Procedures Commonly Assessed With Blepharoplasty
Blepharoplasty assessment frequently overlaps with other facial procedures. This does not mean every patient requires combined surgery — the plan depends on which areas are actually contributing to the patient’s concerns.
- Endoscopic Brow Lift Brisbane — where brow descent is contributing to upper eyelid hooding
- Endoscopic Ponytail Facelift Brisbane — for temple and upper midface support alongside lower eyelid surgery
- Deep Plane Facelift Brisbane — where midface, jowls and neck require broader correction
- Vertical Restore Facelift Brisbane — for multi-zone facial ageing
- SMAS Facelift Brisbane — for early-to-moderate lower-face concerns alongside eyelid surgery
- Neck Lift Brisbane — for neck laxity contributing to overall facial concerns
- Facial fat transfer — for volume change in the temples, lateral brow region or tear-trough area
Your Consultation at Herstellen Clinic, Brisbane
Dr Scott Turner consults with patients at Herstellen Clinic, 490 Boundary Street, Spring Hill QLD 4000 — a dedicated cosmetic surgery facility in Brisbane’s inner city, accessible from across South East Queensland.
At your initial consultation, Dr Turner takes a full medical and ocular history and examines upper and lower eyelid anatomy in detail — including skin excess, fat compartments, lid position, eyelid margin position and muscle tone. Lacrimal (tear) function and dry eye risk are assessed. Brow position is examined alongside the eyelid anatomy because the two are functionally and visually linked. The area is photographed for surgical planning, and the appropriate surgical approach is discussed in full. Recovery, realistic outcomes, risks and alternatives are all covered.
Both consultations are conducted personally by Dr Turner. A minimum of two consultations is required before surgery is scheduled. Queensland regulations require a minimum 7-day cooling-off period between consultation and any elective cosmetic surgical procedure — this is a mandatory requirement, not an optional waiting period. Where a functional component to upper blepharoplasty is being assessed, a GP referral and visual field testing may be required for Medicare eligibility.
Frequently Asked Questions
Will there be visible scarring after blepharoplasty?
Upper eyelid incisions are placed within the natural crease and typically become inconspicuous once healed. Lower eyelid incisions (where used) sit just below the lash line and mature well in most patients. Transconjunctival lower blepharoplasty leaves no external scar. Final scar appearance develops over several months and varies between individuals.
Can blepharoplasty treat dark circles under the eyes?
Not directly. Dark circles are most commonly caused by pigmentation, thin skin, or shadow from hollowing — none of which are addressed by blepharoplasty alone. If under-eye bags are contributing to shadow, surgery may improve that component. Dr Turner will clarify what the examination findings suggest is possible at your consultation.
Is blepharoplasty covered by Medicare?
Upper blepharoplasty may attract a Medicare item number where there is documented functional impairment to the upper visual field caused by skin excess. Lower blepharoplasty is generally considered cosmetic. Eligibility is assessed on a case-by-case basis during your consultation.
Can I have upper and lower blepharoplasty at the same time?
Yes. Combined upper and lower blepharoplasty is commonly performed in a single operative session. Whether this is appropriate depends on your anatomy, health, and anaesthetic plan — all of which are assessed at consultation.
Does Dr Turner perform the surgery in Brisbane?
No. Dr Turner is a Sydney Specialist Plastic Surgeon who consults in Brisbane at Herstellen Clinic, Spring Hill. Surgery is performed at an accredited private hospital in Sydney. Post-operative follow-up care is then provided by Dr Turner and the Herstellen Clinic team locally in Brisbane, so most appointments remain close to home.
How long do blepharoplasty results last?
Blepharoplasty addresses the anatomical changes present at the time of surgery. The ageing process continues after surgery, and the eyelids will continue to change over time. That said, many patients find results remain meaningful for a decade or more. Individual results vary and cannot be guaranteed.
Surgical Technique
Blepharoplasty is performed under local anaesthesia with sedation or general anaesthesia, depending on the extent of surgery and patient preference. Combined upper and lower procedures are generally performed under general anaesthesia. Operating time is typically 1 to 2 hours for upper blepharoplasty alone, 1.5 to 2.5 hours for lower blepharoplasty alone, and 2.5 to 4 hours for combined upper and lower eyelid surgery — extended where brow lift or other facial procedures are added. Most patients are discharged the same day as day surgery.
For upper blepharoplasty, the incision is placed within the upper eyelid crease, where scarring is inconspicuous once healed. Skin is measured and conservatively excised — over-resection is not correctable, so precision matters. Fat may be removed or repositioned where indicated. The incision is closed with fine sutures, typically removed at 5 to 7 days.
For lower blepharoplasty, the approach is determined at consultation: transconjunctival (no external scar, for fat-only work) or transcutaneous (subciliary, for combined fat, skin and muscle work). The technical detail of each approach is covered above in the Transconjunctival vs Transcutaneous section.
Blepharoplasty Cost Brisbane
The cost of blepharoplasty surgery depends on whether upper blepharoplasty, lower blepharoplasty or combined upper and lower eyelid surgery is performed. It also depends on accredited hospital fees, specialist anaesthetist fees, operating time, whether brow lift or facelift surgery is included, and post-operative follow-up requirements.
Upper blepharoplasty as an isolated procedure is generally the most accessible price point because operating time is shortest and the procedure is often performed as day surgery under local anaesthesia with sedation. Combined upper and lower blepharoplasty involves longer operating time and generally requires general anaesthesia, which is reflected in the surgical fee. Adding brow lift or facelift further increases operating time and overall cost.
A detailed written itemised quote is provided after consultation once Dr Turner has assessed eyelid anatomy, brow position, lower eyelid support, medical history and the proposed surgical plan.
Upper blepharoplasty may attract a Medicare item number where strict functional criteria are met — typically documented upper visual field impairment caused by skin excess. A GP referral and visual field testing are required for eligibility assessment. Lower blepharoplasty is generally considered cosmetic and not eligible for Medicare or private health insurance rebates. For broader pricing context, see plastic surgery prices.
Recovery After Blepharoplasty
Recovery from blepharoplasty is typically manageable, though the periorbital area bruises readily and early swelling can be pronounced.
Week 1
Swelling and bruising peak in the first 48 to 72 hours. Cold compresses and head elevation help. The eyes may feel tight or dry. Sutures are usually removed at 5 to 7 days. Vision may be temporarily blurred due to swelling and ointment.
Weeks 2–3
Bruising resolves progressively. Most patients are comfortable returning to desk-based or light work within 7 to 10 days. Strenuous activity and heavy lifting should be avoided.
Weeks 4–6
Residual swelling continues to settle. Vision may fluctuate slightly while swelling is present. Contact lens wear is typically deferred for at least 2 to 3 weeks.
Months 2–6
Incision lines continue to mature and fade. Final scar appearance is not assessed until at least 3 months post-operatively. Brisbane’s UV exposure makes sun protection particularly relevant during scar maturation.
Post-operative appointments are conducted locally in Brisbane by Dr Turner and the Herstellen Clinic team. Recovery varies between individuals.
Risks and Complications
Blepharoplasty is a surgical procedure and carries risks. Informed consent requires understanding these before proceeding.
General surgical risks include bleeding, infection, poor wound healing, adverse reaction to anaesthesia and scarring.
Procedure-specific risks include:
- Dry eye — temporary or, rarely, persistent reduction in tear production. Most significant in patients with pre-existing dry eye, which is why ocular history and tear function assessment are part of every consultation.
- Asymmetry between the two sides — minor asymmetry is common and usually settles as swelling resolves
- Lagophthalmos — incomplete eye closure, usually temporary, more common after upper blepharoplasty
- Ectropion — outward turning of the lower lid, more common with transcutaneous (subciliary) lower blepharoplasty
- Ptosis — drooping of the upper lid, occasionally unmasked or worsened by upper blepharoplasty
- Chemosis — conjunctival swelling, typically self-resolving over days to weeks
- Retrobulbar haemorrhage — extremely rare but serious complication that can affect vision; emergency management is required
- Skin irregularities and the need for revision surgery are also possible
Dr Turner discusses all relevant risks during consultation in the context of your individual anatomy and health history. For broader information, see risks and complications of cosmetic surgery.
About Dr Scott J Turner — Specialist Plastic Surgeon
Dr Scott J Turner is a Sydney Specialist Plastic Surgeon and Fellow of the Royal Australasian College of Surgeons — FRACS (Plas) — with a practice focused on cosmetic plastic surgery of the face, nose and body. He holds AHPRA registration MED0001654827.
Specialist Plastic Surgeon is a protected medical title in Australia. It requires a minimum of 12 years of medical and surgical training, including completion of an accredited surgical training programme in plastic and reconstructive surgery and Fellowship of the Royal Australasian College of Surgeons. It is distinct from the broader term “cosmetic surgeon,” which in Australia does not require Specialist Plastic Surgery training. AHPRA’s public register allows patients to verify any practitioner’s specialist registration.
Dr Turner approaches eyelid surgery with a conservative, anatomy-driven technique. The focus is on outcomes that respect the functional integrity of the eyelid — not only its appearance. His primary surgical practice is based in Sydney at Bondi Junction and Manly. He consults in Brisbane at Herstellen Clinic, Spring Hill, with surgery performed at accredited private hospitals in Sydney and post-operative follow-up provided by Dr Turner and the Herstellen Clinic team in Brisbane.
Frequently Asked Questions
What is the difference between upper and lower blepharoplasty?
Upper blepharoplasty addresses upper eyelid skin and upper eyelid heaviness — and, in selected cases, fat in the upper eyelid. Lower blepharoplasty addresses lower eyelid bags, puffiness, skin excess or contour change around the lower eyelid and cheek junction. Some patients require one procedure only; others may be assessed for both. Whether upper, lower or combined blepharoplasty is appropriate depends on examination findings rather than patient preference for one procedure over the other.
Is upper eyelid heaviness caused by eyelids or brow descent?
It can be either, or both. Brow descent can push tissue toward the upper eyelids and contribute to hooding, in which case removing eyelid skin alone may not address the full cause. Dr Turner assesses brow position, forehead movement, upper eyelid skin, eyelid crease position and eyelid margin position before recommending upper blepharoplasty, endoscopic brow lift, or combined surgery. The distinction matters because the two procedures address different anatomy.
What is transconjunctival lower blepharoplasty?
Transconjunctival lower blepharoplasty is performed through the inner lining of the lower eyelid (the conjunctiva), avoiding an external skin incision. It may be considered where lower eyelid fat prominence or under-eye bags are the primary concern and skin removal is not required. It is not suitable for every patient — where skin excess or muscle laxity also need to be addressed, a different approach may be more appropriate.
What is transcutaneous lower blepharoplasty?
Transcutaneous lower blepharoplasty uses an external incision placed just below the lower lash line — also referred to as a subciliary incision. It may be considered where skin excess, muscle laxity or additional lower eyelid support needs to be addressed alongside fat repositioning. The transcutaneous approach allows direct access to all the relevant layers but creates a small external scar that matures over several months.
Can blepharoplasty treat dark circles under the eyes?
Not directly. Dark circles are most commonly caused by skin pigmentation, thin skin allowing underlying vessels to show through, or shadow created by lower eyelid hollowing — none of which are addressed by blepharoplasty alone. Where lower eyelid bags are contributing to the shadow effect, surgery may improve that specific component. The cause of dark circles is appropriately clarified by clinical examination at consultation.
How much does blepharoplasty cost in Brisbane?
The cost of blepharoplasty surgery depends on whether upper, lower or combined upper and lower eyelid surgery is performed, accredited hospital fees, specialist anaesthetist fees, operating time, whether brow lift or facelift is included, and follow-up requirements. A written itemised quote is provided after consultation. Upper blepharoplasty may attract a Medicare item number where strict functional criteria are met; cosmetic blepharoplasty is not eligible for Medicare or private health insurance rebates.
Is blepharoplasty covered by Medicare?
Upper blepharoplasty may attract a Medicare item number where there is documented functional impairment to the upper visual field caused by skin excess. Strict criteria apply, including visual field testing and clinical documentation. Lower blepharoplasty is generally considered cosmetic and not eligible. Eligibility is assessed on a case-by-case basis during consultation, and a GP referral is required if a functional component is being assessed.
How long do blepharoplasty results last?
Blepharoplasty addresses the anatomical changes present at the time of surgery. The ageing process continues after surgery, and the eyelids continue to change over time. Many patients find the results of upper blepharoplasty in particular last a decade or more before further intervention is considered. Lower blepharoplasty results vary more between patients depending on the relative contributions of fat, skin and underlying tissue support.
Book a Consultation at the Brisbane Clinic
If you are based in Brisbane, Queensland, or elsewhere in Australia and would like to explore your options with Dr Turner, contact the practice to request a consultation at Herstellen Clinic in Spring Hill. For visual reference of surgical outcomes, the eyelid before and after gallery is available. Patients travelling from regional Queensland or interstate may find the out-of-town patient information useful.
Herstellen Clinic 490 Boundary Street, Spring Hill QLD 4000 Phone: 1300 437 758 Email: [email protected] Hours: Monday – Friday, 9am – 5pm
Request a Brisbane consultation
Consultations are with Dr Turner personally. A minimum of two consultations is required before surgery. Queensland’s 7-day cooling-off period applies to all cosmetic surgical procedures.
Brisbane Procedure Pages
- Endoscopic Ponytail Facelift — Brisbane
- Short Scar Facelift — Brisbane
- Deep Plane Facelift — Brisbane
- Vertical Restore Facelift — Brisbane
- SMAS Facelift — Brisbane
- Revision Facelift — Brisbane
- Neck Lift — Brisbane
- Deep Neck Lift — Brisbane
- Direct Neck Lift — Brisbane
- Endoscopic Brow Lift — Brisbane
- Blepharoplasty — Brisbane
