Quick reference: which procedure addresses which concern
| Concern | Likely procedure | Page |
|---|---|---|
| Excess upper eyelid skin, hooding from the lid itself | Upper blepharoplasty | Upper blepharoplasty Sydney |
| Under-eye bags, lower lid puffiness, fat protrusion | Lower blepharoplasty | Lower blepharoplasty Sydney |
| Descended or low brow position causing upper-lid heaviness | Brow lift (endoscopic, gliding, or temporal) | Brow lift Sydney |
| High forehead, hairline sitting too far back | Forehead lowering (hairline advancement) | Forehead lowering Sydney |
| Brow descent with the goal of avoiding a long incision | Gliding brow lift | Gliding brow lift Sydney |
| Heaviness from both brow and excess lid skin | Combined brow lift and upper blepharoplasty | Both pages above |
The diagnostic question that comes first
Roughly half of patients who present with what looks like excess upper eyelid skin actually have a descended brow contributing more than the eyelid itself. The two structures sit close together, and gravity pushes the brow downward over the lid, so the appearance can be hard to separate by eye alone.
The simplest self-test: stand in front of a mirror, look straight ahead, and gently lift the outer third of the eyebrow with a fingertip to where it would naturally sit at age 30. If most of the apparent hooding resolves, the brow is doing most of the work and a brow lift is more likely to address the concern. If the hooding remains, true upper eyelid skin excess is the dominant issue.
Getting this wrong matters. Removing upper eyelid skin without addressing brow descent can pull the brow down further, anchor it in a lower position, and worsen the appearance over time. Brow position is assessed carefully at consultation before any eyelid plan is finalised.
Procedures in detail
Upper blepharoplasty (upper eyelid surgery)
Upper blepharoplasty removes excess skin and, where relevant, herniated fat from the upper eyelids. The incision is placed within the natural eyelid crease so the scar is concealed when the eyes are open and barely visible when closed. Operating time is typically 45 to 60 minutes.
Where excess skin is heavy enough to physically restrict the upper visual field and this is documented appropriately, a Medicare rebate may apply. Most cases are cosmetic and are not Medicare-eligible.
Read the full upper blepharoplasty page →
Lower blepharoplasty (lower eyelid surgery)
Lower blepharoplasty addresses under-eye bags, fat protrusion, and excess lower eyelid skin. Two main approaches are used. The transconjunctival approach places the incision on the inner surface of the lower lid, with no external scar. It suits patients whose primary concern is fat protrusion without excess skin. The transcutaneous approach places an incision just below the lash line and is appropriate where excess skin also needs to be addressed.
Lower blepharoplasty is consistently one of the more visibly impactful eyelid procedures, because the under-eye area is among the first places facial change becomes apparent and structural correction tends to produce a meaningful difference in how rested the face looks overall.
Read the full lower blepharoplasty page →
Brow lift
Brow lift repositions the eyebrow and forehead tissues. Several techniques exist, and the choice depends on the degree of brow descent, the existing hairline position, the depth of forehead lines, and the patient’s preference around incision visibility.
The main techniques offered:
- Endoscopic brow lift. Five small incisions placed within the hair-bearing scalp, with a camera providing magnified visualisation. Suits mild to moderate brow descent without significant hairline elevation concerns.
- Gliding brow lift. Four small hidden incisions within the hairline, wide subcutaneous undermining, allowing the brow to glide upward without disrupting deeper structures. Suits mild to moderate brow descent in patients prioritising recovery and incision concealment.
- Temporal (lateral) brow lift. Small incisions in the temporal hairline, repositioning the outer brow only. Suits patients whose concern is concentrated in the outer brow with the central brow position appropriate.
- Pretrichial or coronal brow lift. Longer incision at or behind the hairline, allowing more substantial correction. Reserved for significant brow descent or deep forehead creasing where smaller-incision techniques would not address the concern adequately.
Read the full brow lift page →
Forehead lowering (hairline advancement)
Forehead lowering surgery moves the hairline forward to reduce the height of the forehead. It suits patients with a constitutionally high hairline who feel their facial proportions would be improved by a shorter forehead. The procedure is distinct from brow lift, which repositions the eyebrow rather than the hairline itself.
Read the full forehead lowering page →
Combined upper blepharoplasty and brow lift
Where both brow descent and excess upper eyelid skin are contributing, both procedures may be performed in the same operation. The surgical sequence addresses the brow first, establishing the new brow position, then assesses the upper eyelid skin against that new position. Removing eyelid skin first can over-correct once the brow is lifted, which is why sequencing matters.
Combined surgery should be based on anatomy, not convenience. If brow descent is minimal, isolated upper blepharoplasty is the more appropriate operation. If lid skin excess is minimal and the issue is brow position, isolated brow lift is the answer.
What consultation covers
Eyelid and brow surgery is highly individualised, and consultation has three jobs:
- Identify which structure is driving the concern (brow, upper lid, lower lid, or a combination), using physical examination including the lift-test and assessment of brow position, lid crease, fat compartments, and tear trough.
- Discuss whether the procedure is medically indicated, cosmetically indicated, or whether non-surgical options should be considered first.
- Provide a written quote with the surgical fee, hospital fee, anaesthesia fee, and consultation requirements set out in full. No quote is provided over the phone or by email.
Two consultations are required before any surgical date is offered, in line with Medical Board and AHPRA requirements for surgical procedures.
Risks and recovery in brief
All surgical procedures carry risk. Specific to eyelid and brow surgery, these include bleeding, infection, scar appearance varying from expected, asymmetry, eyelid position change, dry-eye symptoms (often temporary), and revision surgery if the outcome falls short of plan. Full risk discussion happens at consultation and is documented in writing before surgery.
Recovery varies by procedure. Upper blepharoplasty typically allows return to desk-based work at 7 to 10 days. Lower blepharoplasty is usually similar though bruising can take longer to resolve fully. Endoscopic and gliding brow lift recoveries are generally a similar timeline. Pretrichial or coronal brow lifts take longer. Exercise restriction applies for six weeks across all procedures.
Cost
Cost varies by which procedure is performed, whether procedures are combined, and whether Medicare applies. As a general guide:
- Upper blepharoplasty. Range depends on local-anaesthetic vs general anaesthetic and rooms vs hospital setting. Where Medicare applies, the out-of-pocket reduces significantly.
- Lower blepharoplasty. Performed under general anaesthetic in hospital. Higher fee range than upper blepharoplasty.
- Combined upper and lower blepharoplasty. Typically less than the sum of two separate procedures, reflecting single anaesthetic and single recovery.
- Brow lift. Range depends on technique (endoscopic, gliding, temporal, coronal).
- Combined brow lift and upper blepharoplasty. Cost-efficient where both procedures are clinically indicated.
A written, itemised quote is provided after consultation. See the blepharoplasty cost guide for current pricing context.
About Dr Scott J Turner
Dr Scott J Turner is a Fellow of the Royal Australasian College of Surgeons (FRACS), registered with AHPRA (MED0001654827). His training and practice focus include eyelid and facial surgery, with operating privileges at Bondi Junction Private Hospital and Delmar Private Hospital, Dee Why.
Sydney consultations are held at:
- Bondi Junction Clinic. 39 Grosvenor Street, Bondi Junction NSW 2022.
- Manly Clinic. Suite 504, Level 5, 39 East Esplanade, Manly NSW 2095.
Patients also travel from Brisbane and Canberra for surgery with Dr Turner, with consultation options at the Brisbane location page and Canberra location page.
Frequently Asked Questions
What is the difference between brow lift and upper blepharoplasty?
Blepharoplasty addresses the eyelid tissues themselves: skin, muscle, and where relevant fat. Brow lift addresses the position of the eyebrow and the forehead tissues above the eye. Both can affect how the eye area appears, but they work on different anatomy. Roughly half of patients with apparent excess upper eyelid skin actually have brow descent contributing more than the lid itself, which is why the lift-test at consultation matters. Some patients need one procedure, some need the other, and some benefit from both performed together in the same operation.
Will eyelid surgery change my eye shape?
Standard blepharoplasty is not designed to change eye shape. The procedure addresses excess skin and fat, not the bony orbit or the canthal angles that determine eye shape. Where eye shape change is the patient’s goal, the relevant procedures are canthoplasty or canthopexy, which are separate operations with different indications. The blepharoplasty assessment at consultation includes a clear discussion of what the procedure can and cannot do for the patient’s specific concern.
Is upper blepharoplasty covered by Medicare?
In some cases, yes. Where the weight of excess upper eyelid skin is sufficient to physically restrict the upper visual field, and this is documented through a visual field test, the procedure may meet criteria for a Medicare item number. Most upper blepharoplasty is performed for cosmetic reasons and is not Medicare-eligible. The assessment at consultation includes whether Medicare may apply to the individual case. Lower blepharoplasty is generally not Medicare-eligible regardless of presentation.
How is the right brow lift technique chosen?
The choice depends on three factors: the degree of brow descent, the existing hairline position, and the patient’s preference around incision concealment. Mild to moderate descent with a stable hairline often suits endoscopic or gliding techniques. Significant descent, deep forehead creasing, or a high existing hairline may indicate a pretrichial or coronal approach for adequate correction. The decision is made at consultation based on physical examination, not on patient request alone. Operating a technique outside its intended range tends to produce undercorrection or hairline distortion.
Can I have upper and lower blepharoplasty in the same operation?
In most cases, yes. Combining the two procedures means one anaesthetic, one hospital admission, and one recovery period rather than two separate procedures. There are efficiencies in combining that typically make the combined cost less than two procedures staged separately. Combined surgery suits patients where both upper and lower eyelid concerns are clearly present. Where the issue is clearly upper or lower only, the individual procedure is appropriate.
How long does recovery from eyelid surgery take?
Most patients return to desk-based work at 7 to 10 days following upper or lower blepharoplasty, with visible bruising largely resolved by 2 to 3 weeks. Final settling of the eyelid contour and scar maturation continues over 3 to 6 months. Exercise and heavy lifting are restricted for six weeks. Eye makeup is typically resumed at 2 to 3 weeks. The timeline assumes uncomplicated healing; individual recovery varies with skin type, age, and adherence to post-operative instructions.
What are the main risks of blepharoplasty and brow lift surgery?
All surgical procedures carry risk. The main risks specific to eyelid surgery include bleeding, infection, scar appearance varying from expected, asymmetry between sides, lid position change (lower lid retraction or ectropion in lower blepharoplasty), and dry-eye symptoms which are usually temporary. Brow lift adds risks of altered scalp sensation, asymmetry of brow position, and rarely changes in hairline position depending on technique used. Full risk discussion is documented in writing before any surgical date is offered.
Do I need two consultations before surgery?
Yes. Two consultations are required before any surgical date is offered, with a cooling-off period between them, in line with Medical Board and AHPRA requirements for surgical procedures. The first consultation is the assessment and discussion of options. The second confirms the chosen procedure, the written quote, and the consent process. This applies to all surgical procedures performed by Dr Turner and is not specific to eyelid or brow surgery.
Book a consultation in Sydney
Consultations are held in Bondi Junction and Manly. Surgery is performed at Bondi Junction Private Hospital and Delmar Private Hospital, Dee Why.
Contact the practice on (02) 9387 3900 or email [email protected]. Brisbane and Canberra consulting options are available via the Brisbane location page and Canberra location page.
