Blepharoplasty: does it have to be surgery, and who should perform it?

Does blepharoplasty have to be done with surgery and stitches, and who is best placed to perform it? Dr. Mahmoud El Samkary explains the steps.

A frequent question is whether blepharoplasty has to be a surgical procedure with stitches. To answer, we first need to understand why the eyelids sag.

What causes sagging eyelids?

Over time the eyelid tissues weaken, so the fat and the skin sag. Blepharoplasty therefore relies on strengthening the muscles and tissues, removing excess fat and tightening the sagging skin.

Upper eyelid surgery

It is done through a cosmetic incision in the natural eyelid crease, closed with fine sutures under the microscope, so the scar is not visible after healing. There is no non-surgical alternative that gives the same result for the upper eyelid.

Lower eyelid surgery

It is done through a cosmetic incision just below the lashes that is not visible after healing. In some cases, if the lower eyelid skin is firm and tight, the operation can be done from the inside with a laser and no external incision.

Who should perform blepharoplasty?

Eyelid and tear duct surgery is a subspecialty of ophthalmology, like retina or squint surgery. Dr. Mahmoud El Samkary believes it is best performed by a doctor specialized in this area, who knows the anatomy of the eyelid and the eye well and can manage any complications.