Oculoplastic surgery · London
Upper eyelid blepharoplasty, by a named oculoplastic surgeon.
A day-case operation to remove hooding and open the crease, done by a BAAPS or RCOphth oculoplastic surgeon on a dedicated eyelid list, with ptosis correction, brow lift or deep-plane pathways in the same theatre if the eyelid is only part of the picture.
Why patients choose us
- 01
An oculoplastic or plastic surgeon, not a generalist
A named BAAPS or RCOphth oculoplastic surgeon with a dedicated eyelid list. Not a cosmetic clinic booking upper bleph between fillers.
- 02
The right operation for the eyelid you have
Excess skin is not always the whole story. Brow ptosis and true ptosis often coexist and need their own plan, before you commit to a bleph.
- 03
Independent, and free
We are paid by no clinic, so the recommendation is impartial and costs you nothing.
Indicative pricing
What a private upper bleph costs in London.
Indicative ranges across our partner surgeons and day-case units. Send photos and history and we quote firm figures across two or three options.
In short
Both upper eyelids under LA and sedation: £3,500 to £5,500, home the same day.
| Procedure | Indicative range | Typical duration | Turnaround |
|---|---|---|---|
| Oculoplastic consultation and visual-field assessment | £250 to £450 | 45 min | Same visit |
| Upper blepharoplasty, both eyes, LA and sedation | £3,500 to £5,500 | 45 to 60 min | Day case |
| Upper blepharoplasty, both eyes, GA | £4,500 to £7,500 | 60 to 90 min | Day case |
| Combined upper and lower blepharoplasty | £6,500 to £10,500 | 90 to 150 min | Day case |
| Upper bleph combined with endoscopic brow lift | +£3,500 to £5,500 | Add 60 min | Day case |
| Ptosis correction (levator advancement), added | +£1,200 to £2,500 | Add 30 min | Day case |
Prices vary by surgeon and unit, by anaesthetic choice, and by whether ptosis correction, brow lift or a lower bleph is added on the day. London centres in our network include Cadogan Clinic, London Bridge Cosmetic Surgery, HCA The Wellington Oculoplastic and King Edward VII's.
The journey
From first photo to sutures out, what happens, in order.
One team from first message to your six-week review, including the visual-field test, the operation and the suture removal.
- 01
Before
You send us photos and history
A short confidential form. Front, three-quarter and eyes-closed photos, any dry-eye history, medications including anticoagulants and blood-pressure control.
- 02
Before
We come back with a recommendation
Within one working day: whether upper bleph alone fits, whether ptosis correction or a brow lift is needed, and an indicative price. An honest read either way.
- 03
Before
Consultation and assessment
Visual field for functional dermatochalasis, brow position, levator function, Schirmer and tear film, asymmetry and medical fitness for LA or GA.
- 04
On the day
Arrival at the day-case unit
Marking sitting up, then local anaesthetic with oral sedation for most patients. GA on request or for combined procedures.
- 05
On the day
The operation itself
15 to 20 minutes per eyelid. Supratarsal incision in the natural crease, conservative skin and orbicularis excision, conservative nasal and central fat reduction, fine layered closure.
- 06
On the day
Home the same day
Cold compress, written aftercare and lubricants. Home within a couple of hours. You will need someone to drive you if sedated.
- 07
After
Sutures out and review
Sutures removed at 5 to 7 days. Bruising settles by 7 to 10 days, most swelling by 2 to 3 weeks. Back to work 7 to 14 days, makeup at 2 weeks, exercise at 3 weeks.
When it helps
When upper bleph is the right step, and when it is not.
The eyelids we see most, plus the signs that mean a brow lift, ptosis correction or a completely different plan is a better call.
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Dermatochalasis with hooded upper lids
Excess upper eyelid skin that rests on the lash line, feels heavy at the end of the day, and blurs the crease.
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Functional visual-field obstruction
Superior visual field blocked by skin overhang. A formal visual-field test with lids taped versus untaped supports insurance cover.
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Tired or ageing appearance
A cosmetic complaint of looking tired or older than you feel, even when well-rested. A subtle rejuvenation, not a new face.
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Brow hooding contribution
Lateral brow descent adding to the hood. If the brow is truly ptotic, a brow lift is needed either instead of or with the bleph.
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Coexisting true ptosis
A low upper eyelid margin from a stretched levator aponeurosis. Often asymmetric. Corrected in the same sitting with levator advancement.
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Asymmetric upper lids
One hood heavier than the other, or one crease higher. Marked sitting up, corrected with different resections on each side.
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Prominent nasal fat pad
A fullness at the inner corner. A small, conservative fat reduction gives a cleaner crease without a hollow.
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Not the right operation
Isolated brow ptosis needs a brow lift. Dry eyes, unstable tear film or thyroid eye disease need optimising first, or a different plan.
Procedure options
Upper bleph is a spectrum, not a single operation.
What each option involves, and which fits which eyelid. Over-resection is the pitfall we design against: conservative skin, conservative fat.
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Skin-only upper blepharoplasty
A conservative crescent of skin excised in the crease. Suits younger patients with a fine hood and no fat prolapse.
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Skin and orbicularis strip
A thin strip of orbicularis oculi is taken with the skin when the hood is thick. Deepens the crease without over-hollowing.
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Skin, orbicularis and conservative fat
Nasal and central fat pads reduced conservatively. The workhorse for most upper bleph patients over 45.
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Combined with ptosis correction
Levator advancement done through the same incision when the lid margin sits low. Lifts the lid, not just the skin.
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Combined with endoscopic brow lift
For true brow ptosis. Skin can be taken more conservatively at the eyelid because the brow is repositioned.
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Combined with mid-face or deep-plane lift
Comprehensive rejuvenation in one anaesthetic. Longer recovery but avoids a staged approach.
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Local anaesthetic and oral sedation
The default. You are awake but comfortable, home within a couple of hours, no anaesthetist fee.
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General anaesthetic
For combined procedures, anxious patients, or those unable to lie still. Day case in a fully equipped theatre.
Our vetted London network
A small panel of oculoplastic surgeons, we picked them.
Consultant surgeons with dedicated eyelid lists in CQC-registered day-case units. Names in our network include Dr Sabrina Shah-Desai and Mr Naresh Joshi, alongside colleagues at Cadogan Clinic, London Bridge Cosmetic Surgery, HCA The Wellington and King Edward VII's.
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Oculoplastic surgeons on the GMC Specialist Register in Ophthalmology, or BAAPS plastic surgeons with an eyelid subspecialty
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CQC-registered day-case theatres with anaesthetic and resuscitation cover
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Formal visual-field testing available for functional dermatochalasis and insurance letters
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Combined pathways for ptosis correction, brow lift, mid-face and deep-plane facelift when the eyelid is only part of the picture
Safety and recovery
What to expect afterwards, honestly.
Upper blepharoplasty is a common, well-established operation. Over-resection with dry eye is the pitfall we design against, and satisfaction sits at 85 to 95% in published series.
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Over-resection and lagophthalmos
The single most important pitfall. Taking too much skin leaves the eye unable to close fully, causing dry eye and exposure keratopathy. Conservative excision is deliberate.
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Dry eye exacerbation
A pre-existing dry eye almost always worsens for weeks after surgery. Schirmer and tear-film assessment beforehand, and lubricants for at least a month afterwards.
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Bruising and swelling
Bruising settles by 7 to 10 days. Most swelling by 2 to 3 weeks, though the final crease shape can take 3 months to settle. Cold compresses in the first 48 hours help.
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Retrobulbar haemorrhage
Very rare but a true emergency. Sudden severe pain, proptosis and vision loss in the first hours after surgery. A clear 24/7 contact number matters.
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Blindness
Extremely rare, below 0.05% in published series, from retrobulbar haemorrhage or optic nerve compromise. Discussed openly at consent.
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Asymmetry and residual ptosis
A small degree of asymmetry is normal. Missed or under-corrected ptosis is the commonest reason for a revision. Careful assessment beforehand avoids this.
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Scarring and granuloma
The scar is hidden in the natural crease and usually fades to a fine line. Hypertrophic scars are rare in this area. Small suture granulomas settle with massage or removal.
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Anticoagulation and blood pressure
Anticoagulants and antiplatelets are reviewed with the team and often paused. Uncontrolled blood pressure is a bleeding risk and is optimised first.
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Revision rate
Around 5% of patients have a small revision, most often a touch-up for asymmetry, a persistent skin fold or a suture granuloma.
Recognised by major UK insurers
Functional upper blepharoplasty for visual-field obstruction may be covered by most UK insurers with a formal field test and supporting letter. Purely cosmetic bleph is self-funded.
Frequently asked
Everything we get asked about upper bleph.
Quick answers on insurance, sensation, downtime, scars, ptosis and whether the lower eyelids need doing too.
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Will my insurance cover upper blepharoplasty?
Purely cosmetic bleph is self-funded. Functional upper blepharoplasty for dermatochalasis blocking the superior visual field can be covered by most UK insurers, but requires a formal visual-field test with lids taped versus untaped, photographs and a supporting letter from the oculoplastic surgeon. We prepare that pack for you before booking.
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Will I feel the operation?
No. The eyelid skin is numbed with local anaesthetic and most patients also have a small oral sedative. You may feel a little pressure and hear the surgeon and nurse talking, but the operation itself is not painful. General anaesthetic is available on request and is standard when combining with a brow lift, mid-face or deep-plane facelift.
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How long is the downtime?
Most bruising settles by 7 to 10 days and most swelling by 2 to 3 weeks. Sutures come out at 5 to 7 days. Most people return to desk work at 7 to 14 days, wear eye makeup from 2 weeks and resume exercise at 3 weeks. The final crease shape can take about 3 months to settle fully.
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Will I have a visible scar?
The incision is placed within your natural upper eyelid crease, so the scar is hidden when your eyes are open. It is pink for a few weeks and then fades to a fine pale line. Hypertrophic scarring is rare in this area. Silicone gel and gentle massage from 3 weeks help the scar settle.
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What if I also have a droopy lid margin (ptosis)?
A stretched levator aponeurosis is common and often asymmetric. If your upper eyelid margin sits low, an isolated skin excision will not lift it and can make the asymmetry look worse. A levator advancement is done through the same incision in the same sitting. Your surgeon measures margin-reflex distance and levator function at the consultation.
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Do I need my lower eyelids done too?
Not always. Upper and lower blepharoplasty solve different problems: upper is about the hood, lower is about bags, dark shadows and skin quality. Many patients have only the upper done, some have both in one anaesthetic, and some are better served by a tear-trough filler or a mid-face lift rather than a lower bleph. We assess the whole eyelid, not just the complaint.
Ready when you are
Send us your photos. We come back within a working day with a plan and a firm price.
Related treatments
Looking for something else?
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Tear-trough filler
A non-surgical option for lower-lid shadows and hollows.
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Endoscopic brow lift
For true brow ptosis, often combined with upper bleph.
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Mid-face lift
Repositions the cheek and softens the lid-cheek junction.
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Deep-plane facelift
Comprehensive rejuvenation, often with upper and lower bleph.
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Ultherapy facial HIFU
Non-surgical skin tightening for brow and jawline.
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Anti-wrinkle Botox injections
Softens dynamic lines around the eyes and brow.
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