Blepharoplasty (Eyelid Surgery)

Upper and lower blepharoplasty (eyelid surgery) by FRACS plastic surgeon Mr Ian Holten at National Capital Private Hospital, Canberra. Upper blepharoplasty removes excess upper eyelid skin causing hooding or visual field obstruction; lower blepharoplasty addresses under-eye bags and redundant lower eyelid skin. Both procedures are performed under local anaesthesia with sedation or general anaesthesia at the NCPH facility in Garran ACT.

Blepharoplasty at Canberra Cosmetic and Plastic Surgery is performed by Mr Ian Holten FRACS FRCS(Plast) at National Capital Private Hospital in Garran, Canberra — one of few FRACS-credentialled plastic surgeons available in the ACT for eyelid rejuvenation surgery. Eyelid surgery is among the most commonly performed facial plastic procedures in Australia, addressing age-related changes to the periorbital region including excess upper eyelid skin (dermatochalasis), fat prolapse creating under-eye bags, and lower eyelid redundancy and laxity. Upper blepharoplasty involves removal of a precisely measured ellipse of redundant upper eyelid skin, with or without excision of a portion of the orbicularis oculi muscle and resection or repositioning of prolapsed orbital fat in the medial fat pad. The upper eyelid incision is placed in the natural supratarsal crease and heals to a fine, largely inconspicuous line within the skin fold. In patients where excess upper eyelid skin overhangs the visual axis and causes functional visual field restriction — quantified on visual field testing — the procedure may be classified as medically necessary, making a Medicare rebate under item 45617 or 45620 available for the corrective component. Lower blepharoplasty may be performed via a subciliary (just beneath the lower lash line) or transconjunctival (inside the lower eyelid, no external incision) approach, depending on whether excess skin excision or fat repositioning alone is the primary objective. The transconjunctival approach is preferred when fat removal or redistribution is the main goal and skin quality is good, as it leaves no external scar. Subciliary lower blepharoplasty is used when skin redundancy and fine wrinkling also need to be addressed. Combined upper and lower four-lid blepharoplasty may be performed in a single setting. Recovery involves bruising and swelling settling over two to three weeks, with final results apparent at six to eight weeks. Canberra and ACT patients benefit from access to specialist plastic surgery eyelid procedures within the territory.