We all experience watery eyes occasionally, and it’s normal if you’re outside in the cold or wind or a piece of debris gets in the eyes. Sometimes, it can be due to an allergy or an infection like conjunctivitis. If you’re experiencing prolonged eye tearing and other symptoms, it is often due to a blocked tear duct.

Your tear system keeps your eyes lubricated and comprises three sections – your lacrimal glands, puncta, and nasolacrimal ducts. Each plays a role in ensuring tears can drain away effectively. Tear fluid also contains antibodies that fight against both bacteria and viruses.

The lacrimal glands are located inside the upper eyelids, and the tears flow from the glands to lubricate the eye surface before draining into the puncta. These are the openings in the inner corners of your eyelids. The nasolacrimal or tear ducts are the passage from the puncta to your nose. When your tear ducts become blocked, fluid cannot normally drain from the eye.

What causes blocked tear ducts?

A congenital tear duct blockage is relatively common in babies and maybe because the tear duct is not fully developed or a thin membrane covers the duct. More than 6% of newborns have a blocked tear duct in either one or both eyes.

In adults, infections can lead to scar tissue build-up, which blocks the tear duct. Trauma to your nose, face, or eye can cause swelling. Tumours or growths, either benign or cancerous, can cause blockages in your tear ducts. Tear stones, or dacryoliths, can form when tear fluid collects and hardens. If these are big enough, they can block a tear duct.

Age-related changes to the tear duct system can cause the puncta to narrow. It can also narrow as a result of infection or inflammation. Uveitis, a condition where the blood flow to your retina is impacted, narrows your puncta, as do some types of glaucoma treatment eye drops.

Previous surgery on your eye, eyelid, nasal passage or sinuses can result in a blocked tear duct due to scarring. Blocked tear ducts may also occur as a side effect of cancer treatments such as radiotherapy and chemotherapy.

What are the symptoms of blocked tear ducts?

Blocked tear ducts can present in several ways, including:

  • Constant and/or excessively watery eyes, known as epiphora
  • Swelling and pain
  • Redness
  • Blurred vision
  • Recurring eye infections
  • Crusting and discharge or pus that builds up on your eyelids or in your eyelashes
  • Itchiness in and around the eye
  • Fever

How are blocked tear ducts treated?

Ophthalmic and Oculoplastic Surgeon Dr Nick Koutroumanos will first diagnose the cause of a blocked tear duct. This will be based on the symptoms you’re experiencing and a physical examination of the eye and tear duct. He may then order diagnostic tests.

A blocked tear duct is very treatable. A blocked tear duct typically improves within the first year without any medical intervention in babies. Antibiotics will be prescribed if an infection is related to a blocked tear duct. Applying firm pressure to the inner corner of the eyelids several times daily can help clear the blockage.

One treatment option is a technique called dilation, probing and irrigation. The puncta is dilated, and then Dr Koutroumanos will probe the blocked part of the tear system with specially designed tools that can remove the cause of the blockage if possible. The final stage is irrigating the tear duct with saline fluid.

Other approaches are balloon dilation, stenting or intubation or a surgical procedure known as a dacryocystorhinostomy (DCR) that creates a new path for tears to drain between your eyes and your nose. This can be performed through the nose known as Endonasal DCR (Scarless Tear-Duct Repair) or External DCR.

Functional Oculoplastic Surgery with Dr Nick Koutroumanos

London Ophthalmic and Oculoplastic surgeon Dr Nick Koutroumanos is an expert in ophthalmic plastic and reconstructive eyelid surgery including upper and lower blepharoplasty.

Book Your Consultation

An oculoplastic surgeon is best placed to diagnose and treat eyelid and periocular conditions, focusing on eye function, as well as aesthetics. Book a consultation with Dr Nick Koutroumanos:

We’re delighted to announce that Dr Nick Koutroumanos appears in 2024’s Tatler’s Beauty & Cosmetic Surgery Guide, as one of the London and the UK’s leading blepharoplasty surgeons. 

“Every so often, a new name joins Tatler’s trusted community of cosmetic surgeons and aesthetic experts, having earned a place in the ranks through tireless work and a glowing reputation. One such name is Dr Nick Koutroumanos, a London-based surgeon whose exclusive expertise is eyelid surgery.

“His rapidly growing reputation is for exceptionally natural-looking results, utilising techniques that offer strictly scarless results.

Koutroumanos opts to look after patients whose priority is subtle rejuvenation and, as a result, has been attracting individuals in the public eye who will not risk visible signs of surgery or imperfection.”

To find out what sets Dr Koutroumanos apart, call 020 4531 6760 or email us at info@koutroumanos.com to arrange a consultation.

London Blepharoplasty Surgeon in Tatler Beauty and Cosmetic Surgery Guide

Eyelid surgery returned to the top 5 most popular cosmetic surgery procedures, according to the latest figures released by the American Society of Plastic Surgeons. Its popularity was driven by the ‘Baby Boomer’ cohort – men and women aged between 55 and 70 – who claimed over half of all facial rejuvenation procedures. Eyelid lifts were also the most popular facial procedures with men.

Your eyes are one of the first things that people notice about you, so it’s no surprise you may be more conscious of any changes that distract from making a good initial impression. Here are five reasons why you might also want to consider a blepharoplasty.

1 You are tired of looking tired

The eyes are often referred to as the windows to the soul, and unfortunately, they are also one of the first areas to show signs of ageing. Blepharoplasty surgery can help revitalise your appearance by addressing sagging eyelids, puffiness, and excess skin, giving you a more refreshed and youthful look. This procedure removes excess fat and tightens loose skin, creating a smoother, firmer eye contour that can take years off your face.

2 You can’t see as clearly as you used to

Beyond its cosmetic benefits, blepharoplasty can also enhance your vision. Drooping or sagging eyelids can obstruct your field of vision, causing discomfort and potentially leading to vision problems. By addressing these issues, an upper blepharoplasty not only improves aesthetics but can also contribute to better eyesight, allowing you to see the world more clearly and comfortably.

3 You are seeking a boost in self-confidence

For many individuals, the visible signs of ageing can take a toll on self-esteem. An upper or lower eyelid lift can provide a significant boost in confidence by restoring a more youthful and vibrant appearance. Feeling good about the way you look can have a positive impact on various aspects of your life, from personal relationships to professional opportunities. Confidence is key, and blepharoplasty can be a powerful tool in helping you reclaim it.

Testimonial for Dr Nick Koutroumanos

I can’t thank him enough for solving a problem that I had become very self-conscious about for some time and had impacted my confidence socially. I would highly recommend Dr Koutroumanos to anyone considering eyelid surgery.

4 You want long-lasting results

Non-surgical interventions, such as tear trough filler, are increasingly popular but the results are temporary. While ageing is a natural process, a blepharoplasty procedure will restore a more youthful look that will last for many years without the requirement of regular maintenance.

5 You want a bespoke treatment

Blepharoplasty is a highly customisable procedure that can be tailored to address specific concerns. Whether you’re looking to rejuvenate the upper eyelids, lower eyelids, or both, Dr Nick Koutroumanos will produce a personalised treatment plan to meet your individual preferences and needs.

Eyelid Surgery Patient Testimonials

Nick is a highly skilled surgeon and very personable guy. I felt very relaxed and assured about choosing him for my upper eyelid procedure. I would certainly use him again if need be and recommend him to others. My eyelids had begun to give me a tired look in my mid-late 40s which bugged me. I had lines in my forehead too brought on by over-expressing and raising my eyelids all the time when talking to people, which I seemed to do automatically and subconsciously. The procedure itself seemed to go very well and recovery was surprisingly quick. I am delighted with the final outcome, the result has taken years off my face. I also no longer lift my brow to express myself when talking, and as a result the frown lines on my forehead have almost disappeared, an absolute bonus to the result which I hadn’t expected.

Verified patient review 

Eyelid Surgery with Dr Nick Koutroumanos: Your Solution to Rejuvenated Eyes

London Ophthalmic and Oculoplastic surgeon Dr Nick Koutroumanos is an expert in ophthalmic plastic and reconstructive eyelid surgery including upper and lower blepharoplasty.

Book Your Consultation

Ready to explore how eyelid surgery can enhance and rejuvenate? Book a consultation with Dr Nick Koutroumanos:

Ageing is inevitable, but the thin, delicate skin around the eyes means the signs of ageing reveal themselves much faster than other areas of the face. It’s estimated that the skin is 40% thinner around the eyes. Here are the five most common signs of ageing around the eyes and the appropriate solution.

Sagging on the upper eyelids

As the skin on the upper lids becomes thinner and less elastic and the underlying tissues succumbing to gravity, the heavy, stretched skin can make the eyes appear hooded, with the upper eyelid crease lost. In more severe cases, this sagging skin can even obscure vision.

An upper eyelid blepharoplasty restores a more youthful, refreshed appearance by making an incision along the eyelid crease to remove excess skin, fat and muscle to smooth the upper lid. If there is eyelid hollowness, these tissues can be repositioned. The scar is usually well hidden in the eyelid’s natural fold and will be undetectable when healed.

Undereye bags

Bags under the eyes are a common ageing concern and occur when the tissue supporting the eyelids starts to weaken. As well as skin sagging, the fat pads underneath the eyes push forward.

A lower eyelid blepharoplasty tightens and repositions these supporting tissues and fat pads and removes any excess skin and fat. The incision is made either under the eyelash line or through the inside of the eyelid, known as the transconjunctival or ‘scarless’ approach.

Brow droop

As we age, sagging facial tissues cause the position of the eyebrows to lower, loose skin to appear on the forehead and hooding of the upper eyelids. Patients often complain it makes them look tired or angry. A brow lift can reverse these signs of ageing by tightening the tissues on the brow and opening up the eye area.

There are several brow lift techniques. During your consultation with Dr Nick Koutroumanos, he will advise you on the optimal approach, considering your current eyebrow position, facial structure, hairline and desired results. A brow lift is often combined with an upper eyelid lift for optimal results.

Tear troughs

The descent of the mid-face causes a tear trough deformity. Typically, the youthful face has smooth contours, but a deep crease can appear between the lower eyelid and upper cheek due to volume loss in the mid-face. Patients often complain that it makes them look unduly tired. Weight loss and stress can cause a tear trough deformity to appear more pronounced.

A lower blepharoplasty can improve the appearance of the tear trough by repositioning fat tissue under the eye to produce a smoother contour between the undereye and upper cheek. Temporary hyaluronic acid dermal fillers can also smooth out the crease.

Dynamic wrinkles

Our eyes are our most expressive feature, and our facial muscles’ constant contraction and relaxation as we frown, squint or smile result in frown lines and crow’s feet. The ageing process and damaging lifestyle factors such as sun exposure or smoking can accelerate their development.

The most effective treatment for these lines is neurotoxin injectables that work by softening the actions of the orbicularis oculi muscle. By relaxing the contraction of this muscle, the lines around the eyes are softened and smoothed.

For more advice on the appropriate procedure to address ageing around the eyes, a consultation with an oculoplastic surgeon is essential. While a plastic surgeon is trained in the reconstruction of the entire body, oculoplastic surgeons specialise in the anatomy of the upper third of the face and the functioning of the eye.

Eyelid Surgery Patient Testimonials

I spent several days researching Ophthalmologists in the UK before booking an appointment with Dr. Nick Koutroumanos to discuss an Upper Blepharoplasty. There are many factors to take in to account, reviews being just one. Nick is very personable, reassuring and probably one of the best eye surgeons. I am totally elated with the results.

Eyelid Surgery with Dr Nick Koutroumanos: Your Solution to Rejuvenated Eyes

London Ophthalmic and Oculoplastic surgeon Dr Nick Koutroumanos is an expert in ophthalmic plastic and reconstructive eyelid surgery including upper and lower blepharoplasty.

Book Your Consultation

Ready to explore how eyelid surgery can enhance and rejuvenate? Book a consultation with Dr Nick Koutroumanos:

Puffy bags and dark circles under the eye typically suggest you’ve been burning the candle at both ends. But are late nights and little sleep the only reason for eye bags?

Lifestyle factors play a role, but the ageing process, genetic predisposition and environmental factors often contribute. Oculoplastic surgeons are also trained ophthalmologists, so they will understand how eyelid surgery can affect the health of the eye and the clarity of vision. They can rule out any underlying condition, such as thyroid eye disease, that could be causing changes to the undereye area.

What causes bags under the eyes?

Bags under the eyes can mean different things, including loose skin, bulging fat deposits, pigmentation changes and a deepening tear trough, and the cause is often multifactorial.

As we age, loss of collagen and elastin, which provide skin with scaffolding and elasticity, start to deplete, and the skin under the eyes becomes less firm and wrinkles appear. The underlying tissues that support the eyelids also begin to weaken, and the fat that previously made the undereye area appear smooth and youthful starts to push forward. Fluid can also start to pool in the undereye area, further exacerbating this impression of puffiness.

Dark circles can often be an optical illusion due to the way light reflects facial contours. Any swelling can cast shadows under the eyes, but it can also result from a deepening groove at the junction between the upper cheek and under the eye, often dubbed the tear trough. This is caused by the fat pads in the mid-cheek starting to shrink and descend.

Our skin thins as we age, making blood vessels beneath more prominent, and those with darker skin tones are also more susceptible to pigmentation changes under the eyes.

The lifestyle factors causing eye bags we can control

Several factors have been proven to worsen the bags under the eyes:

  • Sun exposure: UV rays speed up collagen and elastin breakdown, and the eye area is particularly vulnerable as the skin is so much thinner. Sun damage also causes pigmentation changes as the body must produce melanin to protect the skin. Use a broad-spectrum high SPF every day, whatever the time of year, and wear sunglasses with UV protection when exposing the eyes to the sun.
  • Smoking: nicotine is a vasoconstrictor, which means it physically narrows your blood vessels, hampering oxygenated blood reaching where it should be repairing cells and producing collagen.
  • Alcohol: alcoholic drinks tend to be high in sugar, and when sugar enters your bloodstream, it produces enzymes that break down collagen and elastin. Furthermore, once the liver metabolises alcohol, it releases toxins that cause tissue to dehydrate. It also affects our ability to sleep properly.
  • Sleep: when we don’t get enough restorative sleep at night, our blood vessels dilate, and this is more noticeable under the eyes, causing dark circles to appear. The eyes also tend to become irritated, which leads to inflammation and puffiness.
  • Diet: Circulation-boosting antioxidants and hydrating foods are essential and foods rich in minerals that help balance fluids. The most important rule, though, is to avoid a high-sodium diet as eating lots of salty foods causes the body to retain water and tissues to become swollen.
  • Allergies: congestion and inflammation caused by allergies can sometimes exacerbate fluid retention under the eyes.

What eye bag treatment would you recommend?

The skin around the eyes is ten times thinner than other areas of the face, so it’s no surprise that any imperfections here are instantly visible. Although they are harmless, bags under your eyes can be distressing aesthetically. Patients often believe that they make them look older, more fatigued, and less dynamic than they feel.

A lower eyelid blepharoplasty is also known as eye bag surgery or eye bag removal surgery, as it’s the most effective approach to removing bags under the eyes and reducing the appearance of dark circles.

Excess skin and protruding fat are removed, and the lax muscles are tightened by making an incision either hidden just below the lashes in the lower eyelids or through the inside of the lower lid, known as a transconjunctival blepharoplasty. The incision is then closed with fine stitches.

To find out if you are suitable for a lower eyelid blepharoplasty, call 020 4531 6760 or email us at info@koutroumanos.com to arrange a consultation with Mr Nick Koutroumanos.

Eyelid Surgery Patient Testimonials

I’ve recently had a brow lift and blepharoplasty with Mr N Koutroumanos. The whole process from start to finish was handled professionally and each process was very informative. I’m still at the recovery stage, so far I’m really happy with my results. Highly recommend using Mr N Koutroumanos services.

Eyelid Surgery with Dr Nick Koutroumanos: Your Solution to Rejuvenated Eyes

London Ophthalmic and Oculoplastic surgeon Dr Nick Koutroumanos is an expert in ophthalmic plastic and reconstructive eyelid surgery including upper and lower blepharoplasty.

Book Your Consultation

Ready to explore how eyelid surgery can enhance and rejuvenate? Book a consultation with Dr Nick Koutroumanos:

Your eyes are often called the windows to your soul, but when hooded eyelids obscure their beauty, it can affect your overall appearance and self-confidence.

Hooded eyelids, characterised by excess skin that droops over the upper eyelids, can make you look tired, older, and even affect your vision in severe cases.

Understanding hooded eyelids

Various factors, including genetics, ageing, and lifestyle, can cause hooded eyelids. The most common cause is the natural ageing process, which results in the loss of skin elasticity and the weakening of the muscles in the eyelid area. As a result, excess skin accumulates and sags over the upper eyelid, leading to the classic hooded appearance.

Hooded eyelids not only affect your appearance but can also have practical implications. They may obstruct your peripheral vision, causing discomfort and compromising your safety. Additionally, hooded eyelids can make you appear chronically fatigued, regardless of how well-rested you are. This aesthetic concern often prompts individuals to seek solutions, with upper blepharoplasty being one of the most effective.

Can you improve hooded eyelids naturally?

For very mild skin sagging over the eyelids, it is possible to induce a slight lift with non-surgical treatments.

Muscle relaxing injections are the most popular aesthetic treatment in the UK, and it is possible to lift hooded eyelids slightly by injecting into the forehead muscles that pull the eyebrows downward. By weakening these muscles, the eyebrows can lift marginally, resulting in a more open and refreshed eye appearance. The effects are temporary, typically lasting just three to four months, and the procedure is quick with minimal downtime.

There are also treatments such as Ultherapy that use ultrasound technology to tighten and lift the skin on the brow. While it is not a specific eyelid procedure, it can indirectly benefit those with hooded eyelids by improving the overall tightness and tone of the skin around the eyes.

However, for patients with more significant hooding on the eyelids, surgery is typically the only option, and an upper blepharoplasty is an effective and long-lasting solution.

Upper blepharoplasty, also known as an eyelid lift or upper eyelid surgery, is a surgical procedure that aims to rejuvenate the appearance of the upper eyelids by removing excess skin and, if necessary, repositioning or altering the fat and muscles in the area. This surgical technique can restore a more youthful and refreshed look by eliminating the hooded appearance.

The difference between hooded eyelids and ptosis

Hooded eyes and ptosis are similar conditions affecting the upper eyelid but are not the same. Ptosis is a medical condition characterised by drooping or sagging of the upper eyelid, resulting in it partially or entirely covering the eye. It can be caused by muscle or nerve damage or age-related weakening of the muscles that control the eyelids.

In some cases, people with hooded eyes may also have ptosis, and ptosis repair may need to be combined with an upper blepharoplasty to different extents to deliver symmetry. An oculoplastic surgeon has the required training and experience to provide an individually tailored surgical plan. Small, precise changes are made to the delicate muscles and tendons that are responsible for lifting the eyelid.

Blepharoplasty and ptosis repair combined


Blepharoplasty and ptosis repair combined

In this patient, the eye on our left shows significant ptosis (eyelid droop) with a compensatory raised eyebrow and a prolapsed inner fat pad. The eye on our right shows significant skin excess (dermatochalasis), requiring a blepharoplasty. Both surgical procedures were carried out to different degrees on each side in order to deliver a symmetric eye size, symmetric eyelid and symmetric brow.

Call us on 020 4531 6760 or email us at info@koutroumanos.com to arrange a consultation.

Eyelid Surgery Patient Testimonials

Dr Koutroumanos has a unique and umatched expertise in his profession. Highly recomended.

I spent several days researching Ophthalmologists in the UK before booking an appointment with Dr. Nick Koutroumanos to discuss an Upper Blepharoplasty. There are many factors to take in to account, reviews being just one. I was somewhat panic stricken by the idea of a knife+eyelid experience under a local anaesthetic. As it turned out it was much less traumatic than going to the dentist. I was allowed to yap a little throughout the op which helped calm, enabling me to mentally (!) liken it to a hairdressers appointment. Nick is very personable, reassuring and probably one of the best eye surgeons. I am totally elated with the results. He achieved exactly what he/I wanted him to, fixing some assymetry as well as restoring them to how they looked a decade earlier, better than in fact. Even after two weeks the scarring is so minimal that if it did not improve from now (which it may ) it does not bother me. Very happy.

Eyelid Surgery with Dr Nick Koutroumanos: Your Solution to Rejuvenated Eyes

London Ophthalmic and Oculoplastic surgeon Dr Nick Koutroumanos is an expert in ophthalmic plastic and reconstructive eyelid surgery including upper and lower blepharoplasty.

Book Your Consultation

Ready to explore how eyelid surgery can enhance and rejuvenate? Book a consultation with Dr Nick Koutroumanos:

Welcome to our guide to lower eyelid blepharoplasty! As an expert oculoplastic surgeon specialising in aesthetic eye surgery, Dr Koutroumanos was asked to outline the different types of lower eyelid blepharoplasty procedures.

We aim to explain the various techniques – transcutaneous, transconjunctival, fat subtraction, and fat redistribution – in simple terms, so you can make an informed decision about the best option for your needs.

Our Expert Team

By choosing our clinic, you are entrusting yourself to a team of dedicated professionals who focus on achieving natural outcomes in aesthetic eye surgery.

We understand that your appearance matters to you, and our goal is to help you achieve a refreshed and rejuvenated look while maintaining the natural beauty of your eyes.

The two cornerstones of our work are:  (1) Absolutely no signs of surgery and (2) Quick and seamless recovery.

Understanding Lower Eyelid Blepharoplasty

Lower eyelid blepharoplasty is a surgical procedure aimed at improving the appearance of the lower eyelids. As we age, the delicate skin and supportive tissues around the eyes can weaken, leading to drooping, puffiness, and wrinkles.

Lower blepharoplasty can address these concerns, giving your eyes a more youthful and vibrant appearance.

Types of Lower Eyelid Blepharoplasty

1. Transcutaneous Lower Eyelid Blepharoplasty:

Transcutaneous blepharoplasty is the traditional approach to lower eyelid surgery. In this technique, a discreet incision is made just below the lash line.

Through this incision, excess skin and fat can be removed, and the tissues can be tightened. This procedure allows for precise and when needed, extensive correction of the lower eyelids.

The incision line will disappear without 3 weeks leaving no visible signs of a scar.

2. Transconjunctival Lower Eyelid Blepharoplasty:

Transconjunctival blepharoplasty is a more modern approach that involves making an incision inside the lower eyelid, so there are no visible external lines from day one. It is Dr Koutroumanos technique of choice for patients in the younger end of the spectrum.

This technique is primarily used to address puffiness caused by excess fat deposits. By accessing the fat through the inner lining of the eyelid, the surgeon can remove or reposition the fat, resulting in a smoother, more youthful appearance.

3. Fat Subtraction Lower Blepharoplasty:

Fat subtraction lower blepharoplasty is a technique that focuses on the removal of excess fat deposits without the need for significant skin excision.

This method is suitable for patients with good skin elasticity but have bulging fat pockets under their eyes.

The fat is gently extracted, leading to a smoother contour of the lower eyelids.

4. Fat Redistribution Lower Blepharoplasty:

Fat redistribution lower blepharoplasty is an advanced technique that aims to reposition the fat deposits rather than removing them.

The surgeon redistributes the fat to fill in hollow areas and create a natural, harmonious transition between the lower eyelid and the cheek. This method can address both puffiness and under-eye hollows.

Both 3 and 4 can be carried out through the transconjunctival or the transcutaneous approach.

Choosing the Right Technique

During your consultation, Dr Koutroumanos will assess your unique facial anatomy, concerns, and desired outcomes to recommend the most suitable technique for you.

Factors such as skin elasticity, fat distribution, and the presence of under-eye hollows will guide the decision-making process.

The Lower Eyelid Blepharoplasty Procedure in Detail

Lower eyelid blepharoplasty is typically performed under local anesthaesia with sedation or general anesthaesia, depending on your preference and the extent of the surgery.

The procedure usually takes 1 to 2 hours, and you can return home the same day.

Recovery and Results of a Lower Eyelid Blepharoplasty

After the surgery, you may experience mild swelling and bruising, which will gradually subside over the following 2 weeks, sometimes faster.

It is important to follow the post-operative care instructions provided by our team to ensure optimal healing.

Results will vary depending on the chosen technique and individual factors but can generally be seen within a few weeks, revealing a more youthful and refreshed appearance.

I had a low blepharoplasty in June and Dr Koutroumanos did a fantastic job. I am a professional career woman and only have limited time. Dr Koutroumanos achieved the impossible. He and his office not only accommodated my busy schedule but the result was amazing. I was able to meet friends after only 9 days without anyone can tell. Yet, my colleagues who I haven’t seen for more than 20 years said that I have not changed and look beaming! I will most definitely always recommend him.

Google Review

Choosing Our Expert Team

When you choose our clinic, you are placing yourself in the hands of a highly skilled and experienced team who deal exclusively with eye and eyelid surgery day after day. Our focus on natural outcomes means that we prioritise your unique features and aim to enhance your appearance while maintaining the natural beauty of your eyes. We are committed to your safety, satisfaction, and long-term well-being.

Contact us today to schedule a consultation with our expert oculoplastic surgeon and discover how lower eyelid blepharoplasty can help you achieve your desired aesthetic goals. Our team in London, UK, is ready to provide you with the care and expertise you deserve.

Book Your Consultation

Ready to explore how eyelid surgery can enhance and rejuvenate? Book a consultation with Dr Nick Koutroumanos:

Eyelid surgery, also called blepharoplasty, is a common procedure where the skin around the eyelids is removed or altered. The surgery can be performed on the upper eyelids, lower eyelids, or both.

There are two types of blepharoplasty: functional and cosmetic. Functional blepharoplasty is performed to improve vision by correcting eyelid deformities that interfere with vision such as drooping eyelids, eyelid tumors, or eyelid malposition. Cosmetic eyelid surgery is performed to improve the appearance of the eyelids.

Most people who have eyelid surgery are happy with the results. Understanding the blepharoplasty recovery process can help you set expectations and plan accordingly for a successful recovery post-operation.

First Day After Upper or Lower Eyelid Surgery

The first day after blepharoplasty is usually the most uncomfortable. After the surgery, you will likely have some swelling and bruising around your eyes, which is normal. Your eyelids may also feel tight and sore.

When you get home, remember to keep your head elevated. Consider using a few pillows to keep your head propped up while you sleep for the first few days after surgery.

You will have ice packs to use on your eyelids and an eye shield in place when you leave the surgical center. The ice packs help reduce swelling and the eye shield protects your eyes from accidental injury.

First Few Weeks After Eyelid Surgery

Plan on taking it easy for the first few weeks after your surgery. Avoid activities that increase your heart rate or blood pressure, such as exercise, bending over, or lifting heavy objects. These activities can increase swelling.

Most people take approximately one week off from work or their normal activities after blepharoplasty surgery. You may have some residual swelling and bruising for several weeks after surgery. However, this can vary depending on the type of eyelid surgery you had and your own individual healing process.

After 10 days, you can resume applying light makeup and contact lenses. However, you will need to wait until all of the swelling has resolved before using eyeliner, mascara, or other cosmetics near your eyelids. Avoid rubbing your eyes, as doing so can cause irritation and delay healing.

Follow-up appointments to remove the incision stitches are typically scheduled 6-10 days after surgery. At your follow-up appointments, we will check your incisions and remove any sutures. You will also be given specific instructions on how to care for your eyelids as they heal.

These instructions may include:

  • Applying ointment to your eyelids
  • Wearing an eye shield at night
  • Using artificial tears to keep your eyes lubricated
  • Avoiding makeup or contact lenses for a specific period of time
  • Taking oral pain medication
  • Wearing sunglasses when you are outdoors
  • Drinking a lot of water and liquids, but avoiding alcohol

The Next Few Months After Eyelid Surgery

Most people see a significant improvement in the appearance of their eyelids within the first few weeks after surgery. However, it can take several months for the final results to be apparent. At this point, you will start to see your eyes in a new light.

Slight swelling may still be visible, but your eyelids will look rejuvenated with younger-looking skin around them. The process of adjusting can take some time so do not worry if you are unable to see the final results at this stage yet. Blepharoplasty is a very individualised procedure, and your recovery may vary depending on your specific case.

If you have any concerns about the healing process or the results of your blepharoplasty, be sure to contact us.

Factors That Affect the Duration of Blepharoplasty Recovery

There are a few factors that can affect the duration of your blepharoplasty recovery, including:

  • The type of blepharoplasty you had: Upper eyelid surgery recovery time is typically shorter (about one to two weeks) than lower blepharoplasty recovery time (up to four weeks) because the incisions are smaller.
  • Your age and general health: Older patients or those with underlying health conditions may take a bit longer to recover from eyelid surgery than young, healthy patients.
  • Whether you had any other procedures done at the same time: If you had blepharoplasty as part of a more comprehensive facial rejuvenation treatment plan, your recovery time may be longer.
  • How well you follow your eyelid surgeon’s postoperative instructions: If you fail to take care of your eyelids during the recovery process, you may experience complications that could prolong your recovery.

Transform Your Appearance with Eyelid Surgery

Upper and lower blepharoplasty can rejuvenate your appearance and correct your vision. If you are considering blepharoplasty then schedule a consultation with Dr Nick Koutroumanos.

Book Your Consultation

Ready to explore how eyelid surgery can enhance and rejuvenate? Book a consultation with Dr Nick Koutroumanos:

This guide is designed to provide you with a clear understanding of Meibomian Gland Dysfunction (MGD), the various types of blepharitis, chalazion, and stye. As an oculoplastic surgeon and eyelid expert, Dr Koutroumanos is dedicated to your eye health and offers expertise in seamless removal of all types of eyelid lesions, as well as the medical management of blepharitis. This comprehensive document will equip you with the knowledge needed to make informed decisions about your eye care.

Understanding Meibomian Gland Dysfunction (MGD)

Meibomian glands are small oil-producing glands located within the eyelids. MGD occurs when these glands become obstructed or dysfunctional, resulting in an insufficient release of oils onto the surface of the eyes. This can lead to dry eyes, discomfort, and other related issues. MGD is closely associated with the development of chalazion and stye.

Types of Blepharitis

Blepharitis is a common condition that causes inflammation of the eyelids. There are two main types: a. Anterior Blepharitis: This occurs at the base of the eyelashes, often due to bacterial infections or skin conditions. b. Posterior Blepharitis: This affects the inner eyelid, primarily due to Meibomian gland dysfunction.


A chalazion is a localised swelling or bump on the eyelid caused by a blockage of one of the Meibomian glands. This blockage leads to the buildup of oils, resulting in inflammation. Chalazion is often painless but can cause cosmetic concerns and occasionally affect vision if it grows large.

Stye (Hordeolum)

A stye is an acute infection or inflammation of the eyelid, typically affecting the glands at the base of the eyelashes. Styes are usually painful, red, and appear as a small pimple or boil on the eyelid. They can be caused by bacteria entering the glands or by blockages in the oil-secreting glands.

Symptoms and Signs

Common symptoms of MGD, blepharitis, chalazion, and stye may include:

  • Dryness, itching, or burning sensation in the eyes
  • Redness and swelling of the eyelids
  • Crusting or flaking along the lash line
  • Sensitivity to light
  • Watery or sticky discharge
  • Blurred vision or fluctuating vision quality
  • Presence of a painless bump (chalazion) or a painful red lump (stye)

Treatment Options

Medical: Applying a warm compress to the affected area can help open blocked glands, promote oil flow, and alleviate symptoms.

Lid Hygiene: Regular eyelid hygiene using prescribed cleansers can remove debris and bacteria from the eyelid margins.

Antibiotics: In cases of bacterial infection, oral or topical antibiotics may be prescribed to treat styes.

Steroid-Containing Ointments: Your oculoplastic surgeon may prescribe steroid-containing ointments to reduce inflammation and promote healing in certain cases of chalazion and blepharitis.

Surgical Options:

  • Incision and Curettage: For persistent or large chalazia, a minor surgical procedure called incision and curettage may be performed. Dr Koutroumanos, our eyelid expert, is highly skilled in performing this procedure. It involves making a small incision and removing the contents of the chalazion. The procedure is typically performed under local anesthesia and is generally well-tolerated.
  • Stye Drainage: If a stye does not resolve with conservative measures, your oculoplastic surgeon may perform a small incision to drain the abscess and alleviate symptoms.

Eye Drops and Ointments:

  • Artificial Tears: Lubricating eye drops can provide temporary relief from dryness and discomfort associated with MGD, blepharitis, chalazion, and stye.
  • Antibiotic Ointments: In certain cases, your doctor may prescribe antibiotic ointments to address bacterial infections and promote healing.
  • Steroid-Containing Ointments: To reduce inflammation and aid in healing, Dr. Koutroumanos may recommend steroid-containing ointments in specific cases.

Recovery Period and Expectations

Following a chalazion removal procedure, you can typically expect the following:

  • Minimal discomfort and swelling in the treated area, which usually resolves within a few days.
  • Use of prescribed antibiotic ointments or drops to prevent infection and aid in healing.
  • Instructions for post-operative care, including proper eyelid hygiene and the use of warm compresses as recommended by Dr Koutroumanos.
  • A follow-up appointment to monitor your healing progress and address any concerns.

We hope this guide has provided you with valuable insights into Meibomian Gland Dysfunction, the various types of blepharitis, chalazion, and stye. Led by Dr Koutroumanos, our clinic specialises in the diagnosis, seamless removal of all types of eyelid lesions, and medical management of blepharitis. We are committed to providing you with the best possible care and expertise. Please feel free to contact us to schedule an appointment or for any further questions you may have. Trust in our expertise, and let us guide you towards healthier and happier eyes. Check our reviews on site or at Top Doctors.

Book Your Consultation

Book a consultation with Dr Nick Koutroumanos to discuss your concerns:

The ageing process is unavoidable, and the eyes are one of the first areas where we notice ageing changes which is why eyelid surgery can have such an impact, restoring a more youthful, refreshed appearance.

The skin around the eyes is very thin, so it’s more prone to laxity and sagging as collagen and elastin break down over time.

There are several surgical techniques to rejuvenate the eyelids, and an oculoplastic surgeon is best placed to assess and execute surgery which balances aesthetics and eye function. An oculoplastic surgeon must undertake extensive training as an ophthalmologist before further training in oculoplastic surgery that focuses on the eyelids, eye sockets and facial structures around the eye and the brow.

During your consultation with oculoplastic surgeon Dr Nick Koutroumanos, he will carefully assess ageing changes in the upper third of the face and advise you on which approach will achieve the outcome you’re hoping for. Two popular eyelid surgeries are the blepharoplasty and the canthoplasty procedure. These can be performed independently or are often performed in combination.

Am I suitable for an upper blepharoplasty?

An upper blepharoplasty, also known as an eyelid lift, addresses excess skin and sagging tissues on the upper eyelids. An incision is made in the eyelid’s natural crease through which Dr Koutroumanos can remove or reposition fat deposits, tighten the muscles surrounding the eye and remove any excess skin.

What does a lower eyelid lift address?

Over time, our lower eyelids also suffer from sagging of the skin and facial tissues, and this causes the formation of eye bags as pockets of fat push forward. The lower blepharoplasty repositions or removes this excess fat while at the same time tightening sagging tissues to strengthen and smooth the lower lid. Incisions are either made under the lash line or through the inside of the lid, known as a transconjunctival blepharoplasty.

What is the difference between a canthoplasty and a blepharoplasty?

A canthoplasty is a cosmetic procedure to tighten the ligament and muscle that support the outer corner of the eye, known as the lateral canthus. This is the junction where the upper and lower eyelid meets, and a canthoplasty can restore a more youthful appearance by achieving a more upward tilt and improving the tension of the lower eyelid.

During your consultation with Dr Koutroumanos, he will examine past photos, conduct precise measurements under high magnification, and perform a full eye examination, as well as actively listen to your specific concerns. He can then advise you on which approach or combination of techniques will achieve the aesthetic outcome you desire.

Eyelid Surgery Patient Testimonials

Dr Koutroumanos’s pre and post op care was excellent. Provided a detailed diagnosis and treatment options including pros and cons. Very approachable and reassuring throughout. An extremely gifted and skilled surgeon. Would wholeheartedly recommend!

LM. Verified patient from topdoctors.co.uk

Book Your Consultation

Ready to explore how eyelid surgery can enhance and rejuvenate? Book a consultation with Dr Nick Koutroumanos: