Cosmetic surgery guide: Eyes

Whether hooded or puffy eyes run in your family or are as a result of the ageing process, eyelid cosmetic surgery or blepharoplasty, to give it its proper name, could help. What cosmetic surgery can't do though is sort out crow's feet, which are best prevented with eye creams and big sunglasses, and can be softened with Botox or laser treatment.

As we age, skin loses its elasticity and muscles slacken. Around the eyes, this means loose skin, resulting in folds in the upper lids and deep creases in the lower lids. As muscle slackens under this loose skin, fat around the eye area protrudes to create bags – though for some people, this bagginess is genetic and can start to show up in their 20s.

Lack of sleep and too much stress can make baggy eyes worse and things invariably look worse in the morning as fluid settles in the eye area overnight while you are lying down. Thyroid disease can also cause changes in the eye area. Hyperthyroidism for example can cause such an increase of fat around the eyes that they protrude.

What can be done surgically?

Surplus skin and/or fat can be trimmed and removed, usually following the natural lines of your eyes, that is, along the crease of the upper lid and just below the lashes in the lower lid. Scars are fine and should be minimal, fading over a period of months.

If you just have fat underneath the eyes, it can be removed without an incision from inside the lower lid. The operation may be done under general anaesthetic or under 'twilight' anaesthesia, which is a local, plus intravenous sedative. This means you're asleep, but drift in and out of consciousness, and can be seen as a day case.

What are the risks?

All surgery carries risks, but existing eye disorders, diabetes and high blood pressure can create extra risks for this procedure. After the operation there will be swelling, which can last a few weeks, plus bruising. This is definitely the time to invest in a large pair of Jackie O shades. Your eyes can feel very dry, gritty or sting for a few days and it may feel hard to close them because of the swelling.

Cold compresses and sitting with your head raised helps to ease the after effects. Rarely, blood can pool under the skin, which may need another procedure if it doesn't right itself. Sutures are removed after three to five days.

 How much does it cost?

Depending on exactly what you have done, eyelid surgery will cost between £2,500 and £5,000. After spending that amount of money, you might want to look at your lifestyle in order to maintain the effects of the surgery for as long as possible. For example, if you smoke, your skin will age more quickly and the results of your eyelid operation will probably last half as long as in a non-smoker. Ditto sunbathing.

 Where can I find out more?

You can check with the General Medical Council whether your prospective surgeon is on its specialist register. Visit www.gmc-uk.org. The British Association of Aesthetic Plastic Surgeons (www.baaps.org.uk) is a good source for further research about both cosmetic surgery and reputable surgeons.