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265 235 005 | Mon–Fri 8:30am – 8:00pm | Sat 9:00am – 2:00pm

Upper and Lower Blepharoplasty: Eyelid and Bag Surgery | Alegre Clinic

What you need to know before you begin.

  • Objective: To remove excess skin (drooping eyelids) and fat deposits (puffiness) to eliminate a tired appearance.

  • Type of Procedure: Outpatient Surgery (does not require hospitalization).

  • Pain Level (2/10): Virtually painless. Post-operative symptoms include discomfort and a "sand in the eyes" sensation, but no acute pain.

  • Duration: 60 to 90 minutes (depending on whether it is superior, inferior or complete).

  • Downtime (Recovery): 7 to 10 days for social rest (due to bruising). Stitches removed on the 5th day.

  • Results: Long-lasting (10 to 15 years). The eyes open up and rejuvenate immediately after the puffiness subsides.

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What is Blepharoplasty?

Blepharoplasty is plastic surgery of the eyelids, designed to correct structural changes caused by aging in the periocular region. It is divided into two distinct procedures that can be performed together or separately:

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  1. Upper Blepharoplasty: Focuses on removing excess skin (dermochalasia) that falls over the eyelashes, weighing down the eyes and, in severe cases, obstructing the field of vision.

  2. Lower Blepharoplasty: Focuses on treating "bags" under the eyes. These bags are not fluid retention, but rather herniations of orbital fat that protrude outwards, creating shadows and permanent swelling.

Clinical Indications: When to operate?

There is no "right age," there is only anatomical need. It is indicated for:

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  • Sad or Tired Look: People who are constantly asked "Did you sleep badly?" even when they are well-rested.

  • Makeup Difficulty: When the skin of the upper eyelid folds so much that the eyeliner or eyeshadow becomes hidden or smudged.

  • Visual Obstruction (Functional): When the skin "pushes" the eyelashes down, reducing lateral and superior vision (curtain sensation).

  • Structural Bags and Dark Circles: Swelling in the lower eyelid that doesn't go away with creams or ice.

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The Difference: Surgery vs. Plasma Jet

Many patients try non-invasive treatments (such as Plasma Jet or creams) for severe excess skin.

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  • The Reality: Surface treatments only improve skin texture. They don't remove excess tissue or deep fat deposits.

  • The Surgical Solution: Blepharoplasty is the only method capable of physically removing excess skin and fat. For real and transformative results in drooping eyelids, surgery is irreplaceable and, in the long run, more economical than multiple ineffective cosmetic treatments.

Safety: Preserving Volume (Avoiding "Deep Eye")

In the past, all the fat was removed from the eyelid, which left the eye "skeletal" (sunken and hollow) over the years. At Clínica Alegre, we follow the modern technique of Preservation and Repositioning. Instead of excessively removing the bags, we often reposition this fat to fill the under-eye hollow. This ensures a smooth transition between the eyelid and the cheek, maintaining the youthful volume of the eyes without a surgically altered appearance.

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The Patient Journey: The Step-by-Step Procedure

  • Surgical Marking (The Most Important Step): With the patient seated, the surgeon precisely marks the amount of skin to be removed. This ensures symmetry and prevents the removal of excess skin (which would prevent the eye from closing).

  • Comfortable Anesthesia: We use local anesthesia with light sedation. The patient sleeps or relaxes deeply, feeling no pain or discomfort.

  • Strategic Incision:

  • Upper: The scar is hidden in the natural crease of the eye (concave).

  • Lower: The incision is made just below the eyelashes (making it invisible) or inside the eyelid (Transconjunctival - without cutting the skin).

  • Fine Suturing: We use threads thinner than a hair to ensure imperceptible scarring.

Recovery and Post-Operative Care

The recovery from blepharoplasty is visual, not painful.

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  • Days 1-3: Maximum edema (swelling) and possible ecchymosis (bruising) around the eyes. Applying ice 4 to 5 times a day is mandatory.

  • Vision: May be blurry for the first 24 hours due to the ophthalmic ointments used.

  • Stitches: They are removed between the 5th and 7th day. Removal is painless.

  • Makeup: Allowed after stitches are removed to conceal any remaining bruising.

  • Sunglasses: They will be your best friends for the first 10 days when you go out.

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Innovation: The Transconjunctival Technique (Without External Scarring)

For young patients who only have lower eyelid fat pads but no excess skin, we perform Transconjunctival Blepharoplasty. In this technique, the incision is made inside the lower eyelid (in the mucosa). We remove the fat without making any cuts in the skin. Recovery is very quick, and there is no visible scar or stitches to remove.

Clinical Benefits

  • Global Rejuvenation: The face loses its "sad" or tired look.

  • Improved Visual Field: For those whose eyelids covered the pupil, the surgery improves peripheral vision and reduces the effort required to open the eyes (goodbye frontal headaches).

  • Ease of Makeup Application: The eyelid surface is left smooth and ready to receive cosmetics.

  • Invisible Scar: The eyelid skin is the thinnest in the body and heals the best of all. After 2 months, the line is virtually undetectable.

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Risks of Delaying Treatment

The skin of the eyelids loses elasticity every year.

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  • Malar Bags (Festons): If the lower fat pads are ignored for decades, they can irreversibly stretch the skin, creating "Festons" (bags on the cheekbones) that are very difficult to treat surgically.

  • Mechanical Ptosis: Over time, excessive skin weight can weaken the levator palpebrae muscle, requiring more complex corrective surgery. Treating it at the first signs of discomfort is the best prevention.

Contraindications

  • Severe Dry Eye Syndrome (surgery may worsen dryness).

  • Uncontrolled glaucoma (requires authorization from an ophthalmologist).

  • Active ocular thyroid disease (Graves' disease).

  • Uncontrolled high blood pressure (risk of bleeding).

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Frequently Asked Questions (FAQs) about Blepharoplasty

  • It does not affect the eyeball or visual acuity. On the contrary, in cases of severe excess skin, the surgery improves the field of vision that was obstructed. In the first few days, vision may be blurry only due to swelling or ointments.

  • It's the best scar on the human body. On the upper eyelid, it's hidden in the crease that forms when you open your eye. On the lower eyelid, it's flush with the eyelashes or nonexistent (transconjunctival technique). After maturation (3-6 months), it becomes an almost invisible white line.

  • We recommend 7 to 10 days of social rest if you don't want anyone to notice the bruising. If you work from home (teleworking) or wear glasses, you can return to work in 3 or 4 days, provided you avoid physical exertion.

  • No. The goal of classic blepharoplasty is to rejuvenate, not to change your features ("almond-shaped" or "pull" the eyes). We maintain your identity, we just remove the "weight" of the years.

  • No. You should avoid contact lenses for 2 weeks after surgery to avoid manipulating the eyelid and prevent infection. Wear glasses during this period.

  • The removal is permanent. The removed fat does not return. However, with aging (after 10-15 years), the skin may become somewhat saggy again, but it rarely returns to its previous state.

  • Not entirely. Blepharoplasty treats the skin and bags under the eyes. Lateral wrinkles ("crow's feet") are caused by smiling (muscle). For this, the ideal complementary treatment is Botulinum Toxin (Botox), which can be applied after surgery.

  • No. It's a quick and painless process that causes only a slight tingling or sensation.

  • While you still have bruises (hematomas), sun exposure is prohibited to avoid further skin discoloration (pigmentation tattoo). Use large sunglasses and SPF 50+ sunscreen for the first month.

  • Yes. Blepharoplasty is a transformative surgical procedure. At Clínica Alegre, we offer financing plans so you can renew your look without financial burden.

Why Clínica Alegre? Payment Plan and Location

Choosing Clínica Alegre means opting for professionals who understand facial anatomy as an art.

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  • Financial Affordability: At our clinic, this treatment can be paid in installments, allowing you to maintain your self-care routine without straining your monthly budget.

  • Flexible Hours: Available at our Seixal and Setúbal locations, with the convenience of Saturday appointments in Setúbal for those with a busy week.

  • Location:

    • Seixal: We are located in a central area of Seixal, with privileged access for those residing on the South Bank.

    • Setúbal: We are located in a central area of Setúbal, with privileged access for both residents of the city and visitors from the neighboring regions north and south of the Sado River.

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