How long does upper eyelid surgery actually last before you have to get it done again?

Right, so I have finally got a date for an upper blepharoplasty and I am pleased, but I keep getting stuck on one thing that nobody at the two consultations really answered straight.

How long does it LAST. The first surgeon said "many years" and moved on. A friend of a friend told me you basically have to redo it every ten years like a service on a car, and honestly that put the fear in me, because this is not cheap and I am not doing it twice.

So is that true. Do the lids just droop back down and you are back where you started in a decade. Or is it a once and done thing. I am 54 if that matters, and it is definitely the skin, I can feel the extra fold sitting on my lashes when I raise my eyebrows.

For what it is worth I am three years out from an upper this month and it looks exactly the same as it did at six months. No drift, no fold coming back. So the "every ten years" thing is not my experience so far.

That said I was 61 when I had mine, and I have wondered whether someone younger would get a different mileage out of it. I will let the surgeon person answer that properly.

I always assumed the skin just grows back, the same way it does if you cut yourself and it heals over. Isn't that the whole reason it does not last forever? Genuine question, I never actually understood the mechanism.

twolids_tom said:

I always assumed the skin just grows back, the same way it does if you cut yourself and it heals over.

The short answer first: an upper blepharoplasty is one of the longer-lasting operations in facial surgery, and the large majority of people never have it done a second time. The "every ten years" idea is a myth. Nobody is servicing a lid on a schedule.

To take the mechanism question head on, because it is the useful one: skin does not regrow to replace what was excised. When redundant upper-lid skin (the condition is called dermatochalasis) is removed, that tissue is gone and it does not come back. What people are seeing when they say it "came back" is almost always one of two other things, and separating them matters.

The first is ongoing ageing of the same skin that was left behind. The eyelid keeps ageing at the pace the rest of you does, so at ten or fifteen years there can be a little more laxity than on the day the stitches came out. In most cases this is modest and never reaches the point of wanting more surgery.

The second, and this is the big one that gets blamed on the lids unfairly, is the brow quietly descending over the following years. A brow that drops pushes skin down into the upper lid and recreates a heavy, hooded look, even though the lid work itself is holding perfectly. That is a forehead problem sitting on top of a good eyelid result, and it is why the site keeps pushing people to have the brow assessed first. The difference is set out in the piece on blepharoplasty versus a brow lift, and the general longevity numbers live in how long an eyelid lift lasts.

Rough figures, with the usual honesty about ranges: many patients are happy for ten to fifteen years, a good number never seek anything further at all, and where a revision is done it is often a small skin touch-up rather than the whole operation again. On the lower lid the picture differs, because when orbital fat is removed or repositioned that change is essentially permanent; fat does not "grow back" either, though remaining fat can bulge with time.

Where longevity is genuinely shorter or less predictable: someone operated on young, before the tissues have finished changing; a significant untreated brow ptosis, which will re-hood the lid regardless of how clean the excision was; and conditions that keep altering the tissues, such as thyroid eye disease. Those are the cases where "it came back" is a real risk rather than a myth.

I cannot tell you what your own lids will do over the next decade, and at 54 the honest answer depends on your skin quality and, above all, on where your brow sits. Ask the surgeon who is examining you to lift your brow gently at the mirror and show you how much of the heaviness is lid and how much is forehead, before you sign anything.

This is the clearest anyone has put the brow thing to me. So it is possible to have a completely successful upper bleph and still look hooded again years later, just because the forehead has come down and nothing was ever wrong with the lid result itself?

That reframes the whole "does it last" question for me. It is less will the surgery fail and more will something else change above it.

Coming back to close this off since a few people messaged me. Had the op six weeks ago and I asked the surgeon the brow question at my pre-op exactly like was suggested here. She did the finger lift at the mirror, showed me it was almost all lid and only a touch of brow, and said the lid result should hold for a long time on its own.

So I have stopped worrying about the ten year service myth. If anything drifts one day it will most likely be my brow catching up, not the surgery unravelling, and that is a completely different decision for future me to make. Thanks all, this thread genuinely calmed me down.