Eyelid surgery
Eyelid surgery, or blepharoplasty, at Estonian aesthetic clinics: upper, lower, combined. Techniques, recovery, prices. Choose a licensed clinic.
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Eyelid surgery, or blepharoplasty, is a plastic surgery operation that corrects excess skin, fatty tissue or muscle tone in the upper or lower eyelids. It is one of the most common aesthetic surgery operations in Estonia, because signs of ageing around the eyes (drooping upper lids, bags underneath) make the face look more tired and older even when the rest of the tissue is in good condition. Blepharoplasty gives a visible result through small incisions and with a relatively short recovery time. The operation is carried out at an aesthetic clinic licensed by the Health Board (Terviseamet), by a doctor who has completed a residency in plastic surgery or ophthalmology. This guide explains the differences between the various types of blepharoplasty, how to choose a surgeon, and what the stages of the operation are.
What is eyelid surgery and what types are available in Estonia?
Blepharoplasty is an operation that corrects the structure of the eyelids. Upper eyelid surgery (upper blepharoplasty) removes the excess skin that descends over the eye with age and can affect both appearance and, in some cases, the field of vision. Lower eyelid surgery (lower blepharoplasty) corrects the bags that form under the eye (herniated fat pads) and lax skin. Each can be done separately or combined into a single operation.
Technically, lower blepharoplasty divides into two: transcutaneous (the incision is made just below the lashes — suitable when skin needs to be removed) and transconjunctival (the incision is made inside the eyelid, leaving no external scar — suitable when the main problem is fatty tissue). An experienced surgeon chooses the technique according to anatomical need.
In some cases blepharoplasty is combined with additional procedures: a brow lift alongside upper blepharoplasty, lipofilling into the hollows under the eye alongside lower blepharoplasty, or laser resurfacing of the skin to soften fine lines. A comprehensive plan gives a complete result — the eye area looks younger without looking "operated on".
Eyelid surgery prices and how the procedure works
The price of blepharoplasty depends on whether only the upper, only the lower or both eyelids are operated on, on the anaesthesia used (local anaesthesia or sedation) and on the clinic. Upper eyelid surgery on its own typically costs less than a combined (upper + lower) operation. Functional upper blepharoplasty (where a drooping eyelid obstructs the field of vision) may be partly reimbursed by the Health Insurance Fund (Tervisekassa) — an ophthalmologist assesses this.
The operation typically takes 1–2 hours. Upper blepharoplasty is mostly done under local anaesthesia (with light sedation where possible), while lower and combined operations are often done under sedation or general anaesthesia. The surgeon plans the incision on the patient's upper eyelid in advance (in the natural eyelid crease — the scar is almost invisible once healed), removes the excess skin and, if needed, fatty tissue, and closes the wound with fine sutures.
After the operation the patient can usually go home the same day. During the first 48 hours it is important to apply cold compresses with ice packs to reduce swelling. The sutures are removed after 5–7 days. Experienced clinics such as Health Clinic in Tallinn, ProAge Ilukliinik in Tartu and Dr. Mari Laasma Ilukliinik offer a structured recovery plan: check-up visits at 1, 2 and 6 weeks and at 3 and 6 months.
How to choose a surgeon for eyelid surgery
Blepharoplasty requires a doctor who has completed a residency in plastic surgery or ophthalmology and who operates at an aesthetic clinic licensed by the Health Board. The eye area is a delicate one — small changes can produce very different results, which makes experience critical. Check the doctor's background in the Health Care Professionals Register (Tervishoiutöötajate register).
At the consultation the doctor must assess not only the structure of the eyelids but also the position of the brow (if the brow sits low, upper blepharoplasty can pull it lower still — in which case a simultaneous brow lift is worth considering), the position of the eyeball (exophthalmos or enophthalmos affects the result), the position of the lacrimal gland and any relevant health conditions (dry eye syndrome, thyroid disease). A good doctor talks through realistic expectations and shows before-and-after photographs of their own patients.
Favour a clinic with a written contract, a clear price list, a structured aftercare plan and the option of combining blepharoplasty with additional procedures as needed. Warning signs are a promise of results that sound too good, a promise of a "scar-free" operation (every incision leaves a scar, even if it is barely visible) or pressure to take a "today-only discount".
Risks, side effects and contraindications
The side effects of blepharoplasty fall into common ones (swelling, bruising around the eyes, temporary light sensitivity, blurred vision for the first couple of days, a temporary feeling of dry eye) and more serious ones. The latter include infection, wound dehiscence, asymmetry, excessive removal of the upper eyelid (which can cause lagophthalmos — incomplete closure of the eye), downward pull of the lower eyelid (ectropion), changes in vision and, in extremely rare cases, bleeding deep into the orbit, which can threaten sight.
Contraindications are uncontrolled thyroid disease (especially Graves' disease), severe dry eye syndrome, glaucoma, blood clotting disorders, autoimmune diseases in an active phase, planning a pregnancy and breastfeeding, and smoking immediately before and after the operation. Relative contraindications (blood thinners, allergy to anaesthetics) must be discussed separately with the doctor.
After blepharoplasty it is important to avoid the sauna, intense exercise, bending over, lifting heavy objects and contact lenses for 2 weeks. Sun protection is needed for 4–8 weeks so that the scar stays as inconspicuous as possible. Reading and watching television can usually be resumed within 2–3 days.
Eyelid surgery in Estonia's most popular cities
Tallinn offers the widest choice for blepharoplasty — most of the doctors who have completed a plastic surgery residency, and the ophthalmologists who offer blepharoplasty, practise in the capital. Health Clinic, Dr. Mari Laasma Ilukliinik and Decus are examples of clinics that perform the full spectrum of blepharoplasty operations. The wait for a consultation is usually 2–6 weeks, and 4–8 weeks for the operation itself.
In Tartu, blepharoplasty is offered by ProAge Ilukliinik and Medical Aesthetics. Aesthetic clinics in Pärnu, Narva and other county centres mostly cover smaller aesthetic medicine procedures — more complex blepharoplasty cases, especially where a brow lift or lipofilling needs to be combined, are referred to an experienced surgeon in the capital. Since blepharoplasty is an operation with a relatively quick recovery (7–14 days off work), most patients are willing to travel to the capital for an experienced doctor.
Frequently asked questions
How much does eyelid surgery cost in Estonia?
The price of blepharoplasty depends on whether the upper, lower or both eyelids are operated on and on the anaesthesia used. Upper eyelid surgery on its own costs less than a combined operation. Functional upper blepharoplasty may be partly reimbursed by the Health Insurance Fund on medical grounds.
How long does recovery take?
Time off work is typically 7–14 days. The sutures are removed after 5–7 days. Most of the swelling and bruising subsides within 2 weeks, while slight swelling can remain for 1–2 months. The final scar softens over 6–12 months. Reading and television can usually be resumed within the same week.
Who is allowed to perform eyelid surgery?
In Estonia, blepharoplasty may only be performed by a doctor who has completed a residency in plastic surgery or ophthalmology and who operates at an aesthetic clinic licensed by the Health Board. Check the doctor's background in the Health Care Professionals Register before you decide.
What is the difference between upper and lower blepharoplasty?
Upper blepharoplasty removes the excess skin of the upper eyelids that descends over the eye with age. Lower blepharoplasty corrects the bags that form under the eye and lax skin. Each is an operation in its own right, but they are often done in combination.
Does blepharoplasty leave a scar?
Yes, but the scar is usually barely visible. The incision for upper blepharoplasty is made inside the natural eyelid crease, where it heals to be almost invisible. The incision for lower blepharoplasty (transcutaneous) is made just below the lashes. The transconjunctival method leaves no external scar.
Is blepharoplasty permanent?
The result is long-lasting, but not entirely permanent. The result of upper blepharoplasty usually lasts 10–15 years or longer, and lower blepharoplasty and the other structures also hold up over the long term. Natural ageing continues — new excess skin can develop over the decades.
Can I have blepharoplasty while pregnant?
No. Pregnancy and the breastfeeding period are clear contraindications. Postpone the operation until after the birth (preferably after breastfeeding has ended). Anaesthetics and post-operative medication may not be safe during pregnancy.
Does blepharoplasty improve vision?
Functional upper blepharoplasty can improve the field of vision where a drooping eyelid obstructs it. Aesthetic blepharoplasty does not change visual acuity. If a drooping eyelid makes it harder to see, an ophthalmologist may deem the operation medically necessary, and the Health Insurance Fund will reimburse it in part.