Your Complete Guide To

Upper & Lower Eyelid Surgery


Laser vs Scalpel Techniques

Welcome To Sydney Cosmetic & Plastic Surgery Clinic

Sydney Cosmetic & Plastic Surgery Clinic is no newcomer. In fact, we are one of Sydney’s leading cosmetic clinics established by Dr George Mayson over 25 years ago.

These days, we have a team of Cosmetic & Plastic Surgeons offering the full spectrum of cosmetic procedures to meet the needs of every patient.

I have personally been in this industry for over 24 years and have seen that the explosion in the popularity of cosmetic procedures has attracted widespread ‘price cutting’. While some would regard ‘price cutting’ as beneficial for patients, the hidden downside has been the compromise of both standards and quality of results that lower prices can deliver: the old adage ‘You Get What You Pay For’ has never been truer!

Our Clinic has always enjoyed a distinguished reputation in terms of patient satisfaction, high standards, ethics and safety. Therefore, I am very proud that it holds the same reputation to this very day and that we are regarded as one of Sydney’s leading Cosmetic Clinics with only Cosmetic and Plastic Surgeons performing ALL procedures, not Cosmetic Physicians.

My personal undertaking to all patients is that we will continue to deliver premium cosmetic procedures under the highest of professional standards at a Value-For-Money Price but always with the patient’s best interests in mind.



Why Choose
Sydney Cosmetic & Plastic Surgery Clinic
For Your Eyelid Surgery?

What We’re Known For:

  • Our Clinic Has Over 20 Years’ Experience Performing Eyelid Surgery.

Warning: Unfortunately for patients, current medical regulations do not prevent any doctor from performing Blepharoplasty within their own practice with little or no structured training. In fact, we are aware that an increasing number of Cosmetic Physicians without any cosmetic surgical qualifications are now commencing to offer eyelid surgery!

Our Clinic’s experience in Blepharoplasty dates back to 1994 when our Medical Director, Dr George Mayson, first trained in Laser Blepharoplasty in the USA before introducing it in Australia.

  • We Have A Very Impressive Safety Record without a single adverse event during eyelid surgery over our 20+ years!
  • We Only Have Experienced Cosmetic & Plastic Surgeons performing eyelid surgery, not Cosmetic Physicians.
  • We Offer BOTH Techniques: Laser & Scalpel – whichever is the better for YOU!

Warning: Our Surgeon will recommend whichever technique is the more appropriate depending on what exactly needs to be done. The advantages of our being able to also offer the Laser Technique are: (i) with lower eyelids, the incision can be placed on the INSIDE of the eyelid and thereby avoid any scar on the skin under the eyelashes; and (ii) the laser can be switched to Skin Resurfacing mode if the skin also needs to be tightened. Without such a laser, you will not have those choices!

  • We Don’t Do Online Consultations!.

Warning: How can any doctor possibly assess your eyelids accurately with an online or Skype Consultation? Measurements need to be taken and eyelids fully assessed before it can be determined what exactly needs to be done

  • We Don’t Offer Free Consultations!

Instead, we offer a detailed consultation with the Surgeon who’ll be doing your Blepharoplasty so he/she can carefully assess what exactly needs to be done.
Warning: Avoid the temptation of ‘Free’ Consultations which are primarily designed to ‘sell you’ the procedure! Always question the quality and integrity of any consultation that is ‘free’!

  • We Always Have A Specialist Anaesthetist To Keep You Comfortable, Safe And Pain-Free Throughout Your Procedure.

Warning: Resist the temptation to have any form of Eyelid Surgery without an Anaesthetist to keep you comfortable, safe and pain-free. Also, be wary of clinics that list “Anaesthetic” on your quotation: this COULD STILL MEAN you’ll have no Anaesthetist because the word “Anaesthetic” is NOT the same as “Anaesthetist” and it could refer to you being injected with any concoction of anaesthetic medications by someone other than a qualified Anaesthetist – a dangerous and very unsafe scenario!

And, should you have any unexpected reaction to those medications and there is no Anaesthetist present, who in that room will have the knowledge and expertise to treat your emergency? The frightening answer is: NOBODY!

So, if you’re not guaranteed that a qualified Anaesthetist will be present for your entire procedure, go elsewhere!


… for upper lid ‘hooding’ & lower lid ‘bags’!

In terms of your face, your eyes are your most important asset. When your eyes look bright and youthful, so do you. When your eyes look “tired”, you do as well.

As we age, the eyelids can also develop signs of ageing such as:

  • ‘Hooding’ of the Upper Eyelids due to an excess of skin – sometimes in association with a variable degree of muscle laxity and excess fat. Such ‘heaviness’ of the upper eyelids can look worse if there is also a degree of brow ptosis (droop). It is very important at your initial consultation for the surgeon to assess if you have an element of brow ptosis contributing to your upper lid ‘heaviness’. If there is, a Brow Lift may be required as well. ‘Hooding’ of the upper eyelids with obliteration of the youthful crease between the eyelid and brow, is what produces the ‘look’ commonly described by patients as ‘tired-looking’ eyes.
  • ‘Bags’ with or without loose skin on the lower eyelids. These ‘bags’ are actually protrusions of the normal fat within the eye socket around the eyeball. These fatty protrusions, normally held in place by tissue layers, fall forward when these tissue layers become weaker with age.

The above changes most commonly appear from the mid-30’s onwards but they can appear much earlier, even in the mid-20’s. They also tend to run in families with similar appearances often found in siblings and in one or both parents.

Correcting these changes to create a more youthful look is known as Blepharoplasty and it can dramatically improve the appearance of one’s eyes and face.

How We Do It Differently

Firstly, it is important to realise that Blepharoplasty can be performed either by Scalpel or Laser and there are significant differences between the two techniques that warrant your consideration before you decide on which technique to have.
The Laser Technique offers distinct advantages over the Scalpel Technique for the reason that a CO2 Laser seals the tiny blood vessels as it cuts. As a result, there is virtually no bleeding during the surgery. This in turn means:

  • Less post-operative bruising and swelling.
  • A quicker recovery and return to work and social activities.
  • Less risk of post-operative bleeding (unchecked post-operative bleeding can cause blindness) and;
  • In the case of lower eyelids, the laser incision can be placed on the inside of the eyelid thereby avoiding any external scar on the skin!
  • Placement of the incision on the inside of the lower eyelid also significantly lessens the chances of the following lower eyelid deformities that sometimes occur after a scalpel incision through the skin:
    • ‘Rounding’ of the eyelid margin
    • ‘Scleral show’ (too much ‘white of the eye’ showing under the cornea)
    • Ectropion (eversion of the lower eyelid)

Reassuringly, we have never seen any of these complications after the laser approach from the inside of the lower eyelid.

Unfortunately, owing to the high cost of these lasers, only a minority of surgeons have one. If you wish to avail yourself of the advantages of the laser technique, you need to locate an experienced Blepharoplasty Surgeon with a CO2 Laser.

Our Dr Mayson originally trained in Laser Blepharoplasty in the USA in 1994 and has used this technique ever since with great success and quicker recovery times for his patients.

In 1998, Dr Mayson was invited to present Before/After Segments on a Laser Blepharoplasty patient on Channel Nine’s Midday Show with Kerri-Anne Kennerley.

In summary, the essential differences between the Laser & Scalpel Techniques are:

Laser Technique Scalpel Technique
Post-Operative Bruising & Swelling Minimal More
Recovery Period Upper lids: about 7 days
Lower lids: about 4 days
2-3 weeks is not uncommon
Final Scar Upper lids: same
Lower lids: NO external scar (unless skin is also removed)
Upper lids: same
Lower lids: permanent external scar under the eyelashes
Risk of Deforming the Lower Lid Negligible Possible
Risk of Blindness from Post-Operative Bleeding into the Eye Socket Never seen by us. The Laser Technique is believed to significantly reduce this risk. Reportedly 1:40,000 – 1:100,000

How Is Blepharoplasty Done?

The surgery is performed in the privacy of our Clinic’s Operating Theatre Clinic under a combination of Local Anaesthesia and Sedation administered by our Specialist Anaesthetist. You can go home 1-2 hours after your procedure in the company of a responsible person but you cannot go home alone. Post-operative discomfort is minimal and easily relieved with simple analgesics such as Panadol or Panadeine.

Upper Eyelids: An incision is made (by Laser or Scalpel as agreed) in the natural crease of the upper eyelid and then only the excess skin, muscle and fat are removed. Experienced blepharoplasty surgeons limit tissue removal to only those tissues which truly show an excess amount otherwise too deep an eyelid groove will result. The skin is then sutured with ultra-fine sutures which are removed 7 days later. The final scar of the upper eyelid incision should be an inconspicuous, thin white line in the natural crease of the upper eyelid. Due to the laser’s ability to minimise bruising and swelling, you should be able to return to work and social activities after the sutures are removed 7 days later.

Lower Eyelids: Lower Eyelid Surgery is performed in either of two ways:

  • Through a Scalpel Incision in the skin under the eyelashes. This is known as the Trans-Cutaneous Technique; OR
  • A Laser Incision on the INSIDE of the lower eyelid. This approach is known as the ‘Trans-Conjunctival’ Approach. Its advantage is that it allows immediate access to the protruding fat bag from the ‘inside’ and thereby avoids any cutting of the skin, muscle or orbital septum – the subsequent scarring of which can cause lower lid deformities. As well as virtually eliminating the risks of the lower lid deformities described above, this internal approach also avoids any external scar on the skin. No sutures are necessary with this approach as the edges of the incision come together as soon as surgery is completed and the eyelid returns to its normal position. If you only have small or medium-sized ‘bags’ of fat, and your lower eyelid skin still has good elasticity without looseness or significant wrinkles, nothing more needs to be done.
    If, however, you have:

    • large fatty ‘bags’ with eyelid skin stretched over them; or
    • medium-sized ‘bags’ with reduced skin elasticity; or
    • any size ‘bags’ with excessively loose or wrinkled skin…

    … your skin could end up even looser after removal of the fat. Although skin has an inherent ability to shrink to a new shape, the older we get, the less able is the skin to shrink. Whether your skin can do so, and to what degree, cannot be guaranteed and will basically depend on your skin’s elasticity at the time. Our Surgeon will assess your skin’s elasticity at your initial consultation and advise whether Laser Skin Resurfacing or scalpel excision of the excess skin should be included with the Blepharoplasty to avoid the skin ending up looser. In some cases, notwithstanding the advantages of the Trans-Conjunctival Approach, the Trans-Cutaneous technique by scalpel may be the better option.

Asian ‘Double Eyelid’ Surgery

In the Asian Upper Eyelid, the Pre-Tarsal Fold (the skin crease) at times sits much lower on the upper eyelid than is the case in Caucasians. In others, this fold may be completely absent. The Upper Eyelids may also be bulky and have more fat than is considered aesthetic causing the eyes to look ‘tired’ or ‘puffy’ in appearance.

An Asian Blepharoplasty, or a ‘Double-Eyelid Procedure’ is a surgical procedure designed to create a Pre-Tarsal Fold where there is none. Asian Blepharoplasty will give you a more continental, Eurasian look which is very popular. Your eyes will also look brighter and applications of makeup will be easier too.

Before/After Photo Galleries

The following is a small representative sample of the many Blepharoplasty procedures performed over our 25+ years and are displayed here to simply illustrate the dramatic changes that can result with a properly planned and meticulously executed surgery.

Upper Blepharoplasty

Lower Blepharoplasty

Upper & Lower Blepharoplasty


The following are the approximate Surgical Fees for the more common Blepharoplasty Procedures:

Initial Consultation
Upper Eyelid Surgery (Scalpel or Laser)
$3,630 + Theatre Fee + Anaesthetist
Asian ‘Double Eyelid‘ Surgery
$3,630 + Theatre Fee + Anaesthetist
Lower Eyelid Surgery (Scalpel or Laser)
$3,630 + Theatre Fee + Anaesthetist
Upper + Lower Eyelid Surgery (Scalpel or Laser)
$7,260 + Theatre Fee + Anaesthetist

If having Laser Skin Resurfacing Under the Eyes at the same procedure:
ADD $2,915* to Clinic’s quote + $330 additional to Anaesthetist’s Fee:


What are the advantages of Laser over the Scalpel Technique?
The main advantage is that the CO2 Laser is able to cut the skin and deeper tissues without any bleeding. This means minimal chances of bruising, less risk of post-operative bleeding, and less swelling – all of which lead to a faster recovery and quicker return to work and social activities.
Why is the Laser Technique better than Scalpel for Lower Eyelid ‘Bags’?
With the scalpel technique, an incision is made right across the lower eyelid skin just under the eyelashes and therefore will always leave a scar. Also, this approach can sometimes cause deformities of shape and position of the lower eyelid. In contrast, the laser can make a bloodless incision on the inside of the lower lid which avoids any visible scar on the external skin. This internal approach also avoids shape deformities of the lower eyelid sometimes seen after the scalpel technique.
How is it Done?
Laser Eyelid Surgery is performed in the privacy of our own Clinic’s Theatre under Local Anaesthesia & Light Sedation administered by our Specialist Anaesthetist. You can go home shortly after but you must have someone collect you. You cannot go home alone.
What is the average downtime?
Lower lids: 4 days
Upper Lids: 7 days
What is an approximate Total Cost?
Upper OR Lower Eyelids: Surgical Fee $3,630 + Theatre Fee $1,100, Anaesthetist $990
Total Cost $5,720
Can I claim any of my costs on Medicare?
No, unless your Upper Eyelids are obscuring vision, Medicare considers the procedure a cosmetic one and is not eligible for a Medicare rebate, nor can you claim on your Private Health Insurance.
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