An eye surgeon has warned of the growing number of problems linked to people travelling abroad for eyelid surgery. Blepharoplasty, known online as 'bleph', is a rejuvenation procedure that can be performed on the upper or lower eyelids. Daniel Morris, a consultant ophthalmologist and oculoplastic surgeon at University Hospital of Wales, Nuffield Health Cardiff and Vale Hospitals, and Sapphire, says a number of issues are emerging as more younger people seek the surgery after seeing it on social media.
Rising demand among younger patients
Blepharoplasty removes excess skin, muscle, and fat from the eyelids. "It's essentially debulking the eyelids, removing excess skin, fat, muscle, just to tighten them up, a rejuvenation operation," Morris explained. The procedure can be functional, when eyelids hang over the eyes and impair vision, or cosmetic, when patients simply dislike the ageing appearance. Surgeons may refuse to perform the operation if they deem it unnecessary.
Morris noted a trend of younger people opting for the surgery after seeing influencers promote it on social media. "We're seeing is this trend towards younger people suddenly wanting it more. We always had some younger people wanting it, but this—I think through social media and people, influencers and whatever having it, having this type of surgery, then people just want to mimic that and follow suit."
Cost differences and lack of regulation abroad
In the UK, the procedure costs between £4,000 and £6,000, but abroad it can be as low as a quarter of that price. "It's obviously an expensive operation here, it costs sort of £4,000 to £6,000. And abroad you can get it for half or even a quarter of that. Wow. So obviously that's attractive to people. But the problem is the regulation isn't there that you have in this country," Morris said. He added that the UK has cosmetic certification for surgeons via the Colleges of Surgeons, allowing patients to check a surgeon's credentials, whereas abroad "it's Wild West, and often there isn't that regulation at all."
Morris stressed the responsibility of surgeons: "I think it's up to surgeons to take the moral high ground and tell people when they shouldn't be having it rather than just take the money and do it." He often advises patients to reconsider, saying, "Look, this is not the right operation for you," or even, "You're not in the right place." He added, "A lot of the time you need to give patients that bit of time just to think it through rather than push them to sign on the dotted line, which is what a lot of commercial companies, who employ surgeons, do. They just want money in the bank."
Emergency cases and corrective surgery
People returning from abroad with substandard surgery are placing a burden on UK emergency services. "You get is people come back from Turkey having had all four eyelids operated on and they've taken far too much skin so they can't close their eyes. So they'll pitch up in A&E with blurred vision, watery, red eyes, even ulcers on their eyes, which can be sight-threatening," Morris said. These patients often require skin grafts, and "they end up looking worse than when they started," he added.
There are also cases of sight loss. "Eyelids have an important function, and that's to protect your eyes, they're not just to look pretty. And if you can't close your eyes, then you can develop ulcers, if they perforate, you lose your eye. So that can be a sight-threatening problem," he said. Some patients attend clinics unhappy with the results, such as obvious scars, retained stitches, or asymmetrical eyelids. "In some cases, we can do revision work to try and improve things, and in some cases, we can't. The problem is revision work is more expensive than having it done properly the first time because it takes a lot longer," Morris explained.
Industry concerns and safe practice
The instances are now frequent enough for the Oculoplastic Surgery Group to raise collective concerns. The group also sees "upselling," where patients abroad for other procedures are offered eyelid surgery as an extra. Morris said, "They've gone for something completely different and then they make a mess of their eyelids, and that's pretty, again, unscrupulous behaviour." Despite the risks, he emphasised that done properly, blepharoplasty is safe: "Done well and done properly on the right patient, it's a great operation, it's one of the safest and most rejuvenating plastic surgery procedures you can have, but done poorly, it's obviously horrendous."
