We’ve included some research below on a study on upper eyelid blepharoplasty, but before we get to that, did you know there is a viable alternative? It costs less and has no downtime. So there’s no pain!

We think the only reason that many people don’t have radiofrequency therapy on their eyes is simply because they don’t know about it.

We have a ton of information on how it works, which you’re free to read, but essentially we tighten the skin around your eyes by stimulating your body to produce more collagen. the process is natural, by applying heat to a very specific temperature.

How does radiofrequency work and eradicate the need for upper eyelid blepharoplasty?Facial skin tightening non surgical facelift

Our radio frequency machine is top of the range. It’s used by the NHS for their procedures and uses sound waves to create a heat. We measure this heat as we apply it to your lid, the crease around your eyelid and even your brow if you like.

Once it gets to a specific temperature, your body will send collagen and elastin. The end result is tightening the skin around your eye, eyelids and reducing the excess skin lateral to your eye.

Benefits of radio frequency over traditional upper eyelid blepharoplasty
  • There’s no incision to deal with droopy eye lids. We don’t cut your skin at all to remove your bags. Therefore, no bleeding or healing time.
  • The orbital skin is naturally delicate, cutting the skin as a surgeon will do can easily lead to a tear. You don’t run any of this risk with RF therapy.
  • When you have radiofrequency, you’ll find the whole process relaxing, a little like a facial. All we’re doing is applying warmth.
  • There’s no swelling or bruising and as there’s no need for wound closure (there is no wound) then no stitches and therefore minimal risk of complications
  • See below, in some upper eyelid blepharoplasty treatments you can get increased lines around your eyes if your surgeon removes too much skin. We actually reduce your fine lines giving you a natural but improved elevation to your skin.
  • No downtime, you leave and get straight on with your life.
  • We can take the procedure up or down as far as you’d like in your same session. So if you’d like your midface, e.g. cheek working then we can include this at the same time.
  • For aftercare, all you need to do is apply some ointment which we’ll supply as part of your treatment
  • Radio frequency has had copious amounts of research done proving it to be an effective manner of improving skin laxity with few or arguably no risks.
  • It’s suitable for a woman or man and avoids needless surgeries or anaesthetic to get rid of creases, and improve volume. Hence why it’s growing in popularity as more people hear about it.

The other alternative – PRF microneedling

Scientific research has showcased the potential of PRF (platelet-rich fibrin) in conjunction with microneedling as a non-surgical alternative to blepharoplasty for addressing the signs of aging around the eyes. A study published in the Aesthetic Surgery Journal demonstrated that combining PRF with microneedling effectively improved skin texture, reduced fine lines, and increased collagen production in the periorbital area. This approach not only rejuvenates the delicate skin around the eyes but also avoids the invasiveness of traditional eyelid surgery.
Furthermore, to achieve even more enhanced results, the addition of RF (radiofrequency) skin tightening technology can be considered. A study in the Journal of Cosmetic Dermatology revealed that combining microneedling with RF technology can significantly enhance skin tightening and overall skin quality. The RF energy, when applied after PRF-enhanced microneedling, further stimulates collagen synthesis and tightens loose skin. This combination approach provides a comprehensive solution for individuals seeking non-surgical alternatives to blepharoplasty, promoting a more youthful and rejuvenated appearance around the eyes with minimal downtime and lower risks associated with surgery.
Background to the research on upper eyelid blepharoplasty

For some upper eyelid blepharoplasties, maximal removal of the skin may not produce the desired results. Therefore, an increase in the height of the fold can be considered. Currently, there is no method for determining the amount of skin to be cut and/or the increase in wrinkles required to achieve a particular result.


In this study, an equation was extrapolated to determine the amount of skin removal and/or the height of the eyelid fold required to reach a certain distance from the eyelid margin to the wrinkle (MFD).


This HIPAA-compliant study, approved by the Institutional Review Board, was a prospective, non-randomized clinical trial. Patients were included aged 30 to 100 years and underwent upper eyelid blepharoplasty by a surgeon between 2012 and 2014. Exclusion criteria included thyroid disease, myasthenia gravis, myotonic dystrophy, pregnancy, blepharoptosis, previous eyelid surgery or trauma, concomitant forehead surgery, and topical alpha agonists.

The following data were collected before the operation and in postoperative months 1 and 6: age, sex, BMI, eyebrow position, MFD, edge to fold (distance between eyelid margin and wrinkle, DCM) and vertical skin lightening (distance from eyelid margin to forehead, VSD).

Results A total of 322 eyelids from 164 patients underwent 208 skin incisions, 26 wrinkle elevations and 88 combined skin removal and wrinkle lifts. Age, gender and BMI category were negligible and were excluded from the final model. This equation was extrapolated by regression analysis: change in MFD = -0.40 + (-0.28 x change in VSD) + (change 0.53 × GCD) with |R| = 0.28.


To better predict and obtain the desired results of upper eyelid blepharoplasty, the authors created an equation. Blepharoplasty is a common eyelid surgery that deals with redundancy or sagging of the eyelids and also fat prolapse. In 2017 alone, 145,390 blepharoplasty drugs were performed in the United States.1 Most of these operations are performed for functional reasons. A recent survey of members of the American Society for Ophthalmological Plastic and Reconstructive Surgery found that 70% of these cases were functional and 30% were purely aesthetic.

However, regardless of the reason for blepharoplasty, most patients expect an optimal cosmetic outcome. Achieving excellent surgical outcomes and consistently happy patients requires proper examination, discussions of patient expectations, and surgical counseling and planning.

Skin resection alone can lead to suboptimal results in upper eyelid blepharoplasty. Once eyebrow ptosis has been ruled out as a cause, this suboptimal result is generally due to a small fold of the eyelid, which is quantified by the distance from the edge of the eyelid to the wrinkle (GCD; Figure 1A).

As described above, DCM is measured in millimeters from the edge of the eyelid to the first fold in the skin of the eyelid where the skin hangs while the patient looks down at an angle of approximately 45 degrees.3 Upper eyelid sagging may be due to several reasons including blepharoptosis, forehead ptosis, dermatochalasis and/or lower eyelid fold. Blepharoplasty does not treat forehead ptosis, and aggressive blepharoplasty can aggravate brow ptosis.

Once blepharoptosis and ptosis of the eyebrows have been ruled out as the main causative agent, attention can be paid to performing the type of upper eyelid blepharoplasty that is most suitable for the patient. Blepharoplasty 4,5 is described below, assuming that both blepharoptosis and eyebrow ptosis were excluded or addressed separately.

With blepharoplasty, if the maximum removal of the skin produces suboptimal results, it is likely that the cause is a small fold in the eyelid or an NDE.

A typical DCM is around 8 to 11 mm for Caucasians, generally higher for women than for men6. In practice, it is not uncommon for the DCM to be lower than described. This is due to the diversity of ethnic backgrounds adjacent to the Caucasus and changes in ageing7.

A lower DCM causes the skin of the eyelid to hang further down and cover the eyelid platform more. The amount of eyelid platform displayed can be measured as the distance between the edge of the eyelid and the crease, the distance between the edge of the eyelid and the crease of the eyelid. With upper eyelid blepharoplasty, the goals are different for each person, but most patients try to increase MFD.

Increasing MFD helps restore a younger upper eyelid and can greatly increase the field of vision by reducing the amount of skin protruding on the visual axis. Sometimes this MFD does not improve significantly, despite the removal of all excess skin from the upper eyelid. To increase FMD in situations with abnormally low BMD, the eyelid fold can be raised by a procedure known as wrinkle lift (Figure 2). In this procedure, the skin incision is made at the level of the newly desired eyelid fold (see the section “Surgical technique”).

Increased wrinkles can occur only if there is no excess skin, or together with the removal of excess skin. To date, there is no algorithm to determine the best position for the new fold.

Surgeons currently determine how much skin should be removed for upper eyelid blepharoplasty using the skin pinching technique or by measuring the skin of the eyelid to leave a certain amount of skin after surgery (e.g., 20 mm). Some surgeons also take into account the position of the patient’s pre-existing fold (DCM) and may increase it.

As mentioned earlier, the typical Caucasian GCF is 8 to 11 mm, so it could be a reasonable target. However, this one-size-fits-all approach does not take into account that every face is different and that there are asymmetries even within each face.8 In addition, each patient’s goals are unique. What a patient wants as a tarsal platform show (MFD) is different from others.

An equation that takes into account the specific measurements of each eyelid and the patient’s desired postoperative appearance would allow surgical results to be adjusted to improve cosmetic outcomes and patient satisfaction. The crease can also be used to correct small asymmetries, either due to the uneven position of the eyebrows or to the uneven position of the native crease, which become more apparent after blepharoplasty.

As described in Flores, the symmetry of the pretarsal segment of the eyelid (GCD) is much more important than the symmetry of the eyelid crease of the space between the eyebrows.

It is important to discuss the goals with the patient because some patients do not want to change the height of wrinkles and only want to remove the protruding skin. To maintain a natural appearance, variations in tarsal morphology and eyelid crease, which are inherent in ethnic differences, should also be taken into account.

The wrinkle enhancement procedure originated in Asia and is the most requested cosmetic procedure among Asian patients.12 language for the first time described in English by Sayoc in 195413 and Millard in 1964.14 and 1972 popularized by Flowers as a method for East Asian populations.10 In the original description for Asian patients, the procedure consisted of suturing the dermis to the desired height directly at the roots of the tarsus.13 Much later, In 1974, Sheen described a modified version to improve cosmesis in Caucasian blepharoplasty.

Sheen adapted the procedure by finding that, despite multiple skin resections, certain eyelid blepharoplasties had suboptimal results. In these cases, he noticed a low eyelid fold and developed the supratarsal fixation method, which he used in patients with an NDE <10 mm. In this procedure, he sewed the orbicular muscle of the eye to the tarsus at the desired height. A few years later, he updated his procedure to determine the importance of limiting wrinkle elevations to a maximum height of 12 mm to avoid transient postoperative ptosis and discomfort to 16-18 mm in patients with wrinkle fixation.

Later study

A later study by Park showed that the increase in wrinkles should be limited to 10 mm in the Asian population. Although the eyelid crease and upper blepharoplasty have evolved and improved, no studies have been conducted to predict specific outcomes. To improve surgical outcomes and patient and physician satisfaction, the authors created a study to extrapolate an equation that predicts surgical outcome.

Understanding potential outcomes allows the surgeon to modify the surgery to achieve the desired postoperative appearance rather than using the same approach for all patients. There are two ways in which the equation can be used. The equation can be used to determine the height at which the fold should be placed to achieve a specific MFD. The alternative use of the equation is to predict postoperative MFD with skin removal alone. The latter would allow the surgeon to know which patients could benefit from the additional increase in wrinkles for skin removal.

In this study, the FMD outcome measure was used because a common primary goal for patients is to increase this value to achieve a more youthful appearance and a wider field of vision. We extrapolate an equation of blepharoplasty outcomes that predicts surgical outcomes with skin removal alone, different levels of wrinkle elevation and a combination of skin removal with wrinkle enhancement. We hope that this equation will reduce postoperative surprises and improve surgical outcomes and patient satisfaction.

Book your RF therapy today to achieve the results you’d get with upper eyelid blepharoplasty. 07757 946023