What Doesn't Blepharoplasty Do?
While eyelid surgery effectively improves many concerns around the eyes, it's important to understand its limitations. Blepharoplasty typically does not:
- Lift sagging eyebrows — this is addressed surgically with a brow lift or nonsurgically with a neurotoxin like Botox
- Remove "crow's feet" around the eyes or forehead wrinkles — neurotoxins or laser resurfacing may be better suited for these concerns
- Change the fundamental shape or color of your eyes
- Correct significant hollowing under the eyes — dermal fillers or facial fat grafting may be more appropriate
- Eliminate dark circles under the eyes — consider lasers that target pigmentation or visible blood vessels
For comprehensive facial rejuvenation, your surgeon may suggest a combination of procedures. Many of these options can be performed together in a single sitting or strategically sequenced in a staged approach.
Am I a Good Candidate for Eyelid Surgery?
You may be a good candidate for eyelid surgery if you:
- Are bothered by the appearance of drooping upper eyelids or puffiness under your eyes
- Have sagging upper eyelid skin that reduces your field of vision or causes skin irritation
- Are in good overall health without serious eye conditions such as untreated glaucoma or severe dry eye
- Are a nonsmoker or are willing to stop smoking well before and after the procedure
- Have realistic expectations about what eyelid surgery can achieve
A consultation with a board-certified facial plastic surgeon is the best way to determine if blepharoplasty is right for you. During this appointment, your surgeon will examine your facial anatomy, review your medical history, discuss your goals and develop a personalized treatment plan. A good surgeon will make sure you fully understand your options, expected outcomes, risks and recovery process so you can make an informed decision.
How Can I Find a Qualified Facial Plastic Surgeon Near Me?
Choosing the right surgeon is one of the most critical steps in your eyelid surgery journey. While many types of doctors offer cosmetic procedures, surgery on the face — and particularly the intricate and delicate eye area — demands a specific, high level of expertise.
A facial plastic surgeon is uniquely qualified. These specialists focus exclusively on aesthetic and reconstructive surgery of the face, head and neck. Members of the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) have completed rigorous training, typically including a residency in Otolaryngology-Head and Neck Surgery or Plastic Surgery, followed by advanced fellowship training specifically in facial plastic surgery.
Use our interactive search feature to help you find a facial plastic surgeon near you.
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What Should I Expect During My Blepharoplasty Consultation?
A consultation with a facial plastic surgeon is the first step in your eyelid surgery journey. This meeting allows you to ask questions, explore your options and understand what blepharoplasty can (and cannot) do for you.
Here’s what you can expect:
- Discussion of Your Goals: Be ready to articulate why you are considering eyelid surgery. Explain what bothers you about your eyes (e.g., puffiness, drooping skin, tired appearance) and your desired improvements.
- Medical History Review: Your surgeon will review your overall health, any eye conditions or past surgeries, and any medications or supplements you take.
- Physical Examination: Your surgeon will examine your eyelids, greater eye area and facial structure. Photos may be taken to assist with evaluation and surgical planning.
- Exploration of Your Blepharoplasty Options: Your surgeon will determine whether you’re a candidate for upper eyelid surgery, lower eyelid surgery or both, and may discuss other procedures that could complement your results.
- Realistic Expectations: Your surgeon will explain the potential benefits and limitations of blepharoplasty, and outline any associated risks and the typical recovery timeline.
- Process Overview: You’ll receive guidance on how to prepare for surgery, what to expect during the procedure and what the healing process involves.
- Cost and Financing: The consultation typically includes a discussion of costs and available financing or payment plan options.
- Answering Your Questions: Bring a list of questions you wish to ask about the procedure and surgeon. No question is too small.
By the end of the consultation, you should have a clear understanding of the proposed surgical plan, the expected results, the recovery process and the associated costs. Most importantly, you should feel comfortable with your facial plastic surgeon and trust their expertise.
What Are the Different Types of Eyelid Surgery?
Eyelid surgery may involve the upper eyelids, lower eyelids or both, and can be performed for cosmetic or functional reasons.
Upper Eyelid Surgery (Upper Blepharoplasty)
This type of surgery corrects issues such as excess skin that creates drooping or "hooding," puffiness caused by displaced fat deposits, and indistinct eyelid creases. The result is a smoother, more defined upper eyelid contour, a more alert and youthful appearance, and often an improved canvas for applying makeup.
Functional Blepharoplasty
This is a subtype of upper eyelid surgery. While cosmetic blepharoplasty focuses on appearance, functional blepharoplasty addresses severely drooping upper eyelid skin that impairs vision by obstructing the upper field of view. The goal is to restore a clear line of sight.
Lower Eyelid Surgery (Lower Blepharoplasty)
Lower blepharoplasty targets concerns below the eyes, primarily under-eye bags and puffiness. The procedure creates a smoother transition from the lower eyelid to the cheek. Two surgical approaches are used for lower eyelid surgery:
Transconjunctival Approach
The surgeon makes an incision hidden inside the lower eyelid. This technique is ideal for addressing excess fat (bags) when significant skin removal is not needed. It leaves no visible external scar.
Subciliary Approach
An incision is made just below the lower lash line. This approach allows the surgeon to remove excess skin in addition to removing or repositioning fat deposits. The scar is typically well-concealed by the eyelashes.
How Should I Prepare for Eyelid Surgery?
Your AAFPRS facial plastic surgeon will provide detailed, personalized preparation instructions, but general steps often include:
- Medical Evaluation: You may need laboratory testing or a medical evaluation by your primary care physician to ensure you are fit for surgery.
- Adjust Medications: Your surgeon will advise you on which medications and supplements to avoid before surgery, particularly those that can increase bleeding. Discuss all medications you take, including prescriptions and over-the-counter items.
- Stop Smoking: If you smoke, you will be required to stop several weeks before surgery, as smoking significantly impairs healing and increases complication risks.
- Arrange Support: Plan for a responsible adult to drive you home after your procedure and stay with you for at least the first night, possibly longer, depending on your needs and your surgeon’s recommendation.
- Prepare Your Recovery Space: Set up a comfortable area at home for rest. Gather supplies like prescribed eye drops or ointments, cold compresses or small ice packs, gauze pads, clean washcloths and extra pillows to keep your head elevated.
- Fill Prescriptions: Pick up any prescribed medications, such as pain relievers or antibiotics, before your surgery day so they are ready when you get home.
- Follow Fasting Instructions: You will be given instructions about when to stop eating and drinking before your procedure, typically after midnight the night before.
- Plan Your Outfit: On the day of surgery, wear loose, comfortable clothing that does not need to be pulled over your head. A button-front or zip-front top is ideal.
- Arrive Ready: Come to the surgical facility with a clean face, free of any makeup, creams or lotions. Do not wear contact lenses; use your glasses instead.
Carefully follow the preoperative instructions given to you by your surgeon and their team. Thorough preparation sets the stage for a smooth procedure and recovery.
What Are the Steps of Eyelid Surgery?
Anesthesia
Eyelid surgery is usually an outpatient procedure. To ensure your comfort, it's done using local anesthesia with intravenous sedation (making you relaxed and sleepy) or general anesthesia (putting you fully to sleep). Your surgeon will recommend the best option for you based on the extent of the surgery and your preferences.
Incisions
Your surgeon will make incisions designed to be hidden within the natural structures of your eyelid region.For upper eyelid surgery, the incision is typically placed in the natural crease of the eyelid. For lower eyelid surgery, the incision might be made just below the lower lash line (subciliary) or hidden inside the lower eyelid (transconjunctival).
Adjustments
Through the placed incisions, your surgeon will:
- Remove excess skin that causes drooping or wrinkles
- Remove or reposition bulging fat pads that create puffiness or bags
- Tighten underlying muscles if needed
Incision Closure
Once the necessary adjustments are made, the surgeon closes the incisions. They may use sutures that need removal a week later or absorbable sutures that dissolve. Skin adhesives might be used in some cases.
Completion
After the surgical area is dressed, you will be moved to a recovery area. You will be monitored there as the anesthesia or sedation wears off before being discharged home.
What Should I Expect After Eyelid Surgery?
When your surgery is complete, your surgeon may apply a lubricating ointment to your eyes to prevent dryness. Tiny sterile bandages might be placed over the incision lines. This is not done for all types of eyelid surgery, and covering the eyes completely is usually not necessary.
You can expect a certain degree of swelling and bruising around your eyes. Use cold compresses as recommended by your surgeon and keep your head elevated, especially when resting or sleeping, to minimize swelling and discomfort. Your surgeon will prescribe pain medication.
During the initial week or so, you will clean the eye area according to your surgeon's instructions. Your eyes might feel sticky, dry, itchy or sensitive to light during this time; lubricating eye drops may be recommended to help manage these symptoms. Temporary blurred or double vision can also occur.
Your surgeon will provide a list of activities and environments to avoid while your eyes heal. This typically includes strenuous activities, heavy lifting, bending over, swimming, and dusty or smoky environments. Wear sunglasses to protect your eyes from sun and wind irritation.
Most patients feel comfortable returning to work and light activities within seven to 10 days, but always follow your surgeon’s specific guidance.
What Results Can Be Achieved With Eyelid Surgery?
Eyelid surgery helps you look more rested and youthful. Specific results depend on the type of surgery performed (upper, lower or both) and your individual anatomy, but common outcomes include:
- A reduction in excess skin on the upper eyelids
- Smoother upper eyelid skin
- More defined upper eyelid creases.
- A decrease in puffiness or bags under the eyes
- Improved vision if it was obstructed
- An overall brighter and more refreshed appearance
Facial plastic surgeons are meticulous about placing incisions where they are least conspicuous. Upper eyelid incisions are hidden within the natural crease, and lower eyelid incisions are either concealed inside the eyelid or placed just beneath the lash line. Incision lines typically fade over time, but they may not disappear completely. Proper postoperative care, as directed by your surgeon, helps optimize healing and minimize scar appearance.
The effects of blepharoplasty are often best understood visually. Seeing real patient results can help you appreciate the potential changes and set realistic expectations for your own surgery.
Blepharoplasty Before & After Images
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Eyelid Surgery FAQs
What are the risks of eyelid surgery?
Blepharoplasty, like any surgical procedure, carries certain risks. These may include:
- Hematoma or seroma
- Temporary blurred or double vision
- Dry or itchy eyes
- Difficulty closing eyes completely (usually temporary)
- Visible scarring
- Asymmetry
- Infection
- Adverse reaction to anesthesia
Your surgeon should discuss these risks in detail during your consultation.
When is it okay to wear contact lenses after blepharoplasty?
Most surgeons recommend waiting at least one to two weeks to resume wearing contact lenses after eyelid surgery. This allows the initial swelling to subside and reduces the risk of irritating the healing incisions or introducing bacteria. Always follow your surgeon's instructions, as the ideal timing can vary from person to person.
How long do the results of eyelid surgery usually last? Is it permanent?
Eyelid surgery may provide improvement for 10 to 15 years, sometimes even longer. Your face will continue to age, but the area treated should always look better than if you hadn't had the surgery. Think of it as turning back the clock, not stopping it entirely.
How long does the eyelid surgery procedure take to perform?
The duration of eyelid surgery depends on the extent of the procedure. Upper eyelid surgery alone might take about an hour, while lower eyelid surgery can take one to two hours. If both are being treated concurrently, the procedure typically takes around two to three hours.
Can I rejuvenate my eyes without surgery?
Nonsurgical treatments can address some concerns around the eyes. Neurotoxins (like Botox) can soften crow's feet, dermal fillers can help with under-eye hollows (tear troughs), and laser resurfacing or chemical peels can improve skin texture and fine lines.
These treatments cannot remove excess eyelid skin or reposition underlying fat pads. For moderate to severe drooping skin or prominent eye bags, blepharoplasty is the most effective and definitive solution.
How much does eyelid surgery cost?
The cost of eyelid surgery varies widely depending on factors like the surgeon's experience and qualifications, the geographic location of the practice, the complexity of the procedure, anesthesia fees and surgical facility costs. Schedule a consultation with an AAFPRS facial plastic surgeon to get a cost assessment based on your needs.
Does insurance cover eyelid surgery?
Insurance does not generally cover surgery that is done purely for cosmetic reasons. Surgery to correct or improve vision or surgery for eye deformity or injury may be reimbursable in whole or in part. It is the patient’s responsibility to check with their insurance carrier for information on the degree of coverage.
Will eyelid surgery get rid of my crow's feet?
No, blepharoplasty primarily addresses excess skin and fat on the eyelids themselves. Crow's feet are dynamic wrinkles located at the outer corners of the eyes caused by muscle activity (such as smiling and squinting). Treatments like neurotoxin injections (e.g., Botox, Dysport) are typically needed to target and soften crow's feet.
Can I have upper and lower eyelid surgery done at the same time?
Absolutely. It is very common to address both areas during the same operation. This combined approach, sometimes called "quad blepharoplasty," provides more extensive results with a single surgical session and recovery period. Your surgeon will assess your needs during the consultation to determine if this is the best approach for you.
What procedures can be combined with eyelid surgery?
Blepharoplasty is frequently combined with other facial procedures for more comprehensive rejuvenation. Common combinations include:
Combining procedures provides more comprehensive results and may be more cost-effective. Your facial plastic surgeon can recommend complementary procedures based on the aesthetic goals you hope to achieve.
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Find a Facial Plastic Surgeon Near You
Rejuvenating the eye area requires skill and artistry. The AAFPRS Find a Surgeon tool connects you with highly qualified, board-certified facial plastic surgeons in your area who possess deep expertise in procedures like blepharoplasty. They can provide personalized consultations to discuss your eyelid concerns, design a customized treatment plan, and help you achieve natural-looking, refreshed results.
Medical content written by the AAFPRS Multimedia Committee. Medical content reviewed/approved by Dr. Samuel M. Lam and Dr. Albert J. Fox.