Upper and Lower Eyelid Blepharoplasty
What Is Upper and Lower Eyelid Blepharoplasty?
Eyelid blepharoplasty is a customizable surgery designed to improve both the appearance and function of your eyelids by carefully removing or repositioning excess tissue. The procedure can address your upper eyelids, lower eyelids, or both during a single session to create balanced and natural-looking results.
Upper eyelid blepharoplasty removes excess skin that creates heavy, hooded eyes and can block your vision. Your surgeon makes small incisions along the natural crease of your eyelid to hide scars. They then remove or reposition skin and fat to create a smoother contour. This opens up your eyes and restores a wider field of vision.
Lower eyelid blepharoplasty addresses puffy bags and loose skin under the eyes that make you look tired. Incisions may be made just below the lashes or inside the eyelid where no scar will be visible. Fat pockets are then removed or repositioned to smooth out hollows and create a more refreshed under-eye area.
Many patients choose to have both upper and lower eyelids treated at the same time for comprehensive and balanced results. This approach can be more cost-effective and convenient because it requires only one recovery period to address all concerns at once.
Eyelid blepharoplasty is ideally performed by a board-certified ophthalmologist who specializes in oculoplastic surgery or a facial plastic surgeon with deep expertise in eyelid anatomy. At ReFocus Eye Health Marlton, our ophthalmologists have advanced training and experience in eyelid surgery. Choosing a specialist ensures the best functional and cosmetic outcomes while minimizing risks.
The extent and technique of the surgery are tailored to your unique anatomy, aesthetic goals, and eyelid function. A thorough discussion of your expectations and careful surgical planning are critical for achieving the best possible outcome.
Who Is a Good Candidate?
The best candidates are healthy adults who are bothered by the appearance or function of their eyelids and have realistic expectations about the results. A detailed evaluation is essential to determine if blepharoplasty will safely and effectively achieve your goals.
You may be a good candidate if you have droopy upper eyelids that hang over your lashes, create deep folds, or make you look tired. Under-eye bags or puffiness that persist despite good sleep and healthy habits also respond well to surgery.
When droopy upper eyelids block your peripheral or side vision, it can interfere with daily activities like driving and reading. Your eye doctor may perform a visual field test to measure how much vision is lost. If the test shows significant impairment, insurance may help cover the cost of upper eyelid surgery.
Good candidates are generally healthy non-smokers without uncontrolled medical conditions like diabetes or severe dry eye. Most patients are over 35, but younger people with genetic traits may also benefit. There is no strict age limit for the procedure.
Ideal candidates understand both the benefits and potential risks of the procedure. A thorough consultation is key to clarifying goals, ensuring you have realistic expectations, and exploring all available options before making a decision.
Benefits and Results
Blepharoplasty offers both functional and cosmetic improvements that can enhance your quality of life and self-confidence. The results are typically long-lasting, with most patients expressing high satisfaction with their refreshed appearance and vision.
Removing excess tissue creates a more alert, rested, and youthful appearance that can take years off your face. Your eyes often appear larger and more open. Many patients find that makeup applies more easily and stays in place better after surgery.
Lifting droopy upper lids can significantly widen your field of vision, making activities like driving and sports safer and more enjoyable. Many patients also report less eye strain and fatigue because they no longer need to constantly raise their eyebrows to see clearly.
Studies show that over 95% of patients are satisfied with their blepharoplasty results. While the natural aging process continues, the improvements typically last for 10 to 15 years. Many people never need additional surgery on their eyelids.
Many patients report increased confidence and satisfaction with their appearance after surgery. The combined benefits of looking more rested and seeing more clearly can positively impact your daily life, work performance, and social interactions.
Risks and Possible Complications
Like all surgical procedures, blepharoplasty carries some risks that you should understand before deciding on treatment. Most complications are minor and temporary, but your surgeon will discuss how these are managed to ensure a safe outcome.
All patients experience some bruising and swelling, which peaks at 2 to 3 days and gradually improves over 1 to 2 weeks. Mild discomfort, tightness, and temporary blurred vision from ointments are normal. Your eyes may also feel dry or scratchy for several days.
Some patients develop small white bumps along the incision line that usually disappear within a few weeks. Temporary numbness around the incision sites can last for several months but typically resolves completely. Difficulty closing your eyes fully may occur briefly but improves as swelling goes down.
Infection, significant bleeding, or permanent changes to eyelid position are extremely rare, affecting less than 1% of patients. Vision loss is an exceptionally rare risk. These complications require immediate medical attention if they occur.
Minor asymmetry between the eyelids can result from swelling but often improves with time. In rare cases where a noticeable difference persists after complete healing, an additional procedure may be needed to achieve optimal symmetry.
Preparing for Surgery
Proper preparation helps ensure the safest possible procedure and the smoothest recovery. Your surgeon will provide detailed instructions tailored to your specific health history and needs.
Your surgeon will review your medical history and perform an eye exam to check for conditions like dry eye or glaucoma that need to be managed first. Blood tests or additional clearance from your primary care doctor may be required to ensure you are healthy enough for surgery.
You will need to stop taking blood-thinning medications and certain supplements at least one week before surgery to reduce bleeding risk. Your surgeon will provide a complete list of what to avoid, which commonly includes:
- Aspirin and ibuprofen
- Herbal supplements like ginkgo, garlic, and fish oil
- Vitamin E
Quitting smoking at least 4 weeks before surgery is critical because smoking dramatically increases complication rates and slows healing. You must also arrange for someone to drive you home and stay with you for at least 24 hours after the procedure.
Prepare your recovery area with extra pillows to keep your head elevated, as well as ice packs, eye drops, and easy-to-prepare meals. Having everything you need within reach will help you rest comfortably during the first few days.
The Surgical Procedure
Understanding what happens during surgery can help reduce anxiety and prepare you for the experience. Most eyelid procedures are performed in an outpatient setting and take 1 to 3 hours, depending on the complexity.
Most eyelid surgeries use local anesthesia with sedation to keep you comfortable and relaxed while awake. General anesthesia may be used for more extensive procedures. An anesthesia provider will monitor you throughout the entire procedure to ensure your safety.
Your surgeon marks the areas to be treated and makes precise incisions in natural creases or inside the eyelids where scars will be hidden. Excess fat is carefully removed or repositioned to create smooth contours. Excess skin is trimmed and tightened to achieve the desired shape while maintaining natural eyelid function.
Very fine sutures are used to close the incisions and minimize scarring. Your surgeon may use absorbable stitches that dissolve on their own or removable stitches that come out in 5 to 7 days. An antibiotic ointment is then applied to protect the incisions.
Recovery and Aftercare
Following your surgeon's aftercare instructions carefully is essential for optimal healing and the best possible results. A smooth recovery is key to achieving your desired outcome with minimal complications.
Apply cold compresses for 10 to 15 minutes every hour while awake for the first 48 hours to reduce swelling and bruising. Sleep with your head elevated on 2 to 3 pillows. Use prescribed antibiotic ointment and artificial tears as directed. Avoid bending, lifting heavy objects, and strenuous activity during this time.
Most bruising and swelling will fade significantly, allowing you to gradually resume normal activities. You can often return to work within 7 to 14 days. Light exercise like walking is encouraged, but avoid activities that increase blood pressure, such as running or weightlifting.
Scars will continue to fade and soften for 6 to 12 months. It is crucial to protect your healing skin from sun exposure with sunglasses and a sunscreen of at least SPF 30. Your final results will become apparent as all swelling resolves, typically within 3 to 6 months.
While rare, you should contact your surgeon immediately if you experience severe pain, sudden vision changes, significant bleeding that will not stop, or signs of infection like increasing redness, warmth, or discharge from the incision.
Frequently Asked Questions
Here are answers to some of the most common questions patients have about eyelid surgery.
Most visible bruising and swelling improve within 1 to 2 weeks, allowing you to return to work and social activities. You can typically resume strenuous exercise within 3 to 4 weeks. Complete healing and final results take 3 to 6 months as the tissues fully settle.
Incisions are strategically placed in natural eyelid creases or inside the lower lids where they are well hidden. With proper wound care and sun protection, most scars fade to thin, nearly invisible lines within a year.
Upper eyelid surgery may be covered by insurance if drooping lids significantly block your vision. This condition must be documented by a formal visual field test. Lower eyelid surgery and procedures performed for purely cosmetic reasons are typically not covered.
The results of eyelid surgery are long-lasting, typically for 10 to 15 years or even longer. While the surgery does not stop the natural aging process, most patients will always look more refreshed than if they had never had the procedure.
Select a board-certified ophthalmologist or plastic surgeon who specializes in oculoplastic or eyelid surgery. You should review their before-and-after photos, read patient reviews, and confirm they have extensive experience performing the specific procedure you need.
Costs can vary based on your geographic location, the surgeon's expertise, and the extent of the surgery. On average, surgeon fees can range from $3,000 to $5,000 for upper lids alone or $5,000 to $8,000 for a combined upper and lower procedure. This does not include separate fees for anesthesia or the surgical facility.
For mild concerns, non-surgical options like Botox, dermal fillers, and laser treatments can provide temporary improvement by relaxing wrinkles or adding volume. However, these treatments cannot remove significant excess skin or fat pads and are not a substitute for surgery in moderate to severe cases.
You should call your surgeon immediately if you experience severe or worsening pain, any sudden change or loss of vision, heavy bleeding, or signs of an infection such as fever, pus from the incision, or increasing redness and warmth around the eye.
Expert Eyelid Surgery in Marlton
ReFocus Eye Health Marlton offers expert eyelid blepharoplasty performed by our ophthalmologists who specialize in oculoplastic surgery. Serving patients throughout the Greater Philadelphia Metropolitan Area, our multispecialty team uses advanced surgical techniques and technology to deliver safe, effective, and natural-looking results. Schedule a consultation to discuss your goals, review before-and-after photos, and determine if eyelid surgery is the right choice for you.
Dr. Grossman is the best. His personality is comforting, and his surgical skills are second to none. He takes the time to explain every procedure and eye exam result. I highly recommend Dr. Grossman!
Jim Stimeck
Dr. Grossman is an excellent ophthalmologist and takes time to explain everything in detail. I have been his patient for many years.
Jesmin Mitra
Dr. Charles Glass at Refocus is exceptional with his professional and thorough care and absolute confirm for his patients. I would highly recommend him!
Lauren Stith
Dr Grossman and his staff are professional, caring and do a great job taking care of my eyes. An extra shout out to Leslie who was very professional and thorough!
Rich Shakarjian
I had my appointment today with Dr Glass and it was great. Dr Glass is one of best in the group. He has improved my vision a lot over the years .
George Field
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