Eyelid Lift (Blepharoplasty)
Learn How to Choose an Expert Surgeon for Your Eye Lid Lift
Sagging eyelids or puffy under-eye bags may disproportionately age your appearance, or make you look tired when you are not. An eyelid lift, or blepharoplasty, is a cosmetic surgery procedure designed to improve their appearance. This treatment targets both the upper and lower eyelids, eliminating droopy lids, bags under the eyes, and excess skin that can impair vision and make you look tired or aged. Performed by expert, board-certified facial cosmetic surgeons, blepharoplasty can provide a refreshed and youthful appearance.
Blepharoplasty techniques
The eyelid lift procedure varies slightly for the upper and lower eyelids, but both remove excess skin and/or fat to create a smoother, more refreshed appearance. Patients may have upper and lower blepharoplasty together in one procedure, if needed.
Upper eyelid lift
During an upper blepharoplasty, the surgeon makes an incision in the natural crease of the eyelid to minimize visible scarring. The surgeon then removes excess skin and removes or repositions fat. If necessary, they will also adjust the muscle to lift droopy eyelids. The incision is then closed with fine sutures or surgical glue.
Lower eyelid lift
In a lower blepharoplasty, the surgeon makes an incision either just below the lash line or inside the lower eyelid (a transconjunctival incision). Excess fat is removed or repositioned to reduce bags under the eyes, and excess skin may also be removed. The incision is then closed with sutures, or simply left to heal naturally in the case of an incision within the lower lid.
Key Benefits
- Creates a well-defined jawline
- Smoothes sagging or crepe-like skin
- Tightens the muscles and skin of the neck for a firm contour
- Addresses a “double chin” or “turkey neck”
Terms to Know
Anesthesia: To prevent pain during neck lift surgery, anesthesia is administered. Anesthesia can be general, where the patient is unconscious; sedation anesthesia, which involves medications that relax the patient but keep them awake for surgery; or local anesthesia, where only a specific part of the body is numb and the patient is fully alert.
Botox: Derived from the bacterium Clostridium botulinum, Botox is injected into a face or neck muscle to temporarily relax the local area. It is a popular treatment for reducing the appearance of wrinkles caused by muscle contractions (dynamic wrinkles).
Collagen: A protein found abundantly in the skin to provide its strength and elasticity. Collagen production decreases with age, contributing to sagging skin and wrinkles.
Direct Excision: A surgical technique where excess or loose skin is directly cut away, or excised, to create a tighter, smoother appearance.
Dermal Filler: Injectable substances used to fill in wrinkles, restore volume, and smooth the skin. Juvederm, Restylane, RHA, and Sculptra are examples of dermal fillers.
Eye Lift: Medically termed blepharoplasty, an eye lift is a surgical procedure that improves the appearance of the upper and/or lower eyelids by removing excess skin, fat, and muscle.
Lifts: Surgical procedures that aim to ‘lift’ or tighten sagging skin. Neck lifts and face lifts are examples of this type of procedure.
Nonsurgical Neck Lift: A procedure that tightens and lifts the skin of the neck without the need for surgery, achieving a mild improvement for early signs of aging. This can be achieved through treatments like thread lifts or energy-based skin tightening.
Nose Jobs: Also known as rhinoplasty, this is a surgical procedure that changes the shape or size of the nose for cosmetic or functional reasons.
Platysmaplasty: A surgical technique used in a neck lift to tighten the platysma muscle in the neck, reducing the appearance of neck bands and creating a smoother neck contour.
Post-operative: The period of time following a surgical procedure. This often involves recovery time and follow-up care.
Radiofrequency: A type of energy that can be used in nonsurgical treatments to heat the skin and stimulate collagen production, resulting in tighter, smoother skin.
Reconstructive Surgery: Surgery that is performed to restore function and normal appearance, and to correct deformities.
Surgical Procedures: Medical procedures that involve an incision into the body. Neck lift, face lift, and nose job are examples of surgical procedures.
Thread Lift: A less invasive alternative to traditional face lifts. The procedure involves inserting medical-grade dissolvable thread material into the face and pulling it tight to lift and rejuvenate the skin. Threads also typically stimulate collagen production.
Who is a good candidate for an eyelid lift?
Ideal candidates for eyelid surgery are non-smokers in good overall health. If you have droopy eyelids, bags under the eyes, or excess skin around the eyes that impairs vision, then you may benefit from this procedure. It is also important to have realistic expectations about the results that your surgeon can achieve through this surgery.
Key Benefits
- Restores youthful appearance
- Removes sagging skin
- Reduced bags and dark circles under the eyes
- Improves vision if droopy lids were interfering with sight
Terms to Know
Bilateral Ptosis: A condition where both upper eyelids droop due to weakening of the levator muscle or nerve damage.
Blepharitis: An inflammation of the eyelids, often causing symptoms like redness, swelling, itching, and a feeling of dry eye.
Blepharoplasty: A surgical procedure performed by a surgeon to improve the appearance of the upper eyelids, lower eyelids, or both. It involves the removal of excess skin and fat, addressing symptoms of heavy or ptotic eyelids.
Blepharoptosis: Another term for ptosis, it refers to the drooping or falling of the upper eyelid.
Botox® & Dysport®: Neurotoxins used in non-surgical treatment options to alleviate certain eyelid conditions by temporarily relaxing the muscles around the eyes.
Droopy Eyelid: A condition where the edge of the upper eyelid falls to a position that is lower than normal, often due to age, muscle weakness, or nerve damage.
Dry Eye: A condition characterized by insufficient moisture in the eyes.
Excess Skin: Extra or sagging skin that can accumulate over time due to aging, often resulting in a heavy or hooded appearance of the eyelids.
Eyelid Ptosis: A condition characterized by the drooping or falling of one or both of the upper eyelids.
Fat Transposition: During eye surgery, repositioning or removing excess fat, i.e. to reduce under-eye puffiness.
Graves’ Disease: An autoimmune condition that affects the thyroid, leading to symptoms like bulging eyes or dry eye.
Heavy Eyelids: A condition characterized by excess skin, muscle, and fat in the upper eyelid, often causing a weighed down or droopy appearance.
Hooded Eyes: A term often used to describe eyelids that appear heavy or droopy due to excess skin covering the natural crease of the upper eyelid.
Lazy Eye: Also known as amblyopia, a vision development disorder where one eye doesn’t achieve normal visual acuity.
Levator Muscle: The primary muscle responsible for lifting the upper eyelid. Weakness or damage to this muscle can cause ptosis.
Ptosis: A condition characterized by drooping or falling of the upper eyelid. If severe enough and left untreated, the drooping eyelid can limit or block normal vision.
Ptotic Eyelids: A term used to describe eyelids suffering from ptosis or droopiness.
Ptosis Surgery: Addressing underlying muscles of the eyelids that contribute to eyelid drooping, when needed; can be combined with blepharoplasty.
Skin laxity: Skin laxity refers to the loss of firmness and elasticity in the skin. This condition is typically characterized by sagging or loose skin and is usually a natural result of the aging process, in which the skin’s production of collagen and elastin—proteins responsible for maintaining skin’s tightness and elasticity—slows down. Environmental factors, such as sun exposure and lifestyle choices, can also contribute to skin laxity. Treatments like topical products, laser therapy, and surgical procedures can be used to improve the appearance of lax skin.
Side effects, risks, and complications
During your brow lift consultation, your cosmetic surgeon will review your medical history and medications to determine whether you are in good health for elective surgery. They will then evaluate your facial structure and skin quality and talk with you about your goals and expectations. Based on this conversation, they will be able to recommend the most appropriate brow lift technique (or other options) to achieve your desired outcome.
Your cosmetic surgeon should explain the procedure, recovery, and potential risks before surgery with full transparency, allowing you time to ask any questions you have. Treat this meeting as an opportunity to further vet your surgeon’s qualifications, research options, and ensure you feel comfortable with the proposed treatment plan.
Preparing for your eyelid lift
Pre-surgery care
Prior to surgery, patients are advised to avoid medications and supplements that can increase bleeding, such as aspirin, ibuprofen, and certain herbal supplements. Smokers will need to stop smoking well in advance of the procedure.
If you are a parent of young children, make any childcare arrangements needed to allow you a restful recovery period per your surgeon’s instructions. All patients will need a responsible adult to drive them home after surgery, and if you undergo general anesthesia, they should stay with you for at least 24 hours after the procedure.
What to expect during the procedure
Talk with your surgeon about what will happen during surgery, and what options you may have. Blepharoplasty can be performed under local anesthesia, which numbs only the area being operated on; sedation anesthesia, in which you remain awake but sedated; or under general anesthesia, where you are fully unconscious. The choice depends on your comfort and your surgeon’s recommendation, so be sure to talk with them about what kind of sedation they recommend for you, and how it will affect your recovery and comfort level. Blepharoplasty is performed as an outpatient procedure, which means that you will go home with a responsible adult after surgery.
Recovery after eyelid lift
After the procedure, patients typically experience discomfort, swelling, and bruising, which should subside within a week or two. Cold compresses and elevating your head while sleeping or resting can help reduce these symptoms.
Post-surgery recovery care
Most patients return to normal daily activities within a week to ten days post-surgery. During the recovery period, it’s crucial to protect the eyes from excessive strain, sunlight, and dust. Following post-operative instructions, including avoiding heavy lifting and strenuous exercise, is essential to having a smooth recovery and avoiding complications.
Results
Noticeable improvements in the appearance of the eyes and the overall facial aesthetics are typically apparent within several weeks, as the bulk of your swelling and bruising diminish. The results of blepharoplasty are long-lasting. Ask your surgeon to see before and after photos of patients with similar concerns and surgical plans, which will provide a visual representation of the transformation you will have with an eyelid lift.
Cost of eyelid lift
The cost of blepharoplasty varies based on the complexity of the procedure, surgeon’s fees, and average costs in your geographic location. If the procedure is performed for medical reasons, such as to improve vision obscured by droopy eyelids, insurance may cover a portion of the cost; talk with your insurance company about any requirements for this coverage. For cosmetic procedures, most facial cosmetic surgeons offer financing options to make the procedure more affordable.
Can eyelid lift be combined with other procedures?
Yes, eyelid lift is frequently performed at the same time as other facial cosmetic procedures such as a facelift or brow lift to enhance the overall rejuvenating effect. Your cosmetic surgeon can provide personalized advice based on your aesthetic goals.
Non-surgical enhancements
For patients seeking additional facial rejuvenation, non-surgical treatments like Botox® or fillers can complement the results of an eyelid lift.
Alternatives to eyelid lift
For those not ready for surgery, there are non-surgical alternatives to blepharoplasty, such as laser resurfacing, microneedling, or chemical peels, which can improve the skin’s texture and tone. However, these treatments are not able to address excess eyelid skin or fat pockets around the eyes.
References
Finsterer J. Ptosis: causes, presentation, and management. Aesthetic Plastic Surgery. 2003 May-Jun;27(3):193-204. doi: 10.1007/s00266-003-0127-5.
Bernardini FP, Devoto MH, Skippen B. The “Eyelid Lift” Orbicularis Suspension Technique for Lower Blepharoplasty Surgery. Facial Plastic Surgery & Aesthetic Medicine. 2020 May/Jun;22(3):227-228. doi: 10.1089/fpsam.2020.0028.
Rao V, Sullivan PK. Lower Lid Blepharoplasty in Men. Clinics in Plastic Surgery. 2022 Apr;49(2):213-220. doi: 10.1016/j.cps.2021.12.001. PMID: 35367031.
Will MJ. Upper Eyelid Blepharoplasty. Atlas of the Oral and Maxillofacial Surgery Clinics of North America. 2016 Sep;24(2):125-33. doi: 10.1016/j.cxom.2016.05.008.
Olds C, Most SP. Upper Blepharoplasty. JAMA. 2019;321(13):1320. doi:10.1001/jama.2019.1957
Branham GH. Lower Eyelid Blepharoplasty. Facial Plastic Surgery Clinics of North America. 2016 May;24(2):129-38. doi: 10.1016/j.fsc.2015.12.004
Why choose a board-certified facial cosmetic surgeon for your eyelid lift?
Surgeons certified by the American Board of Facial Cosmetic Surgery (ABFCS) are carefully vetted for adherence to the highest standards of surgical skill, patient care, safety, and satisfaction. Selecting a board-certified facial cosmetic surgeon means that your procedure will be performed by a specialist with extensive training and experience in facial aesthetics. Schedule a consultation with a surgeon near you to discuss your aesthetic goals and learn if an eyelid lift is right for you.