Eyelid Surgery (Blepharoplasty)

Upper eyelid — removing excess skin

Upper blepharoplasty removes redundant skin and, in some cases, a strip of muscle or a small amount of fat from the upper lid. The incision is hidden in the natural crease of the upper eyelid — the same fold that forms when you open your eye — where it heals nearly invisibly within months. The goal isn’t to reshape the eye; it’s to restore the open, rested contour that the lid used to have.

Lower eyelid — repositioning or removing fat

Modern lower blepharoplasty often uses a transconjunctival approach — an incision placed inside the lower lid, with no external scar — to reposition or reduce the herniated fat pockets that create bags. For patients who also have excess lower-lid skin, a subciliary incision just below the lash line may be added to allow careful skin removal. Whenever possible, fat is repositioned into the tear-trough hollow rather than simply removed, which avoids the skeletonized, aged look that over-resection can cause.

Combining with brow lift or fat transfer

Heavy upper lids sometimes come from a descended brow rather than excess skin alone — in those patients, a brow lift may be more appropriate than (or in addition to) an upper blepharoplasty. Similarly, lower-lid hollowing may be better treated with fat transfer than with fat removal. Honest consultation differentiates these, because the wrong operation for the underlying anatomy will never produce a fully satisfying result.

Anesthesia & duration

Blepharoplasty is often performed under local anesthesia with sedation, and under general anesthesia when it’s combined with a larger procedure. Surgical time is typically one to two hours for upper lids, one to two hours for lower lids, or two to four hours when both are addressed together. Patients go home the same day.

• Blepharoplasty doesn’t address everything around the eye. It won’t lift a heavy brow, smooth forehead lines, or improve skin quality and fine wrinkling — those need their own tools (brow lift, neurotoxin, resurfacing).
• Over-aggressive lower-lid surgery can cause ectropion. Taking too much skin or muscle can pull the lower lid downward or outward — a preventable complication that conservative, anatomy-respecting technique is specifically designed to avoid.
• Transient dry eye is common. Many patients notice temporary dryness or sensitivity after surgery. It’s almost always short-lived and responds to lubricating drops, but patients with pre-existing dry eye should be screened carefully before surgery.
• Results are long-lasting. Upper eyelid results typically last ten years or more; lower eyelid results often last fifteen years or more. Aging continues, but the improvement is durable.
• It pairs well with other facial work. Many patients benefit from combining blepharoplasty with a facelift, neck lift, or fat transfer — it’s one of the single biggest-impact add-ons to any broader facial rejuvenation.