You’ve looked in the mirror countless times and perhaps noticed subtle changes in your appearance over the years. Once bright and youthful, your eyes may now appear tired and aged due to sagging upper eyelid skin. If you find yourself considering upper blepharoplasty, you’re not alone.

This procedure, also known as eyelid surgery or an eyelid lift, is popular for individuals looking to rejuvenate their eyes and achieve a more youthful, refreshed appearance.

This comprehensive guide will take you through everything you need to know as a patient considering eyelid surgery. From understanding the procedure to finding the right surgeon, navigating the recovery process, and addressing potential risks, we’ve got you covered.

What Is Upper Blepharoplasty?

Upper blepharoplasty, often simply referred to as “blepharoplasty,” is a cosmetic surgical procedure designed to rejuvenate the appearance of the upper eyelids. It primarily addresses excess skin and fat that can accumulate in the upper eyelid area over time. Our primary goal is to create a more youthful, refreshed appearance by removing or repositioning these tissues, resulting in a smoother, firmer upper eyelid contour.

Common Reasons for Undergoing the Procedure

People choose to undergo upper blepharoplasty for various reasons, each unique to their individual concerns and goals. Some common motivations for considering this procedure include:

• Excess Skin: Over time, the upper eyelid skin can lose elasticity and begin to sag, creating a heavy, tired appearance. Upper blepharoplasty can remove this excess skin, restoring a more youthful eyelid contour.
• Fat Pockets: Fat accumulation in the upper eyelid can create puffiness and a tired look. The procedure can address these fat pockets, resulting in a smoother, more defined eyelid crease.
• Improved Vision: In some cases, particularly when excess upper eyelid skin significantly impairs vision, upper blepharoplasty enhances the visual field and clarity.
• Aesthetic Enhancement: Many individuals choose upper blepharoplasty to enhance their overall appearance. A refreshed and rejuvenated eye area can profoundly impact self-esteem and confidence.

How Upper Blepharoplasty Differs from Other Eyelid Surgeries

It’s important to note that upper blepharoplasty differs from other eyelid surgeries, such as lower blepharoplasty and ptosis repair. While these procedures all target the eyelid area, they address different concerns and have unique surgical approaches.

Lower Blepharoplasty

This procedure addresses under-eye bags, excess skin, and fat deposits in the lower eyelid area.

Ptosis Repair

Ptosis refers to the drooping of the upper eyelid margin. Ptosis repair aims to correct this condition by repositioning the upper eyelid to a more natural and functional position. It may be performed in conjunction with upper blepharoplasty if ptosis is present.

Candidacy Criteria for Upper Blepharoplasty

Determining whether you are suitable for upper blepharoplasty is a crucial first step in achieving your desired eyelid rejuvenation. This procedure is generally well-suited for individuals with certain cosmetic concerns about their upper eyelids. The ideal candidate often falls into the following categories:

• Excess Eyelid Skin: If you’ve noticed sagging or redundant skin on your upper eyelids, creating a heavy or tired appearance, you may be an excellent candidate for upper blepharoplasty. This procedure can effectively address this concern, providing a smoother, more youthful eyelid contour.
• Fat Deposits: Accumulated fat deposits in the upper eyelid region can lead to puffiness and an aged appearance. Candidates with localized fat pockets not responsive to non-surgical treatments may benefit from upper blepharoplasty.
• Healthy Individuals: Candidates should be in good overall health, with no uncontrolled medical conditions that could increase surgical risks. A comprehensive medical history evaluation will be conducted during your initial consultation to ensure your safety.
• Non-Smokers: Smoking can impede healing and increase the risk of complications. Candidates are typically advised to quit smoking or avoid tobacco products for a specified period before and after surgery, based on your surgeon’s instructions.
• Realistic Expectations: It’s essential for candidates to have realistic expectations about the outcomes of upper blepharoplasty. While the procedure can significantly improve eyelid appearance, it’s not a guarantee of perfection. Open and honest communication with your surgeon during consultation can help align expectations with achievable results.

During your initial consultation with a board-certified plastic surgeon, a thorough assessment of your eyelid anatomy, concerns, and medical history will be conducted to determine if you meet the candidacy criteria for upper blepharoplasty. Your surgeon will also discuss your goals and expectations, helping you make an informed decision about proceeding with the surgery.

Finding the Right Plastic Surgeon

When embarking on your blepharoplasty journey, choosing the right plastic surgeon is one of your most critical decisions. This decision can significantly impact the success and safety of your procedure. Here are the essential steps to help you find a qualified surgeon:

1. The Importance of Board Certification:First and foremost, ensure that your chosen surgeon is board-certified in plastic surgery. Board certification signifies that the surgeon has undergone rigorous training and met high standards of competence and ethics. It’s an assurance that they possess the necessary skills and knowledge to perform blepharoplasty and other cosmetic procedures safely and effectively. You can find a board-certified plastic surgeon near you on the American Society of Plastic Surgeon’s website.
2. Researching and Selecting a Qualified Surgeon:Take the time to research and compile a list of potential plastic surgeons in your area. Recommendations from trusted sources, such as friends, family, or healthcare professionals, can be valuable. Additionally, online resources and directories, such as the American Society of Plastic Surgeons, can help you identify qualified surgeons in your region.
3. Initial Consultation with the Surgeon:Once you’ve identified potential surgeons, schedule an initial consultation with each to discuss your blepharoplasty procedure. This consultation allows you to evaluate the surgeon’s expertise and ensure a good fit. Here’s what you can expect from your surgical consult:

Discuss Your Goals and Concerns

Clearly articulate your aesthetic goals and concerns related to your upper eyelids. Be open and honest about what you hope to achieve with the surgery. We will listen attentively and provide honest feedback about what can be accomplished based on your anatomy.

Review Your Medical History

We will ask about your medical history, including any pre-existing conditions, allergies, medications, or prior surgeries. This information is crucial in assessing your eligibility for the procedure and planning for a safe surgery.

Assess Before-and-After Photos of Previous Patients

Remember to ask to see before-and-after photos of previous patients who have undergone blepharoplasty with your surgeon. These photos offer tangible evidence of their skill and the types of results they can achieve. Pay attention to cases that are similar to your own, as this can give you a better idea of what to expect.

Ask Questions About the Procedure

During your consultation, don’t hesitate to ask questions about the procedure, including risks, complications, recovery, a cost breakdown, and payment options.

The Upper Blepharoplasty Procedure

Undergoing upper blepharoplasty is a carefully orchestrated process that involves pre-operative preparations, the day of surgery, the surgical procedure itself, and the consideration of potential additional procedures.

Pre-operative Preparations: What to Do Before Surgery

Before your upper blepharoplasty, your surgeon will provide you with pre-operative instructions. We usually include guidelines for:

• Medications: Your surgeon may advise you to avoid certain medications and supplements that can increase the risk of bleeding, such as blood thinners, aspirin and non-steroidal anti-inflammatory drugs (NSAIDs).
• Smoking: If you are a smoker, your surgeon will likely recommend quitting or abstaining from smoking for a specified period before and after surgery to enhance the healing process.
• Fasting: You may be instructed to fast for a specific period before surgery, typically starting at midnight the night before the procedure.

Preparing Your Home for Post-operative Recovery

Ensuring a comfortable and conducive recovery environment at home is essential. Before your surgery, consider the following preparations:

• Arrangements: Arrange for someone to drive you home after surgery and stay with you for the first day or two of recovery.
• Recovery Area: Set up a comfortable area at home with pillows, blankets, and entertainment options to help you relax during your initial recovery period.
• Supplies: Stock up on necessary supplies such as gauze, cold compresses, and any prescribed medications.

The Day of Surgery: What to Expect at the Surgical Center

On the day of your upper blepharoplasty, you will typically arrive at the surgical center or hospital where the procedure will occur. Here’s what to expect:

• Check-In: You will check in at the reception area and complete any required paperwork.
• Pre-Operative Assessment: A nurse or medical team member will conduct a pre-operative assessment, including taking vital signs and reviewing your medical history.
• Preparation: You will be prepared for surgery, which may involve changing into a surgical gown and receiving an intravenous (IV) line for hydration and medication delivery.
• Anesthesia: Your anesthesia provider will discuss your options and administer the chosen method.

Anesthesia Options

Upper blepharoplasty can be performed using only local anesthesia, combining local anesthesia with sedation, or general anesthesia, depending on your preferences and the surgeon’s recommendations. Local anesthesia with sedation allows you to remain comfortable and relaxed while awake during the procedure. General anesthesia induces a state of unconsciousness, ensuring you are completely unaware of the surgery.

The Surgical Process

Incision Techniques

The surgeon will create incisions along the natural creases of your upper eyelids, ensuring that any resulting scars are well-concealed within these creases. The precise location and length of the incisions will be determined based on your anatomy and aesthetic goals.

Removal of Excess Skin and Fat

After making the incisions, the surgeon will carefully remove excess skin and, if necessary, excess fat. This process results in a smoother, more rejuvenated upper eyelid appearance. The surgeon will exercise precision and expertise to achieve balanced and natural-looking results.

Closing the Incisions

The surgeon will meticulously close the incisions using fine sutures once the necessary adjustments have been made to your upper eyelids. The goal is to create a secure closure that promotes optimal healing and minimizes scarring.

Potential Additional Procedures

In some cases, a brow lift may be recommended with upper blepharoplasty to address sagging eyebrows and create a more harmonious and youthful eye area. If you have concerns about the lower eyelids, your surgeon may discuss the option of lower blepharoplasty, which can address issues like under-eye bags and excess skin in the lower eyelid area. A facelift and/or facial fat grafting best address the lower face and neck. When combined with upper blepharoplasty, these additional procedures can provide a comprehensive rejuvenation of the entire eye area, resulting in a more balanced and youthful appearance. During your consultation, your surgeon will discuss the suitability of these procedures based on your unique needs and goals.

Blepharoplasty Recovery and Aftercare

After undergoing upper blepharoplasty, a carefully planned and executed recovery period is essential to achieve the best possible results. In this section, we’ll explore the various aspects of the recovery process, including immediate post-operative care, the timeline for resuming daily activities, incision care, follow-up appointments, and long-term considerations.

Immediate Post-Operative Period

It’s normal to experience some discomfort or mild pain following upper blepharoplasty. Your surgeon typically prescribes pain medication or recommends over-the-counter pain relievers to manage discomfort. Follow your surgeon’s instructions regarding medication usage for optimal pain relief.

Swelling and bruising around the surgical area are common side effects of blepharoplasty. Applying cold compresses to the eyes can help reduce swelling during the initial days after surgery. Bruising usually diminishes within a few weeks. Your surgeon may recommend arnica supplements or topical creams to accelerate healing.

Recovery Timeline

Typically, patients can expect to return to work and non-strenuous activities within 7-10 days after surgery. However, avoiding vigorous exercise and heavy lifting for a few weeks is essential to minimize the risk of complications. Proper care of your surgical incisions is crucial for optimal healing and minimal scarring. Your surgeon will provide specific post-operative instructions, including keeping the incisions clean and dry, avoiding direct sunlight, and using prescribed or recommended ointments. It’s essential to follow these instructions diligently to support the healing process.

Follow-Up Appointments with Your Surgeon

Scheduled follow-up appointments with your surgeon are integral to your post-operative care. These appointments allow your surgeon to monitor your progress, remove any sutures or stitches, and address any concerns or questions you may have. Be sure to attend all recommended follow-up visits, as they ensure a smooth recovery and successful results.

Long-Term Care and Results

Scarring is an inevitable part of any surgical procedure. However, with upper blepharoplasty, incisions are typically made along the natural creases of the upper eyelids, which helps minimize visible scarring. Most patients find that any residual scarring becomes less noticeable over time. Following your surgeon’s scar care instructions and protecting the incisions from sun exposure can further aid in minimizing scarring.

The long-term success of your blepharoplasty results depends on several factors. To maintain the rejuvenated appearance of your upper eyelids, practicing good skincare habits and protecting your skin from sun damage is essential. A healthy lifestyle, including a balanced diet and not smoking, can help preserve the results. Over time, your eyelids will naturally age, but the effects of blepharoplasty can provide lasting improvements that make the aging process more graceful.

By following these guidelines and maintaining a proactive approach to your recovery and long-term care, you can maximize the benefits of your upper blepharoplasty and enjoy a refreshed and youthful appearance for years to come.

Costs and Financing

According to the American Society of Plastic Surgeons, cosmetic eyelid surgery costs around $4,000. The total cost of upper blepharoplasty can vary depending on several factors, including:

• Surgeon’s Fees: This covers the cost of your surgeon’s expertise, experience, and the surgical procedure. Surgeon fees can vary based on their qualifications and geographic location.
• Anesthesia Fees: You will incur additional costs if the procedure requires anesthesia. The type of anesthesia used can influence the overall price.
• Facility Fees: Fees associated with the surgical facility, such as the operating room and equipment, are part of the total cost.
• Medical Tests and Prescriptions: Pre-operative tests and any necessary prescriptions, such as pain medications and antibiotics, are typically separate costs.
• Post-Operative Care: Expenses related to post-operative care, including follow-up appointments and additional treatments or medications, should also be considered.

Insurance Coverage

Upper blepharoplasty is often considered a functional procedure, and insurance may cover it. If excess upper eyelid skin impairs your vision and a medical professional deems blepharoplasty medically necessary, there is a possibility that insurance may cover the cost of the procedure. This typically requires documentation of vision impairment and a prior authorization process. If upper blepharoplasty is performed in conjunction with a medically necessary procedure, such as ptosis repair, insurance may cover the functional portion of the surgery.

Turn Back the Clock with Blepharoplasty

Book a consultation with one of our board-certified plastic surgeons or qualified aestheticians to discuss your desired outcomes and treatment options.

Author Profile: Brian Cripe, M.D., is an award-winning, board-eligible plastic and reconstructive surgeon proudly working with the Plastic Surgeons of Northern Arizona practice. Dr. Cripe specializes in cosmetic surgery, limb salvage, peripheral nerve microsurgery, hand surgery, and oncologic reconstructive procedures. He has performed over 5,000 surgical cases during his nine-year tenure as a surgeon.