Thinking about upper or lower eyelid surgery? Here’s a clear look at what blepharoplasty can do, where it helps most, and the risks you should weigh before you book.
Are you in the planning phase, read our guide about eyelid surgery for a youthful look, what to expect for the step-by-step plan.
What Eyelid Surgery Treats (Upper vs. Lower)
Upper blepharoplasty trims extra skin and sometimes a small strip of muscle or fat to open the eyes, lift heavy lids, and make makeup sit cleanly on the crease. When skin hangs over the lashes and blocks vision, insurance may consider a functional repair after visual-field testing.
Lower blepharoplasty reduces under-eye bags (bulging fat pads), smooths the lid–cheek junction, and can tighten crepey skin. Surgeons often combine fat pad repositioning with light skin tightening for a smooth—not hollow—look.
What it doesn’t do: it won’t raise droopy eyebrows (that’s a brow lift), erase crow’s feet (that’s neurotoxin/laser), or fill mid-cheek volume loss (that’s filler or fat grafting). Many patients choose a small combo plan for the most natural refresh.
Benefits of Eyelid Surgery (Blepharoplasty)
1) Brighter, less tired eyes
Extra skin and puffy fat can make eyes look sleepy or weighed down. Trimming what you don’t need and supporting what you do, opens the aperture so your eyes look fresher without changing your expression.
2) Better visual field (upper lids)
If skin rests on your lashes, you may notice side vision improves after surgery. Patients often report easier driving and less brow strain from “holding the lids up” all day.
3) Makeup sits better
With a defined crease and smoother lower lids, liner and shadow stop smearing; concealer needs less “baking.”
4) Natural, durable change
Hidden incisions in the lid crease (upper) or just under the lashes/inside the lid (lower) heal well for most people. When fat is repositioned (not over-removed), results look soft and last for years.
5) High satisfaction with a short downtime window
Most people go back to desk work in about a week. Bruising and swelling fade quickly, especially after upper-only surgery.
Do you want brows or jawline refinement with minimal time off? See neck lift vs. facelift for how surgeons tailor face/neck options if you’re planning a staged refresh.
Risks of Eyelid Surgery
Every operation has risks. Your consult should cover each of these and how your surgeon prevents or handles them.
Common, Usually Temporary
- Bruising and swelling: Peaks at 48–72 hours; cool compresses help.
- Tightness, dry or watery eyes: Preservative-free tears and ointment ease symptoms while the surface stabilizes.
- Light sensitivity or blurry vision: Often from ointment or swelling; improves over days.
Less Common Surgical Risks
- Asymmetry or residual skin/fat: May need a small office tweak once swelling settles.
- Over-resection (too much skin/fat): Can cause hollowness or trouble closing eyes; prevention is careful measurement and conservative removal.
- Eyelid malposition (ectropion/retreating lower lid): Tends to follow over-tightening or heavy scarring; surgeons prevent it with lid-tightening support and conservative skin removal.
- Lagophthalmos (temporary incomplete closure): Usually settles as swelling drops; lubrication protects the cornea.
- Scars you can feel/see: Upper scars hide in the crease; lower scars hide under lashes or inside the lid. Scar care and sun protection help them fade.
- Infection or bleeding: Rare with proper technique. Sudden, painful swelling with vision change is an emergency, teams screen risk factors and give strict aftercare to prevent retrobulbar hematoma.
- Dry eye worsening: If you already struggle with dry eye or wear contacts, your surgeon will tailor the plan and aftercare to protect the tear film.
- Changes in sensation: Numb spots near the lashes or lash line usually improve as nerves recover.
Anesthesia risks
Light sedation or general anesthesia can cause nausea or sore throat; a thorough history helps the team pick the safest plan.
Who’s a Good Candidate and Who Should Wait
Great candidates
- Healthy adults with realistic goals who want to fix hooding, bags, or a tired look.
- Stable eye surface (manageable dry eye) and no uncontrolled medical issues.
- Non-smokers (or willing to stop nicotine at least 4–6 weeks before/after).
Consider postponing or adjusting the plan if you have
- Uncontrolled dry eye, recent LASIK/PRK without stability, or exposure keratitis.
- Thyroid eye disease (active phase) or severe allergies that inflame the lids.
- Poor eyelid tone (snapback test): you may need supportive tightening to avoid lower-lid descent.
- Unrealistic goals (e.g., “no lines at all” or a completely different eye shape).
Upper vs. Lower vs. Combo
| Area | Main fixes | Incision | Typical downtime | Notes |
| Upper lids | Hooding, lash-touching skin, medial fat | Crease line | ~5–7 days to public-ready | Often the quickest recovery |
| Lower lids | Bags, lid–cheek hollow, crepey skin | Inside lid (transconjunctival) ± subciliary | ~7–10+ days | Fat repositioning helps avoid hollowness |
| Upper + Lower | All of the above | As above | ~10–14 days | Plan extra time for social downtime |
How Surgeons Lower Risk
- Surface protection: pre-op dry-eye screening, tear-film support, and lubrication protocol.
- Conservative removal + support: preserve or reposition fat; tighten the lateral canthus when needed to protect lower-lid position.
- Blood-thinner review: pause aspirin/NSAIDs/supplements that raise bleeding risk as advised.
- Nicotine zero: no smoking/vaping/nicotine gum—these delay healing.
- Head-elevated recovery + cold compresses: keeps swelling/bleeding down in the first 72 hours.
- Clear red-flag plan: sudden pain, vision change, or rapidly growing swelling → call the office immediately or go to the ER.
Bring this checklist to your consult and ask how each point is handled.
Eyelid Surgery Recovery Roadmap
Days 0–2
Head-elevated rest, cool compresses 10–15 minutes each hour while awake, preservative-free tears often, ointment at bedtime.
Take the prescribed pain plan (usually acetaminophen) and avoid heavy reading/screens if eyes feel gritty.
Days 3–5
Bruising peaks and starts to fade. Most people feel comfortable on short walks. Keep the incisions clean and dry; no makeup yet.
Days 6–10
Sutures come out (if not dissolvable). You can return to desk work and wear light, clean eye makeup when your surgeon clears you. Still avoid heavy lifting and sweaty workouts.
Weeks 2–3
Most bruising resolves; swelling continues to trend down. Gentle cardio returns; no hot yoga, swimming, or contact sports.
Weeks 4–6
Heavier workouts resume as cleared. Scar care continues (silicone + SPF). Eyes feel more “normal” each week.
Months 3–6
Final refinement. Any residual firmness softens. Photos look like the “real” result.
For a broader recovery style, see eyelid surgery (what to expect).
Alternatives & Add-Ons
- Neurotoxin for crow’s feet or a subtle brow lift.
- Energy resurfacing (laser/peel) for fine lines and texture; pairs well with lower-lid fat repositioning.
- Brow lift if forehead descent, not eyelid skin, is the real culprit.
A good consultant sorts out which lever delivers the most natural improvement for you.
Cost & Smart Payment Options
Pricing depends on upper vs. lower vs. combo, whether you need lid-tightening support, anesthesia time, and facility fees.
If heavy upper-lid skin blocks your vision on visual-field testing, a functional repair may qualify for coverage; purely cosmetic changes are self-pay.
If you want to spread payments, compare options and avoid promo-APR traps:
FAQs
Will I still look like me?
Yes, the goal is a rested version of you. We avoid over-removal that hollows or changes your eye shape.
How visible are scars?
Upper scars live in the crease; lower scars hide under lashes or inside the lid. With silicone and SPF, most fade to a fine line.
Can I wear contacts?
Usually after 1–2 weeks, once the surface feels normal and your surgeon clears you.
What if I only hate my under-eye bags?
A transconjunctival lower blepharitis (incision inside the lid) lets us reduce/reposition fat without a skin cut under the lashes, great when skin quality is good.
Ready to take the next step?
Book your consultation and get a personalized plan (upper, lower, or combined) that protects eye health and delivers a natural, long-lasting refresh.Call (562) 275-3843 or Book Your Consultation.
