Blepharoplasty is a surgical procedure to remove excess skin and muscle from both the upper and lower eyelids along with underlying fatty tissue. A blepharoplasty can improve dropping skin and bagginess. It can help improve vision in older patients who have hooding of their upper eyelids. Although it can add an upper eyelid crease the Asian eyelid, it will not erase evidence of the one’s racial or ethnic heritage. Blepharoplasty will not remove “crow’s feet” or other wrinkles, eliminate dark circles under the eyes, or lift sagging eyebrows.

Upper lid blepharoplasty is done through an incision in the upper eyelid crease. This scar heals nicely and is very difficult to see after it has healed. Ptosis, or droopy eyelid, correction can also be done through this same incision simultaneously. Usually, excess skin and a small amount of muscle are removed. In some cases, excess fat may be removed as well. Lower lid blepharoplasty is done through either an incision through the skin just below the eyelashes (subciliary incision) or through an incision on the inside of the eyelid (transconjunctival incision). The subciliary incision typically heals with a nearly invisible scar, while the transconjunctival scar is not visible. The choice of incision depends upon the particular problems being addressed: excess skin, excess fat, sagging or laxity of the muscle layer, or other issues. In addition, some patients may benefit from fat or filler injections to efface or soften grooves and deep lines around the lower eyelids. Some patients may also benefit from a midface lift, since sagging of the midface, or cheek soft tissues, can create a separation between the lower eyelid and cheek. A midface lift together with lower lid blepharoplasty can help to restore the youthful, smooth transition between the lower lid and the cheek.

Blepharoplasty surgery is customized for every patient, depending on his or her particular needs. It can be performed alone involving upper, lower, or both eyelid regions, or in conjuction with other surgical procedures of the eye, face, brow, or nose. Eyelid surgery cannot stop the process of aging. It can however, diminish the look of loose skin and bagginess in the eyelid region.

Alternative Treatments

Alternative forms of management consist of not treating the skin laxness and bagginess in the eyelids by surgery. Improvement of skin laxness, fatty deposits and skin wrinkles may be accomplished by other treatments or surgery such as a brow lift when indicated. Other forms of eyelid surgery may be needed should you have disorders affecting the function of the eyelid such as drooping eyelids from muscle problems (eyelid ptosis) or looseness between the eyelid and eyeball (ectropion). Minor skin wrinkling may be improved through chemical skin-peels or other skin treatments. Risks and potential complications are associated with alternative forms of treatment.


Health Insurance

If hooding of the upper eyelids interfere with your vision, your health insurance company may cover blepharoplasty surgery for the upper-eyelids only. Most health insurance companies exclude coverage for cosmetic surgical operations such as the lower-eyelid blepharoplasty or any complications that might occur from surgery. Please carefully review your health insurance subscriber-information pamphlet.

Additional Surgery

There are many variable conditions in addition to risk and potential surgical complications that may influence the long term result of eyelid surgery. Even though risks and complications occur infrequently, the risks cited are the ones that are particularly associated with blepharoplsty surgery. Other complications and risks can occur but are even more uncommon. Should complications occur, additional surgery or other treatments may be necessary. The practice of medicine and surgery is not an exact science. Although good results are expected, there is no guarantee or warranty expressed or implied, on the results that may be obtained.