Blepharoplasty (Upper Blepharoplasty)

Upper blepharoplasty or aesthetic eyelid surgery is performed on adults of all ages. Some people have upper  blepharoplasty (blepharoplasty) to correct problems that are a result of aging, while others have inherited traits that cause them to seek treatment as early as their 20s or 30s.

Upper blepharoplasty is one of the most frequent surgeries performed by plastic surgeons.  It is also one of the first cosmetic surgical procedures people get.  "Tired and aged" eyes are one of the earliest stigmatas of aging. 

Am I a good candidate for blepharoplasty upper blepharoplasty surgery?

Any one or combination of the following conditions may indicate that you are a good candidate for upper  blepharoplasty surgery:

•  excess skin obscuring the natural fold of the upper eyelids

•  loose skin hanging down from the upper eyelids, perhaps impairing vision

•  a puffy appearance to the upper eyelids, making the eyes look tired

•  excess skin and fine, crepey wrinkles of the lower eyelids

•  bags and dark circles under the eyes, often with a depression along the bony border of the lower eyelids

•  droopiness of the lower eyelids, showing white below the iris
  (colored portion of the eye)

Aesthetic upper  blepharoplasty surgery can usually correct these problems, though other treatments may also need to be considered. For example, if the upper eyelid condition is accompanied by sagging of the eyebrows, then a forehead lift may be recommended. Smoothing of crow's feet may require chemical peeling or laser resurfacing procedures. Circles beneath the eyes caused by dark pigmentation may be treated with a bleaching solution or chemical peel. Your plastic surgeon can provide further upper  blepharoplasty information if you have an interest in any of these additional procedures.

Your Personal Upper Blepharoplasty Consultation

During the initial upper  blepharoplasty consultation, you may be asked to look in a mirror and point out exactly what you would like to see improved. This will help your plastic surgeon to understand your expectations and determine whether they can realistically be achieved.

How will my plastic surgeon evaluate me for aesthetic upper blepharoplasty surgery?

You should come to the upper  blepharoplasty consultation prepared to discuss you medical history including previous surgeries, past and present medical conditions and current medications. It is important for you to provide complete information. High blood pressure, thyroid problems or diabetes are among the medical conditions that may increase the risks associated with upper  blepharoplasty surgery.

Your plastic surgeon will want to know if you have allergies, especially if they affect your eyes. He or she may ask whether you have ever tried and were unable to wear contact lenses, you should bring them with you in case your surgeon wants to test your vision.

It will be necessary for your upper  blepharoplasty surgeon to know if you were ever told by an ophthalmologist that you have a condition called "dry eye" or if you have any other problems with your eyes.

One of several surgical techniques may be suggested to improve the appearance of your eyelids. The particular technique that your upper  blepharoplasty plastic surgeon recommends will depend on may factors such as the amount of excess fat and skin in the eyelid areas, the position of your eyebrows, and the condition of muscles around your eyelids.

How Aesthetic Upper Blepharoplasty Surgery is Performed

Because of individual factors, not everyone will achieve the same results from upper  blepharoplasty surgery. Your plastic surgeon will select the surgical technique that he or she feels will obtain the best outcome for you.

How is my upper blepharoplasty plastic surgeon able to improve the appearance of my upper eyelids?

For upper eyelid surgery, generally an incision is hidden within the natural fold of the upper eyelid and extends slightly beyond the outside corner into the laugh lines or other existing creases. Through this incision, excess skin and fatty tissue are removed. Because the incision follows the natural contour of the upper eyelid, it will be well camouflaged when healed.

What is done to improve the appearance of my lower eyelids?

For lower eyelid surgery, often an incision is hidden just below the lower lashes. Through this incision, excess skin, muscle and fat are removed, or fat may be redistributed to eliminate puffiness or bulges. Other adjustments to correct special problems such as muscle laxity may be performed. As in upper eyelid surgery, the incision is well camouflaged by natural creases.

In some cases, you and your upper  blepharoplasty surgeon may decide that the best approach for removing excess fat is through an incision placed inside the lower eyelid. This technique requires no external incision, but it cannot be used to remove excess skin. A laser may sometimes be used in conjunction with this method to tighten the lower eyelid skin.

Understanding Risks

Fortunately, significant complications from aesthetic upper  blepharoplasty surgery are infrequent. Every year, many thousands of people undergo successful upper  blepharoplasty surgery, experience no major problems and are pleased with the results.

I understand that every upper blepharoplasty surgical procedure has risks, but how will I learn more so that I can make an informed decision?

The subject of risks and potential complications of upper  blepharoplasty surgery is best discussed on a personal basis between you and your surgeon, or with a staff member in your surgeon's office.

Some of the potential complications that may be discussed with you include hematoma (an accumulation of blood under the skin that may require removal), infection and reactions to anesthesia. Following the upper  blepharoplasty surgery, there can be a feeling of dryness or irritation in the eye that requires treatment. There is a possibility of a temporary decrease in sensation of the eyelid skin or impaired eyelid function that sometimes may need to be corrected by additional surgery.

You can help minimize certain risks by following the advice and instructions of your upper  blepharoplasty plastic surgeon, both before and after your eyelid surgery.

Your Upper Blepharoplasty Surgical Experience

The goal of your upper  blepharoplasty plastic surgeon and the entire staff is to make your surgical experience as easy and comfortable for you as possible.

How should I prepare for upper blepharoplasty surgery?

If you are a smoker, you will be asked to stop smoking well in advance of upper  blepharoplasty surgery. Aspirin and certain anti-inflammatory drugs can cause increased bleeding, so you should avoid taking these medications for a period of time before surgery. Your upper  blepharoplasty surgeon will provide you with additional preoperative instructions.

Aesthetic upper  blepharoplasty surgery is usually performed on an outpatient basis. If this is the case, be sure to arrange for someone to drive you home after surgery and to stay with you at least the first night following surgery.

What will the day of upper blepharoplasty surgery be like?

Your upper  blepharoplasty surgery may be performed in a hospital, free-standing ambulatory facility or office-based surgical suite.

Medications are administered for your comfort during the surgical procedure. Frequently, local anesthesia and intravenous sedation are used for patients undergoing upper  blepharoplasty surgery, although general anesthesia may be desirable in some instances. For your safety during the operation, various monitors are used to check your heart, blood pressure, pulse and the amount of oxygen circulating in your blood.

When upper  blepharoplasty surgery is completed, you will be taken into a recovery area where you will continue to be closely monitored. Your vision will be blurry as a result of ointment used to soothe and protect the eye during surgery as well as from the swelling that is a normal aftermath of eyelid procedures. There is surprisingly little discomfort, however, from the upper  blepharoplasty surgery.

You probably will be permitted to go home after a few hours, although some patients may stay overnight in the hospital or surgical facility.

How will I look and feel initially?

It is important to realize that the amount of time it takes for recovery varies greatly among individuals.

The first evening after upper  blepharoplasty surgery, you should rest quietly with your head elevated. Your upper  blepharoplasty surgeon may instruct you to apply cold compresses to your eyelids. Remember, you must not take aspirin or certain anti-inflammatory medications.

Initially, you may feel a "tight" sensation around the eyes and some mild discomfort that can be controlled with oral medication. During the first 48 hours following surgery, upper  blepharoplasty patients experience varying degrees of swelling and bruising. Some patients find that mild swelling persist for several weeks, while others may see swelling resolve in as little as one week. Bruising typically disappears within seven to ten days. Within the first week you will be permitted to use makeup, if desired, to conceal any discoloration. Stitches are usually removed within a week of surgery.

Your vision may continue to be somewhat blurry for a few days or longer. Your eyes may be temporarily sensitive to light, and you may experience excess tearing or dryness. Some upper  blepharoplasty plastic surgeons recommend eye drops to help relieve any burning or itching. You may want to wear dark sunglasses for a couple of weeks to protect your eyes from wind and sun irritation.

When can I resume my normal activities?

Straining, bending and lifting should be avoided during the early postoperative period. In many instances, you will be able to resume most of your normal activities within ten days or less. Although you might feel like going back to work just a few days after surgery, your vision may still be slightly blurry which could make reading or other paperwork more difficult. You should not wear contact lenses for a week or two.

Results of Your Upper Blepharoplasty Surgery

Aesthetic upper  blepharoplasty surgery has the effect of making you look more rested, refreshed and alert. Since the healing process is gradual, you should expect to wait at least several weeks to get an accurate picture of the results of your eyelid surgery. Incisions will fade over a number of months until they become barely visible.

How long will the results of upper blepharoplasty last?

The results of aesthetic upper  blepharoplasty surgery are long-lasting, but they may be affected by your heredity and lifestyle factors.

Removal of fat from your eyelids, which is usually the cause of puffiness and bags, is permanent, and these conditions generally will not recur. The skin continues to age, however, and skin laxity along the fine wrinkling of the eyelid area may, at some point, return. Sometimes loss of tone in the forehead causes additional sagging of the eyebrows which mimics a recurrence of drooping upper eyelids. if this happens, correction may require a forehead lift or a secondary eyelid procedure.

Even though the aging process continues, patients are usually happy with their appearance for many years following upper  blepharoplasty surgery. Some patients find that they want to make additional improvements at a later time.

Maintaining a Relationship with Your Upper Blepharoplasty Plastic Surgeon

You will return to your plastic surgeon's office for follow-up care at prescribed intervals, at which time your progress will be evaluated. Your upper  blepharoplasty surgeon will encourage you to schedule routine follow-up evaluations at the frequency recommended for your age group and the procedure performed.

Please remember that the relationship with your upper  blepharoplasty plastic surgeon does not end when you leave the operating room. If you have questions or concerns during your recovery, or need additional information at a later time, you should contact your upper  blepharoplasty surgeon.

What do our upper blepharoplasty patients say?
"I love my new eyes!  What was I waiting for?" - FS, Park Ridge
"Wasn't there supposed to be any bruising?  I would recommend this to anyone!" - LL, Niles
"I thought I would have to hide out for a month - boy was I wrong!" - WD, Evanston
"I feel and look great!" - HS, Palatine

Upper Blepharoplasty Patient Pictures & Photos

48 year old male patient before and 2 years after bilateral upper  blepharoplasty with lower blepharoplasty.  Notice the maintained natural result.  There was no fat removed explaining why there is no "hollowing" of the eyes.

33 year old female patient before and 3 months after bilateral upper blepharoplasty.  Notice the nice natural improvement of her upper eyes.  Again, no fat was removed which avoids the skeletonized and hollowed-out look frequently seen after this procedure (most patients think that looks worse than the aging skin they had before surgery).  She did not want anything done to her lower eyes at this time.

33 year old female patient before and 3 months after bilateral upper blepharoplasty.  Notice the recaptured youthful appearance.

33 year old female patient before and 3 months after bilateral upper blepharoplasty.  She had no other procedures.

68 year old male patient before and 1 year after bilateral upper and lower blepharoplasty.  Notice the rejuvenated appearance.  There was no fat removed.  The patient had no other facial procedures.

68 year old male patient before and 1 year after bilateral upper and lower blepharoplasty.  Notice the nice improvement of his lower eyelid excess skin and crow's feet.

68 year old male patient before and 1 year after bilateral upper and lower blepharoplasty.  Notice the smoother lower eyelid skin. 

83 year old female patient before and 1 year after bilateral upper  blepharoplasty with lower blepharoplasty.  Notice the rejuvenated appearance without any other procedures at all.  There was no fat removed.

83 year old female patient before and 1 year after bilateral upper  blepharoplasty with lower blepharoplasty.  Notice the smoother lower eyelids achieved with this simple 30 minute procedure.

55 year old female patient before, 3 days postop and 6 weeks postop after bilateral upper and lower blepharoplasty.  Notice the minimal bruising and swelling at 3 days after surgery.  The patient will undergo a forehead lift at some point in the future but was not concerned about her forehead and her eyebrow asymmetry at this time.  The newer techniques for eyelid rejuvenation do not get rid of the periorbital fat because a common complaint after removing it is a skeletonized look - especially in the upper eyelids.  This problem is seen more frequently in thin patients such as this one.  The goal is to look natural and reshaping and repositioning accomplishes this.

62 year old male patient before and 1 year after bilateral upper  blepharoplasty with lower blepharoplasty and midface lift.  Notice the correction of his tear trough deformity.  There was no fat removed.  The patient had no other procedures.

The Scars:

Anytime a human being gets cut (with surgery or trauma), scars heal the following way:  Initially they are red, raised and hard.  Within 6-12 months, they are flat, white and soft.  Younger people (<18 years old) have scars that might stay active or red for up to 2 years.  Older people (>65 years old) have scars that might stay active or red for less than 3 months. 

44 year old male patient before and 6 weeks after bilateral upper  blepharoplasty with lower blepharoplasty.  The scars are healing wonderfully.

39 year old female patient before and 1 year after bilateral upper  blepharoplasty with lower blepharoplasty.  Notice the maintained rejuvenation.  There was no fat removed.  Notice she does not have a skeletonized look - which she would have been especially prone to given her anatomy.  She has had no midface or facelifting procedures and no fat injection.  Her nasojugal groove (trough under the eyes) correction is excellent.

53 year old female patient before and 3 months after bilateral upper and lower blepharoplasty.  Notice the nice improvement of her periorbital area.  No fat was removed.  There were no other procedures done.

53 year old female patient before and 3 months after bilateral upper and lower blepharoplasty.  Notice the eyelid rejuvenation achieved without a forehead lift.

53 year old female patient before and 3 months after bilateral upper and lower blepharoplasty.  Notice the terrific improvement of her nasojugal groove - especially considering she did not have a midface lift done!

56 year old female patient before and 6 weeks after a redo facelift, midface lift and upper  blepharoplasty and lower blepharoplasty.  Her eyes have been nicely rejuvenated.  No skin care program, Botox, peels or laser have been done.  To me, this is a below-average result. There is some minimal left upper eyelid skin that can be excised, but the patient is happy and does not want a revision.

45 year old female patient before and 6 weeks after bilateral upper blepharoplasty.  Notice the nice natural improvement of her upper eyes.  She wanted to retain her ethnic features and did not want to achieve a Westernized eyelid.  She did not want anything done to her lower eyes at this time.

45 year old female patient before and 6 weeks after bilateral upper blepharoplasty.  Notice the retained fullness and youthfulness of her upper eyes.  No fat was removed which avoids the skeletonized and hollowed-out look frequently seen after a standard upper blepharoplasty procedure.  Most patients think that a skeletonized look does not appear aesthetically pleasing.  They also think it looks worse than the aging skin they had before a surgical intervention. 

48 year old female patient before and 6 weeks after bilateral upper  blepharoplasty with lower blepharoplasty and midface lift.  Notice the correction of her tear trough deformity and nasolabial folds.  There was no fat removed.  The patient had no other procedures.

48 year old female patient before and 6 weeks after bilateral upper  blepharoplasty with lower blepharoplasty and midface lift.  Notice the smoothness under her eyes in this close-up.  She still has some edema of her lower eyelids above her scar and her scar is still hyperemic (red).  Patients are not usually as swollen and red as she is at this point.  However, she can still easily conceal this with make-up.

48 year old Asian female patient before and 3 months after a short scar facelift, midface lift with lower blepharoplasty.  Notice there was nothing done to her upper eyelids because she did not want anything done at this time.

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