You’re not alone if you’re struggling with tired-looking eyes due to drooping skin and puffiness. The area around the eyes is often the first area to age, but Upper and Lower Blepharoplasty can help boost your appearance. In this guide, we will help you with everything you need to know with the procedures, the best candidate, recovery, and how to choose the best surgeon to achieve a brighter, confident eye.  

Key takeaways:  

• Blepharoplasty, or upper and lower, involves the correction of sagging skin on the upper eyelids, bags under the eyes and excess skin on the lower eyelids.  

• Upper eyelid blepharoplasty surgery can also help with sagging skin that blocks the upper visual field aiding in correction.  

• The effects are durable, recovery is quite easy, scars are often out of sight and concealed.   

What is Upper and Lower Blepharoplasty?  

Upper and lower blepharoplasty is the name of a pair of eyelid procedures that aim to enhance the appearance of the eye area. The upper procedure removes excess skin and muscle and fat that is associated with hooding. The lower procedure smooths puffy bags under the eyes and can soften deep hollows. In combination, Upper and Lower Blepharoplasty creates a natural, rested open-eyed and rejuvenated appearance.

• Upper eyelids: With “Upper eyelid blepharoplasty surgery,” makeup smudging is caused by redundant skin, lax muscles, and fat pockets that form a “heavier” eyelid.

• Lower eyelids: In addition to the under-eye fat pads, ‘crepey’ skin and shadows contribute to a fatigued appearance, so these are also targeted in lower eyelid surgery.

These procedures, when done together, improve the harmony and the balance between youthful and surgical appearance of the upper and lower lids.

Who Is a Good Candidate?

If you have the following conditions, you may be eligible for Upper and Lower Blepharoplasty:  

• Skin that hangs limply over the lash line

• Sustained under-eye bags that are perpetually present

• Laxity and fine lines around the lids

• Concealing or enhancing the eyes with make-up is extremely difficult due to excessive skin

• Obstruction of the visual field due to hanging skin

Ideal candidates for these procedures are healthy, non-smokers, and possess optimistic, yet, realistic expectations. Stable vision is also a must. In some cases, an examination of the eyes may be necessary in order to evaluate the level of tear production and verify the presence of dry eyes. Upper eyelid blepharoplasty surgery is known to enhance vision by correcting droopy eyelids for some patients. This can be evaluated with a visual field test.

How the Procedures Work  

Upper Eyelid Approach  

In blepharoplasty, upper eyelid cutting cosmetically enhances the eyelid by the incision placed around the crease from the adjoining skin. This gives the surgeon access for skin and muscle trimming, and fat adjusting using minimally invasive methods. The crease incision guarantees a hidden scar and the eyelid cosmetic surgery blepharoplasty scar is hardly visible after healing. Upper eyelid blepharoplasty surgeries are done within an hour and can be done using local anesthesia with sedation, or general anesthesia.  

Lower Eyelid Approach  

With regards to lower eyelid surgery, two methods are the most used:  

• Transconjunctival - This is the incision on the eyelid that is best for fat pad removal or repositioning as it leaves no external scars.  

• Subciliary - This cuts through the skin just below the eyelash and allows fat repositioning and skin tightening for crepe-like skin.  

Surgeons can correct the sunken look by adjusting placement of fat and skin tightening. The skin tightening can be done alone or with laser or chemical peel.  

Benefits You Can See (and Feel)  

• Eyes perceivably brighter and more open: This is an effect of upper and lower blepharoplasty that reduces the hooding and puffiness placed around the eye and enhances the gaze.  

• Natural contour: The smooth lid-cheek contour is preserved with slight fat repositioning. Modern methods prioritize a subtle approach.

• Functional Improvement: Having upper skin excess can obstruct vision; upper eyelid blepharoplasty can enhance the visual field and improve cosmetically the skin excess.

• Long-lasting results: In the majority of patients, results can be enjoyed for 8-10 years or even longer than this, depending on genetics, skin quality, and lifestyle.

Recovery Timeline and discomfort advice

Most patients are able to resume their regular, non-strenuous routine, utilized within a week. Below is a typical framework:

1. Days 1-3: Expect ankle and mild swelling, Use cold compresses and head elevation. Prescribed eye drops or eye ointments provide comfort.

2. Days 4-7: Bruising improves, and with stitches that were used, they are typically removed on 5-7 days. and many patients feel comfortable around day 5-7.

3. Weeks 2-3: Remaining swelling goes away. Light exercises are allowed to be performed with the approval of their surgeon.

4. Weeks 4-6: Significant reduction in swelling. Most of the results are natural and refined.

Comfort advice:

• Discontinue wearing contact lenses and see fully healed.

• Refrain from engaging in structurally intense work for a week.

• Sleep on your back with your head elevated for the first few days.

• Protect the area from sun with eyewear and sun protection.

Safety, Risks, and How Surgeons Manage Them

Upper and lower blepharoplasty is a common procedure and considered safe if performed by a board-certified plastic surgeon or oculoplastic surgeon. As with any surgery, there are potential risks, including bruising, dry eyes, temporary blurred vision, asymmetry, and, on rare occasions, bleeding or infection. These risks are minimized through proper surgery, conservative tissue removal, and careful postoperative care. Persons with dry eye, thyroid eye disease, or uncontrolled hypertension will have their risks managed with a modified plan or alternative therapies.  

Will It Look Natural?  

A natural result is what all patients desire and what all skilled surgeons work towards. Well-trained surgeons preserve the patient’s brow position and eyelid crease height. For instance, in blepharoplasty upper eyelid surgery, excess skin removal can result in eye closure issues. To obviate this, many skilled surgeons only perform skin pinch measurements with muscle and fat sculpting to balance skin removal. During lower eyelid surgery, conservatively repositioning fat can prevent the hollowness while preserving the softness, which ages the appearance.  

How Upper and Lower Blepharoplasty Compare to Other Non-Surgical Options  

Dermal fillers can improve the appearance of under-eye hollows, but they do not eliminate excess skin and large fat pads. The effects of fillers last for 6 to 18 months.

• Energy devices and lasers: Treat fine lines and mild crepiness but do not address significant bulging or padding beneath the eyes.  

• Neurotoxins: Treat dynamic lines such as crow’s feet however do not address lax, excess skin.  

For structural concerns, Upper and Lower Blepharoplasty remains the most effective, durable option. A number of patients opt to combine the procedure with some lasers or light chemical peels to improve skin texture.  

Cost Factors and Value  

Cost will always differ depending on the expertise of the surgeon, the blepharoplasty technique used, over or under the eyes, facility and anesthesia fees, and if both lids will be operated on. While most cosmetic procedures fall under the expense of not being covered by insurance, upper eyelid blepharoplasty surgery has the potential to be reimbursed if there is documented skin redundancy. With eyes and vision as the central focus of human anatomy, do not forget long term value as results tend to last for many years.  

Choosing the Right Surgeon  

The surgeon you choose will greatly influence your results. With that in mind, make sure to check for the following:  

• Proven and active plastic or ophthalmology with oculoplastic fellowship and board certifications;  

• Substantial before and after photo set for Upper and Lower Blepharoplasty;

• Competence in both transconjunctival and subciliary lower techniques; and  

• Transparency on risks, benefits, and recovery;  

• A conservative, bespoke approach instead of standardized.  

In consultation, inquire about the approach to be taken for the fat pads, excess skin, and lid cheek junction. Suggest displaying the results with patients who share the same anatomy as the patients in question.

What Results Can You Expect?

With both Upper and Lower Blepharoplasty, you’ll have a more rested appearance, and the eyes look less puffy. You may also have a better range of vision if the upper skin was obstructing your sight previously. Results are most noticeable after a few years, and the eyes look more soft and open as makeup application improves. Scars are not visibly seen as they are concealed in the upper lid crease as well as below the lower lash line and inside the eyelid. Eyelid surgery results, when accompanied with appropriate skin care, sun protection, and healthy living, are long-lasting.  

Your Next Move

To discuss Upper and Lower Blepharoplasty, book a consultation if you are ready to bring out a younger look in your eyes with lasting and natural results. A qualified surgeon will check your anatomy, discuss options with you such as blepharoplasty upper eyelid surgery and lower eyelid blepharoplasty, and create a plan tailored to your dreams. Don’t wait too long to look brighter, you can begin your journey today and find out how confidently you can have your eye area transformed with upper eyelid blepharoplasty and precise lower eyelid approaches.