Blepharoplasty (Eyelid Surgery)

Blepharoplasty is the general term for aesthetic eyelid surgery. The upper eyelids (upper blepharoplasty) and lower eyelids (lower blepharoplasty) can be safely addressed separately or together.

As we age, the skin of the upper eyelid can become loose which obscures the lid crease, makes it difficult to apply makeup, and, more importantly, detracts from the youth and beauty of the eyes. In rare instances, this skin can affect certain parts of a patient’s upper visual field. Upper blepharoplasty aims to remove excess skin in a tasteful, subtle way. If performed well, the incision hides in the native crease and the eyes look refreshed without appearing “operated on.” Certain patients also benefit from tightening of the underlying muscle that elevates the eye. This procedure is referred to as a “ptosis repair.” Ptosis repair is not a standard maneuver for most surgeons who perform upper blepharoplasty. If one eye or both eyes droop, a discussion with your surgeon regarding the need for ptosis repair should be had prior to undergoing an upper blepharoplasty.

Lower blepharoplasty aims to address the three fat pads of the lower orbit that can become more apparent as we age. A combination of loss of subcutaneous fat, decent and retraction of midface strunctures, and hypertrophy or growth of the orbital fat can lead to the appearance of “bags” of the lower eyelid. These bags can cast shadows on the face and often leave a patient looking tired even after a great night of sleep. Lower blepharoplasty aims to reduce or reposition these fat pads and then address excess skin, muscle, and lid position as needed. Autologous fat transfer (fat grafting) to the midface can be a nice adjunct to a lower eyelid blepharoplasty in the correct patient. There are many ways to perform this operation and they all have their benefits and risks. A thoughtful discussion should be had with your surgeon prior to undergoing lower blepharoplasty.