Upper and lower blepharoplasty (eyelid surgery)

With age, the skin of the upper lids can droop and hood over the eyes, and fat can bulge under the lower lids, giving a tired or older look. Blepharoplasty removes or repositions that extra skin and fat. In some people, heavy upper lids also narrow the field of vision, and the surgery can help.

Upper blepharoplasty trims excess skin, and sometimes a little fat, through an incision hidden in the natural crease of the upper lid. Lower blepharoplasty treats under-eye bags and loose skin, with the incision either inside the lower lid, which leaves no visible scar, or just below the lashes.

Your surgeon checks which parts of the eye area need treatment and may recommend doing both at the same time.

Expect swelling, bruising, tightness and dry or irritated eyes at first. Cold compresses, lubricating drops and keeping your head raised help. Avoid rubbing your eyes, strenuous activity, and contact lenses for a while if your surgeon advises. Stitches are usually taken out within about a week.

Most bruising fades in one to two weeks, and fine swelling can take longer to settle.

Risks include dry or irritated eyes, bruising, asymmetry, a visible scar, difficulty closing the eyes fully for a short time, infection, a lower lid that rounds or pulls down, and, rarely, problems with vision. Tell us about any eye conditions, dry eyes, thyroid problems and the medicines you use. Results differ from person to person, and any procedure can need a touch-up or revision.

Do I need upper lids, lower lids, or both? Where will the incisions and scars be? How long will my eyes feel dry? When can I wear makeup and contact lenses again?