When Is It Time to Consider Cosmetic Surgery on Your Eyelids?

Blepharoplasty, or eyelid surgery, is hugely popular. Among cosmetic procedures, only liposuction and breast augmentation are more popular. Eyelid reshaping can promote a more youthful appearance, give the eyes a more vibrant appearance, and eliminate puffiness and bags. It can even improve quality of life for patients whose vision is obstructed by drooping or sagging eyelids. It’s no wonder that more than 300,000 blepharoplasty procedures are performed every year in the U.S.

But while there’s no questioning the popularity of cosmetic surgery on the eyelids, how can you know if the procedure is right for you? Before you go under the knife, it’s important to determine whether you would be an ideal candidate. 

What Is an Eyelid Lift? 

First, it’s important to address what we’re talking about when we refer to an eyelid reshaping or blepharoplasty. In its most general terms, an eyelid lift refers to any procedure that tightens and reshapes the eyelid. Often, the surgeon will remove excess skin, fat, and muscle tissue to achieve a more smooth and youthful aesthetic. 

To break it down even more, there’s upper eyelid blepharoplasty and lower eyelid blepharoplasty. 

• An upper eyelid blepharoplasty removes fat and trims excess skin along the upper eyelid. This solution is often recommended to remove excess skin that droops below the eyelid or hangs over the lash. An upper eyelid reshaping often requires surgery if excess loose skin is present. 
• A lower eyelid blepharoplasty is similar, but it focuses on the loose skin directly beneath the eye. A lower eyelid blepharoplasty may be recommended to treat dark circles, bags under the eyes, or wrinkles. While surgery is sometimes required for lower eyelid reshaping, doctors can often achieve the desired effect using laser resurfacing or chemical peels. It all depends on your unique condition, your general health, and the look you’re trying to achieve. 

Other eyelid treatments are also common. In some cases, for example, a ptosis repair surgery may be recommended to lift the upper eyelids as they naturally sag with age. This procedure involves manipulating the eyelid muscles while also trimming excess fat and skin. One advantage of a ptosis repair surgery is that it can often be completed without making an incision on the eyelid. This may not be the right approach for every patient, however. In some cases, ptosis repair and blepharoplasty are done in conjunction with one another. 

Eyelid Surgery vs Brow Lift 

Before deciding on eyelid surgery, it’s important to determine whether your eyelids are truly the problem. Some patients will request cosmetic surgery on their eyelids without realizing that the problem they’re experiencing is eyebrow ptosis. 

Eyebrow ptosis is characterized by a sinking of the forehead skin that results in a partial to full loss of the eyebrow arch. This, in turn, can present the appearance of sagging eyelids even if the eyelid skin remains firm. Eyebrow ptosis is more common in women than in men, but it can occur in anyone—usually as a result of aging. 

If a doctor determines that you have eyebrow ptosis, they might recommend a brow lift or forehead lift in lieu of (or sometimes in addition to) a blepharoplasty treatment. Two types of surgical lifts can be pursued here: an endoscopic lift or a classic lift. The main difference is the incision size. An endoscopic lift requires an incision large enough to accommodate the insertion of an endoscope. 

In either case, a forehead lift can be used to tighten forehead skin, reposition the eyebrows, and (in some cases) improve the appearance of the eyelids. But again, this type of treatment will only work for eyelids if drooping forehead skin is indeed the problem. 

When to Consider Cosmetic Surgery on the Eyelids

An eyelid lift or similar procedure might benefit you if: 

• Your vision is obstructed by sagging eyelids 
• You struggle with the appearance of soft or aging eyelids 
• You’ve tried everything (unsuccessfully) to get rid of dark circles 
• You want your face to appear more youthful
• Your eyebrows are starting to sag and your cosmetic surgeon determines that a blepharoplasty would be more effective than a brow lift 

The typical patient is over 35, but the procedure may be the right choice for anyone who’s looking to achieve a more youthful aesthetic. The important thing is to have realistic expectations for the procedure. Your plastic surgeon will discuss the details of the procedure during your free online consultation and give you an idea of what to expect. 

How to Know if Cosmetic Surgery on the Eyelids Is Right for You 

Blepharoplasty is a minimally invasive outpatient surgery that’s safe and effective. Before your procedure, your plastic surgeon will conduct a basic health assessment to ensure that you’re a good candidate for the procedure. In addition to asking questions about your health history, your cosmetic surgeon will typically conduct a physical exam as well as vision and tear tests. Then they’ll take images of your eyelids so that they can develop a custom plan for your procedure. 

Certain chronic illnesses may negatively affect recovery and therefore preclude you from the eyelid lift treatment. In these cases, non-surgical alternatives may be available to you. 

In addition, smoking can negatively affect your recovery as it disrupts healthy blood flow. If you’re a smoker, it’s advised that you abstain from smoking in the weeks before and after your treatment. The same goes for consuming alcohol. If you take any prescription medications, over-the-counter medications, or herbal preparations, you’ll need to notify your plastic surgeon during the consultation. Your cosmetic surgeon will generally ask you to refrain from taking any medications that can increase your bleeding risk. 

When to Schedule Cosmetic Surgery on the Eyelids 

When scheduling your treatment, the timing is important. Although blepharoplasty has a shorter recovery time than many procedures, you’ll still need to set aside at least a week for rest and recovery in most cases. Your eyes will be swollen for at least the first couple of days, and you may have short-term side effects like blurry vision and light sensitivity. 

It’s generally a good idea to take at least a week off to recover, so plan accordingly. Even if you work from home, you’ll need to reduce screen time while your eyelids are recovering. If you wear contact lenses and don’t have prescription eyeglasses to use as a backup, you might want to take a few extra days off. You won’t be able to wear contacts for at least two weeks after your treatment. 

Try to schedule your treatment at a time when your personal and professional demands are at a minimum. If you teach for a living, the summer is a great time to undergo the procedure. If your industry has a slow season, that may be a great time for your eyelid surgery. If you have two or three weeks in March with no holidays, birthdays, or important social engagements, that might also be a great time. In most cases, you’ll be back to your old self in about a week. But in the rare instance that your recovery takes a bit longer or you experience mild complications, it helps to have a little extra time to recover. 

What to Expect When Undergoing Cosmetic Surgery on the Eyelids 

If you’re considering cosmetic surgery on the eyelids but you’re still not sure if the procedure is right for you, it’s important to understand what to expect. First, you’ll need to have someone drive you to and from the surgical center, so make sure to plan accordingly. 

The procedure itself is relatively quick and straightforward. The plastic surgeon may provide a general anesthetic, though this isn’t always required. Most patients require only a numbing agent that’s injected into the eyelids. 

For an upper eyelid blepharoplasty, the cosmetic surgeon makes a small incision in the eyelid and removes excess skin and muscle. The incision is then closed. In some cases, the plastic surgeon may transfer the extracted skin, muscle, and fat to another part of the eyelid before closing the incision. 

For a lower eyelid blepharoplasty, the plastic surgeon makes a small incision on the inside of the eyelid or the outside beneath the lower lash. The cosmetic surgeon then removes fat (and sometimes a small amount of skin) from inside the eyelid before closing the incision. In some cases, the plastic surgeon might secure the lower eyelid to the skeleton to promote a firmer appearance. 

Depending on your goals, the cosmetic surgeon might perform an upper eyelid blepharoplasty, a lower eyelid blepharoplasty, or both. Once the procedure is done, you’ll be moved to a recovery room and monitored for a short time to ensure that there are no complications. Once you’re given the all-clear to leave, you can return home and begin your recovery the same day. Though the plastic surgeon might send you home with gauze to protect the eyelids, you’re generally not required to keep your eyes covered throughout the entire recovery. Your cosmetic surgeon will give you aftercare instructions to follow. 

In the days following your procedure, you might notice certain common side effects like eye soreness, blurry vision, dry eyes, itchiness, and difficulty closing your eyes. Your plastic surgeon may recommend or prescribe medications to help keep these symptoms to a minimum. 

Paying for Cosmetic Surgery on the Eyelids

Because cosmetic surgery on the eyelids is an elective procedure, it is typically not covered by medical insurance. However, your eyelid surgery may be covered if you’re seeking to address a problem with obstructed vision. 

FAQ

Are There Any Alternatives to Cosmetic Surgery on the Eyelids? 

Non-cosmetic procedures include Botox, dermal fillers, platelet-rich plasma, and laser therapy. While not everyone is a candidate for these treatments, they may be ideal in certain cases for smoothing out mild to moderate sagging. Whereas the effects of cosmetic surgery on the eyelids are usually permanent or semi-permanent, non-surgical treatments usually require an occasional refresh. 

How Long Do the Effects of Blepharoplasty Last? 

The eyes will continue to age naturally, but in most cases, the effects of an upper eyelid blepharoplasty should last at least 5 to 7 years. The effects of lower eyelid surgery are generally permanent. If your effects start to wear off after a few years, your plastic surgeon may recommend a forehead lift. 

How Long Do Side Effects of Blepharoplasty Last? 

While you might experience general discomfort for a few days, you should only experience blurry vision or light sensitivity for a couple of days. If these side effects persist, contact your cosmetic surgeon right away.