What can it address?
Extra upper-eyelid skin and some lower-eyelid bags or loose skin.
It does not reliably correct dark circles, crow’s-feet, or drooping eyebrows.
Aesthetic surgery • Eyes and eyelids
Blepharoplasty (Upper / Lower)
Blepharoplasty is surgery that removes or repositions eyelid skin and fat, and sometimes adjusts muscle, to address upper-eyelid folds or lower-eyelid bags.
Can upper and lower lids be treated together?
Sometimes, if your examination supports it.
The plan depends on eye health, eyelid strength, anatomy, and the extent of surgery.
How much downtime should I plan for?
Often about 10 to 14 days before feeling comfortable in public.
Bruising and swelling vary, and returning to work does not mean healing is complete.
01 · Overview
Understanding upper and lower eyelid surgery
Upper blepharoplasty addresses excess skin that can hang over the eyelid crease. Selected amounts of fat may also be adjusted. If skin interferes with vision, an eye examination and visual-field testing may help document the problem. [1]
Lower blepharoplasty addresses bags and, when appropriate, loose skin beneath the eyes. Fat may be removed or repositioned. The approach depends partly on skin quality and how firmly the lower eyelid sits against the eye. [2]
Blepharoplasty is not the same as a brow lift or ptosis repair. A brow lift raises the eyebrow; ptosis repair addresses a drooping eyelid margin by treating its lifting mechanism. These problems may occur together and require different treatment plans. [1]
- Treatment area
- Upper eyelids, lower eyelids, or both
- Typical setting
- Usually outpatient surgery
- Anesthesia
- Local anesthesia with or without sedation, or general anesthesia
- Incisions
- Usually in the upper-lid crease, beneath lower lashes, or inside the lower lid
Why does eye health matter?
Dry eyes, thyroid eye disease, previous eye surgery, and trouble closing the eyelids can affect safety and planning. Your surgeon may recommend an eye specialist’s assessment before surgery.
Will surgery remove dark circles?
Not necessarily. Shadows from bags may improve, but pigmentation, visible blood vessels, and thin skin can remain. Ask which part of your concern is likely to respond to eyelid surgery.
02 · Concerns & Goals
What brings people to a consultation
You may notice heavier upper lids, puffiness beneath your eyes, or a change in how rested you look. What matters is how these changes affect you and what you would like to discuss.
Heavy upper-eyelid folds
Extra skin can make the lids feel heavy or cover the natural crease. The surgeon will distinguish this from a low eyebrow or a drooping eyelid margin.
Under-eye bags
Prominent fat can create puffiness beneath the eyes. Surgery may address these bags, but swelling from allergies or other medical conditions needs separate evaluation.
Loose lower-eyelid skin
Fine folds and skin laxity may be part of the concern. Removing too much skin can affect eyelid position, so treatment needs to preserve support.
Blocked upper vision
Some upper-eyelid folds interfere with the visual field. An examination can help determine whether excess skin, eyelid drooping, or another eye condition is responsible.
03 · Options
How the approaches differ
These are common approaches to discuss, not interchangeable choices. A consultation determines which approach, if any, fits your anatomy and eye health.
Upper blepharoplasty
Addresses excess upper-eyelid skin.
How it worksAn incision in the natural crease allows measured removal of skin and selected adjustment of fat or muscle.
May suitMay suit people with upper-lid folds when eyebrow position and eyelid lifting function have been assessed.
Main tradeoffIt does not independently correct a low brow or true eyelid ptosis; excessive removal can impair eye closure.
Lower blepharoplasty through an internal incision
Addresses lower-eyelid fat without an external skin incision.
How it worksA transconjunctival incision inside the lower eyelid allows fat removal or repositioning.
May suitMay suit people whose main concern is bags rather than substantial excess skin.
Main tradeoffThe internal approach alone does not remove loose external skin, and it still carries eye and eyelid risks.
Lower blepharoplasty through an external incision
Allows treatment of loose skin as well as underlying fat.
How it worksAn incision just beneath the lower lashes gives access for conservative skin removal and fat adjustment.
May suitMay suit people with both bags and excess lower-eyelid skin.
Main tradeoffA skin incision leaves a scar, and lower-lid pulling or turning outward is a concern. Added support may be needed.
Combined upper and lower blepharoplasty
Treats both eyelid areas during one operation.
How it worksThe surgeon combines upper- and lower-lid techniques based on each area’s needs.
May suitMay suit people with concerns in both areas who are medically appropriate for the combined procedure.
Main tradeoffA larger treatment area can mean more swelling, a longer operation, and more involved recovery.
Fat removal, fat repositioning, and additional eyelid support are individualized decisions. Preserving comfortable eye closure and stable eyelid position is central to planning. [1] [2].
Why might the surgeon recommend lower-lid support?
A loose lower eyelid may need a support procedure, such as canthopexy or canthoplasty, to help maintain its position. Ask why it is recommended and how it changes risks and recovery.
Can I choose to treat only one area?
Yes, that can be discussed. Upper and lower surgery do not have to be combined. Your surgeon can explain whether treating one area meets your goals or whether another concern would remain.
04 · Results
What may improve and what may remain
Changes you may notice
The goal is a less heavy or puffy eyelid contour, not a different face.
- Upper surgery may reveal more of the eyelid crease.
- Lower surgery may reduce bags or soften the transition to the cheek.
- Vision may improve when excess upper skin was the cause of obstruction.
What may remain
Eyelid surgery does not address every change around the eyes.
- Pigmentation, fine lines, and crow’s-feet may remain.
- Natural differences between the two sides may persist.
- Brow position and eyelid lifting problems may need separate treatment.
How results develop
Early swelling can hide the eventual contour.
- Bruising and swelling usually improve gradually.
- Scars and residual swelling can take months to settle.
- Changes can be long-lasting, but aging continues and further treatment may sometimes be considered.
Results vary with anatomy, eye health, healing, and the procedure performed. Some people need additional treatment for persistent concerns or complications. [1]
05 · Recovery
Planning your recovery
Recovery at a glance
- Stay after surgery
- Usually same day
- Initial recovery at home
- Varies by Individual
- Return to desk work
- Depends on procedure and job demands
- Light daily activities
- Based on Individual Recovery
- Strenuous exercise
- Confirm specific activity with surgeon
Returning to work does not mean fully healed. Follow your surgeon’s instructions; strenuous activity requires clearance.
Sources and planning notes
Research-based planning estimates; follow your surgeon’s guidance
- Stay after surgery source — Blepharoplasty is an outpatient procedure. That means you can go home the same day.
- Return to desk work source — Most people take about 2 weeks off work to recover from eyelid surgery, depending on their job.
- Strenuous exercise source — When can I resume normal activity and exercise?
Your recovery plan should reflect the eyelids treated, the surgical approach, and your eye health. Follow your surgical team’s instructions rather than a general timeline.
Step 1 · Day of surgery
Treatment day
You will be monitored before discharge. Ointment and swelling may blur vision temporarily. Arrange transportation and any adult assistance required by your team.
Step 2 · First several days
Early healing
Swelling, bruising, irritation, and light sensitivity are common. Use only the eye medicines and wound care your team recommends. Ask your surgical team whether compresses are appropriate and exactly how to use them.
Step 3 · Often within 1 to 2 weeks
Follow-up and everyday routines
Your team checks healing and removes stitches if needed. Many people feel ready for public-facing activities around 10 to 14 days, but comfort and appearance vary.
Step 4 · Following weeks to months
Continued settling
Residual swelling and scar appearance continue to change. Exercise, contact lenses, makeup, and sun protection should follow your team’s specific guidance.
Planning everyday activities
ActivityGeneral planning contextWhat affects the plan
Desk work and screensPlanning context: Return depends on vision, dryness, comfort, and job demands. [1]What affects it: Screen use may feel tiring before swelling and irritation settle.
DrivingPlanning context: Wait until your team clears you and vision is clear.What affects it: Sedation, impairing pain medicine, ointment, and blurred vision can make driving unsafe.
Exercise and liftingPlanning context: Strenuous activity is commonly restricted early in recovery. [1]What affects it: Exertion can increase swelling or bleeding risk; obtain a personalized restart plan.
Contact lenses and eye makeupPlanning context: Resume only when your team says the eyelids are ready. [1]What affects it: Handling or rubbing the area can irritate healing tissue.
Return-to-work estimates are not complete healing. Your surgical team may recommend different timing for your procedure and occupation.
Before your procedure
- Share your eye history, including dryness, glaucoma, thyroid eye disease, and prior eye surgery.
- Provide a complete list of prescriptions, over-the-counter medicines, vitamins, and supplements.
- Ask which medicines need adjustment; do not stop prescribed blood thinners on your own.
- Discuss nicotine use and the team’s requirements before and after surgery.
- Arrange transportation, help at home, and time away from work based on your planned procedure.
- Confirm fasting instructions, prescribed supplies, follow-up appointments, and the after-hours contact number.
Is blurry vision always expected?
Ointment can cause temporary blur, but do not assume a new vision change is harmless. Sudden loss or worsening of vision, severe eye pain, or rapidly increasing swelling requires immediate assessment.
What if my eyes feel dry?
Tell your team, especially if you had dryness before surgery. They may recommend specific lubricating drops or ointment and check eyelid closure. Persistent discomfort or inability to close an eye needs prompt contact.
06 · Safety
Risks and what your clinician assesses
Temporary bruising, swelling, tightness, irritation, tearing, and light sensitivity are common. They should generally improve; worsening symptoms deserve a call to your surgical team.
Bleeding
Bleeding or a collection of blood can require treatment. Bleeding behind the eye is rare but can threaten vision.
Infection or healing problems
Infection, wound separation, or delayed healing may require medicine or further care.
Dryness or incomplete eye closure
Dry eyes can worsen, and the eyelids may not close fully. Persistent exposure can damage the eye’s surface.
Changes in eyelid position
The lower lid may pull downward or turn outward. Tightness or position changes may require additional treatment.
Scars, asymmetry, or contour concerns
Visible scars, uneven contours, hollowing, or remaining excess skin can occur. Revision surgery may be considered.
Vision and anesthesia complications
Eye injury, double vision, and rarely vision loss can occur. Anesthesia also carries risks that depend on your health and the medicines used.
Discuss these risks and your individual health history with your surgeon. [3]
What your clinician assesses
- Eye surface health, tear production, vision concerns, and previous eye treatments
- Eyebrow position, eyelid lifting function, lower-lid support, and ability to close the eyes
- Medical conditions, bleeding risk, medications, nicotine use, and anesthesia history
- Your priorities, natural asymmetry, and expectations about what surgery can change
07 · Costs
What makes up the Total Procedure & Care Cost
Compare written estimates for the same planned scope: upper lids, lower lids, or both, including any added eyelid support or related procedure. Ask which services are included and which are billed separately.
Surgeon
Surgical care
The surgeon’s work for the agreed eyelid procedure and any planned additional surgical steps.
Ask your surgeonConfirm which eyelids are treated and whether consultation or revision-related fees are separate.
Facility
Anesthesia and facility
Anesthesia services, operating-room use, and recovery-area care.
Ask your surgeonAsk who bills these services and whether the estimate reflects the expected procedure length.
Supplies
Supplies and follow-up
Possible charges for prescribed medicines, wound-care supplies, and postoperative visits.
Ask your surgeonConfirm what is included, how long routine follow-up lasts, and how unexpected care is billed.
TRC
Patient Services
Any separately described scheduling, education, or care-coordination services.
Ask TRCAsk whether a separate fee applies, what it covers, and whether the service is optional.
Your written estimate should explain the services included, any separate charges, and payment terms.
08 · Questions
Common questions
Will insurance cover eyelid surgery?
Cosmetic eyelid surgery is generally not covered. Upper-eyelid surgery for documented visual obstruction may qualify under some plans. Ask about testing, prior authorization, and your expected responsibility before scheduling.
Will I have visible scars?
Upper incisions usually sit in the eyelid crease. Lower incisions may be beneath the lashes or inside the lid. External scars often fade but do not disappear completely.
Can surgery change my eye shape?
The aim is usually to preserve your natural appearance, but eyelid contour or position can change. Discuss any planned support procedure and the risk of unwanted shape changes.
Can I have surgery if I already have dry eyes?
Possibly, but dryness needs careful evaluation because surgery can worsen it. Your surgeon may recommend treatment first, a modified approach, an eye specialist’s assessment, or avoiding surgery.
0 consultation questions in your plan
View in My TRC workspaceMy Aesthetic Plan
Prepare for your consultation
Bring these to help your consultation:
- Confirm the eyelids being treated, the approach, and any separate procedures.
- Obtain personalized preparation, recovery, and urgent-contact instructions.
- Review the written estimate, follow-up plan, and any insurance requirements.
View My Aesthetic Plan
Choices stay in this visit until saving to your account completes. Nothing is sent to a clinician.
Sources
- [1]Mayo Clinic — BlepharoplastyUpper and lower eyelid indications, distinction from ptosis treatment, preparation, outpatient care, recovery timing, activity restrictions, results, insurance considerations, and warning symptoms.
- [2]American Society of Plastic Surgeons — Eyelid Surgery ProcedureUpper-crease and lower-lid incision approaches, transconjunctival access, fat removal or repositioning, skin removal, and anesthesia options.
- [3]American Society of Plastic Surgeons — Eyelid Surgery Risks and SafetyBleeding, infection, dryness, difficulty closing the eyes, lower-lid malposition, scarring, revision, visual complications, and anesthesia risks.
Photographs are illustrative scenes, not patients, staff, facilities or outcomes. This information does not replace a personal assessment by your treating clinician.