What does it treat?
Excess upper-eyelid skin and lower-eyelid bags or loose skin.
The plan may involve skin removal, fat adjustment, and lower-lid support, depending on your anatomy.
Face & Neck · Eyes & Eyelids
Upper and Lower Blepharoplasty
Upper and lower blepharoplasty is eyelid surgery that adjusts excess skin and fat to address upper-lid hooding and under-eye bags.
Will it remove dark circles?
Not reliably.
Shadows from bags may improve, but pigmentation, visible blood vessels, and thin skin may remain.
How much time should I plan away?
Many people plan about 10 to 14 days away from public-facing activities.
Bruising and swelling vary. Returning to work does not mean healing is complete, and activity clearance comes from your surgical team.
01 · Overview
Understanding upper and lower eyelid surgery
Upper blepharoplasty usually uses an incision in the natural eyelid crease to remove excess skin and selectively adjust fat. If skin hangs into your field of vision, evaluation may include visual-field testing. [1]
Lower blepharoplasty addresses bags and sometimes loose skin beneath the eyes. Fat may be removed or repositioned through an incision inside the eyelid or just below the lashes. Some people also need support for a loose lower lid. [2]
This is different from a brow lift, which raises the brow, and ptosis repair, which corrects a drooping eyelid edge. Eyelid surgery does not reliably erase crow’s-feet or dark circles. Your surgeon will explain which structures contribute to your concerns. [1]
- Area treated
- Upper and lower eyelids
- Anesthesia
- Local anesthesia with sedation or general anesthesia
- Care setting
- Usually outpatient surgery
- Healing
- Early recovery takes weeks; scars and swelling settle over months
Why does an eye-health review matter?
Eyelid position affects blinking and the tear film. Dry eyes, thyroid eye disease, previous eye surgery, and trouble closing the eyes can influence whether surgery is appropriate and how much tissue can safely be changed.
Do the upper and lower lids have to be treated together?
No. They can be treated together or separately. The decision depends on your goals, eye health, examination, and the extent of the proposed surgery.
02 · Concerns & Goals
What brings people to a consultation
You may notice heavier upper lids or bags beneath your eyes. A consultation can help separate eyelid changes from brow position, skin texture, and other causes.
Upper-lid hooding
A fold of excess skin may cover the upper crease or feel heavy. A low brow can contribute and may need a different approach.
Under-eye bags
Prominent fat beneath the eyes can create a puffy contour. The surgeon considers whether removing or repositioning fat would better preserve support.
Loose lower-lid skin
Fine folds and lax skin may be concerns, but removing too much skin can pull the eyelid away from the eye.
A tired-looking appearance
You may feel your eyes look more tired than you feel. Surgery can address some structural causes, but skin color, facial movement, and natural asymmetry remain important.
03 · Options
How the approaches differ
These are components your surgeon may combine, rather than interchangeable procedures. The choice depends on eyelid support, skin excess, fat position, and eye health.
Upper-eyelid crease approach
Addresses excess upper-lid skin.
How it worksAn incision follows the natural crease so skin and, when appropriate, a small amount of fat can be adjusted.
May suitPeople with upper-lid skin excess whose brow and eyelid-edge position have been assessed.
Main tradeoffA scar remains, and overly aggressive removal can cause hollowing or difficulty closing the eye.
Inside-the-lid lower approach
Addresses lower-lid fat without an external skin incision.
How it worksA transconjunctival incision inside the lower eyelid allows access to fat.
May suitPeople with lower-lid bags and limited excess skin, depending on examination.
Main tradeoffIt does not remove external skin by itself and may need another step to address skin excess.
Below-the-lash lower approach
Allows access to lower-lid skin and fat.
How it worksAn incision just below the lashes allows careful skin removal and fat adjustment.
May suitPeople with both lower-lid bags and excess skin when lid support is adequate or can be reinforced.
Main tradeoffAn external scar and a risk of lower-lid pulling or turning outward must be discussed.
Fat repositioning and lid support
May help smooth contours while protecting lower-lid position.
How it worksThe surgeon may move fat into a hollow and tighten or support the outer eyelid with a canthopexy or canthoplasty.
May suitSelected people with a bag-to-hollow transition or lower-lid laxity.
Main tradeoffThese steps add complexity and can affect swelling, eye shape, and recovery.
The safest plan may be more conservative than you expected. Preserving eye closure and eyelid position takes priority over removing every fold. [1] [2].
Is removing more fat better?
Not necessarily. Removing too much can leave a hollow appearance. Your surgeon may recommend limited removal, repositioning, or leaving some fat untouched.
Will I need a brow lift or ptosis repair too?
Only an examination can determine that. A low brow and a drooping eyelid edge are different from excess eyelid skin, so blepharoplasty alone may not address them.
04 · Results
What may improve and what may remain
Changes you may see
A lighter upper-lid fold and smoother lower-lid contour may become visible as swelling settles.
- The amount of change depends on anatomy and the extent of surgery.
- Natural differences between the two eyes may remain.
What may remain
Eyelid surgery does not address every cause of an aged or tired appearance.
- Dark pigmentation, crow’s-feet, and fine skin texture may persist.
- A low brow or true eyelid droop may require separate evaluation.
How results evolve
Results can be long-lasting, but aging continues.
- Early swelling can temporarily hide the contour or make the eyes look uneven.
- Scars and residual swelling can take months to settle; revision is sometimes considered.
Your surgeon can discuss likely changes, but cannot promise a particular appearance or how long it will last. [1]
05 · Recovery
Planning your recovery
Recovery at a glance
- Stay after surgery
- Determined by Your Surgeon
- Initial recovery at home
- Varies by Individual
- Return to desk work
- Varies by Procedure and Work Activity
- Light daily activities
- Based on Individual Recovery
- Strenuous exercise
- Based on Surgeon Clearance
Returning to work does not mean fully healed. Follow your surgeon’s instructions; strenuous activity requires clearance.
Recovery depends on which lids are treated and whether support procedures are added. Your surgical team should provide a plan tailored to your operation and eye health.
Step 1 · Day of surgery
Treatment day
You will be monitored before discharge. Arrange a ride and any required adult support after sedation or general anesthesia. Temporary blurred vision from ointment, tearing, and swelling can occur.
Step 2 · First several days
Early swelling and eye comfort
Bruising, swelling, tightness, and irritation are common. Follow your prescribed eye-care plan. Ask your surgical team whether compresses are appropriate and exactly how to use them.
Step 3 · About 1 to 2 weeks
Follow-up and daily routines
Your team checks healing and removes stitches if needed. Some people feel ready for desk work or social activities around 10 to 14 days, although bruising and swelling may still be visible.
Step 4 · Following weeks to months
Continued settling
Residual swelling and scars continue to change. Exercise, contact lenses, and other activities should resume according to your team's clearance, not appearance alone.
Planning everyday activities
ActivityGeneral planning contextWhat affects the plan
Work and screensPlanning context: Desk work may be manageable before swelling has fully settled. [1]What affects it: Dryness, blurred vision, and visual fatigue can limit comfort and concentration.
DrivingPlanning context: Wait until your team clears you and vision is adequate for safe driving. [1]What affects it: Sedating medicines, ointment, and blurred vision can make driving unsafe.
Exercise and liftingPlanning context: Strenuous exercise and heavy lifting are restricted during early healing. [1]What affects it: Straining can increase bleeding and swelling; ask for a staged return plan.
Contact lenses and eye makeupPlanning context: Ask when each can safely resume. [1]What affects it: Pulling on the eyelids, irritation, and wound contamination can interfere with healing.
These are planning topics, not a substitute for your postoperative instructions. Return to work is not the same as complete healing.
Before your procedure
- Describe your goals and any vision changes, dryness, tearing, or trouble closing your eyes.
- Share your medical history, previous eye procedures, and any thyroid or eye disease.
- Review all medicines and supplements; do not stop prescribed medicines without the prescribing clinician's guidance.
- Discuss nicotine use and the surgical team's requirements before and after surgery.
- Arrange transportation, home support, and time away from work based on your planned procedure.
- Confirm fasting instructions, prescribed eye care, follow-up visits, and an after-hours contact number.
What if my eyes feel dry?
Tell your team about dryness before surgery and report worsening symptoms afterward. They may prescribe lubricating drops or ointment and assess eyelid closure. Severe pain or a change in vision needs urgent assessment rather than routine dry-eye care.
When can I judge the result?
Early swelling can distort eyelid shape and symmetry. Your surgeon will follow the healing process over weeks to months and explain when it is reasonable to assess the result.
06 · Safety
Risks and what your clinician assesses
Temporary bruising, swelling, mild discomfort, tightness, tearing, dryness, and light sensitivity can occur. Symptoms should generally improve; severe pain or worsening vision is not routine recovery.
Bleeding
Bleeding can occur under the skin or, rarely, behind the eye. Pressure behind the eye is an emergency because it can threaten sight.
Infection or delayed healing
Incisions can become infected or heal slowly, sometimes requiring medication or additional care.
Dry eyes or incomplete closure
Dryness can develop or worsen. Difficulty fully closing the eyes may be temporary or persistent and can affect the eye surface.
Lower-lid position changes
The lower eyelid can pull down or turn outward, causing irritation, tearing, or visible changes. Further treatment may be needed.
Scars or contour differences
Noticeable scars, asymmetry, hollowing, or remaining bags can occur. Revision may be discussed but cannot guarantee correction.
Vision and anesthesia complications
Eye-muscle injury, double vision, and rare loss of vision are possible. Sedation and general anesthesia also carry risks that require an individual assessment.
Discuss these risks and your individual health history with your surgeon. [1]
What your clinician assesses
- Tear production, dry-eye symptoms, eye disease, and previous eye surgery
- Brow position, eyelid-edge height, skin excess, and lower-lid support
- Medical conditions, bleeding risk, medicines, and nicotine use
- Goals, existing asymmetry, and ability to follow the recovery plan
07 · Costs
What makes up the Total Procedure & Care Cost
Compare written estimates for the same planned scope: both upper and lower lids, the chosen anesthesia, and any fat repositioning or eyelid-support procedures.
Surgeon
Surgical care
The surgeon's fee for the agreed upper and lower eyelid procedures.
Ask your surgeonAsk whether support procedures, additional treatments, and possible revision care are included or separate.
Facility
Anesthesia and facility
Anesthesia services and use of the surgical facility.
Ask your surgeonConfirm who bills each service and whether additional operating time changes the estimate.
Supplies
Supplies and follow-up
Items such as prescribed medicines, eye-care supplies, and postoperative visits.
Ask your surgeonAsk which supplies and visits are included and how unexpected care is billed.
TRC
Patient Services
Any separately listed care-coordination or administrative services.
Ask TRCAsk whether these services apply, what they include, and whether they are optional.
Your written estimate should explain the services included, any separate charges, and payment terms.
08 · Questions
Common questions
Can insurance cover eyelid surgery?
Cosmetic surgery is generally not covered. Upper-lid surgery may qualify when excess skin affects vision and the insurer's documentation requirements are met. Lower-lid cosmetic treatment is usually separate. Confirm benefits and authorization before scheduling.
Will the scars be visible?
Upper incisions usually sit in the crease. Lower incisions may be inside the lid or below the lashes. External scars often fade, but their visibility varies and they do not disappear completely.
Will my eye shape change?
It can. Swelling may temporarily alter shape, and lid-support procedures or healing changes can affect the final appearance. Discuss which features you want to preserve.
Can I have surgery if I already have dry eyes?
Possibly, but dry eyes need careful assessment and sometimes treatment before surgery. Your surgeon may recommend a more limited plan, an eye specialist's evaluation, 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 planned procedures, their limits, and any separate brow or ptosis treatment.
- Have a personalized recovery plan, follow-up schedule, and urgent-contact instructions.
- Review the written estimate and arrange transportation, support, and time away.
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 surgery, limits of treatment, vision-related indications, preparation, recovery timing and restrictions, dry-eye and eyelid-closure risks, rare vision complications, and urgent postoperative symptoms.
- [2]American Society of Plastic Surgeons: Eyelid SurgeryConcerns treated by blepharoplasty, upper and lower incision approaches, fat removal or repositioning, eyelid support considerations, and the distinction between eyelid changes and brow position.
Photographs are illustrative scenes, not patients, staff, facilities or outcomes. This information does not replace a personal assessment by your treating clinician.