Blepharoplasty (Eyelid Surgery)

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Facial aging is often most evident in the areas under and around the eyes. As facial skin begins to loosen over time, fatty deposits and lax skin can congregate around the upper and lower eyelids and cause them to droop. When the upper eyelids experience skin drooping, the common result is a “hooding” effect that not only contributes to an aged aesthetic, but can also impair or partially obstruct vision. In the lower eyelids, a youthful appearance can be compromised by excess skin and fat that leads to puffiness, under-eye bags, or hollow tear troughs. With an eyelid lift, medically referred to as blepharoplasty, the eyelids can be rejuvenated for a younger-looking and well-rested appearance, as well as an unimpeded field of vision. Depending on your unique concerns, our Boston plastic surgeon, Geoffrey Leber, MD, FACS, can perform eyelid surgery on the upper and/or lower eyelids to achieve a natural-looking, refreshed aesthetic.

Key Blepharoplasty Terms to Know

When it comes to eyelid surgery, there are many terms specific to the blepharoplasty procedure that patients may come across throughout their research. Familiarizing yourself with these key phrases can give you a more robust understanding of eyelid surgery and whether the procedure is the best option to achieve your goals:

  • Hooding: “Hooding” is a phenomenon in which sagging skin and tissue in the upper eyelids begin to droop into a patient’s field of vision, often accumulating on the upper lash line. Hooding can obstruct one’s vision, as well as create a more exhausted and aged look.
  • Eyelid ptosis: “Ptosis” is the medical term used to describe drooping of the upper eyelids.
  • Tear trough: The tear troughs refer to the under-eye hollows, marking the transition between the lower eyelids and upper cheeks. As patients grow older and lose facial fat, the tear troughs can appear more sunken and flat.
  • Skin elasticity: “Skin elasticity” is known as the skin’s ability to tighten and contract over time. A lack of skin elasticity can lead to sagging and overall tissue laxity.

Dr. Leber prioritizes strong patient education and will patiently answer all of your questions to enhance your understanding of the blepharoplasty procedure. He will also listen to your cosmetic goals and make sure eyelid surgery is the best facial plastic surgery to address your concerns.

What Can an Eyelid Lift Do for Me?

Eyelid surgery can dramatically improve the mechanisms that may be causing a perpetually tired, sad, or aged appearance in men and women. The eyelid lift procedure is designed to provide a revitalized facial appearance by removing excess skin, smoothing out the remaining skin, and extracting or repositioning fatty deposits that may be causing eyelid droop. For patients with upper eyelids that sag into their line of sight, an eyelid lift can be utilized to restore the full scope of vision. Based on your concerns and goals for the outcome, blepharoplasty is personalized to smooth the contours around the eyes and give you a more refreshed, bright-eyed look.

Who is a Candidate for Blepharoplasty?

Ideal candidates for an eyelid lift are in good health and have realistic expectations for what can be achieved by the procedure. Individuals who would benefit from an eyelid lift typically exhibit common signs of facial aging and exhaustion around the eyes, including:

  • Excess fat in the upper or lower eyelids
  • Drooping upper eyelids that can negatively affect vision
  • Puffiness below the eyes
  • Bags under the eyes
  • Hollow tear troughs
  • Lower eyelid laxity that exposes concealed tissue underneath the iris
  • Excess skin or fine lines in the lower eyelids

During a consultation, Dr. Leber will examine your aesthetic concerns and suggest treatment options that can help you reach your cosmetic goals. Sometimes, drooping of the upper eyelids can be a result of lax forehead skin and sagging eyebrows—in this case, a brow lift is likely the most effective procedure to attain the desired outcome. Patients also have the option of combining both enhancement procedures to maximize their results.

Types of Eyelid Surgery

Eyelid surgery uses varying techniques, depending on whether an upper or lower eyelid lift (or both) is being performed. Depending on the nature of your treatment plan, an eyelid lift by Dr. Leber takes approximately one hour to complete. This surgery is typically performed as an outpatient procedure and utilizes a local anesthetic and sedation. Dr. Leber takes great care to make incisions along the natural folds and contours of the eyelid region to allow a natural-looking cosmetic outcome.

Upper Eyelid Surgery

For an upper eyelid lift, an incision is placed along the eyelid’s natural crease. From here, fat deposits may be removed, muscles are tightened, and excess skin is excised to eradicate a drooping appearance. If loose skin is drooping into your line of sight, this can effectively restore your full field of vision and yield a more youthful aesthetic.

Lower Eyelid Surgery

Dr. Leber’s unique approach to lower eyelid surgery is performed with the goal of avoiding complications characteristic of the traditional method of lower lid rejuvenation, such as lower lid malposition and dry eye. While traditional blepharoplasty in the lower eyelids aims to remove and reposition the orbital fat pockets under the eyes, this technique can sometimes create more of a hollowed, skeletal, and aged appearance. To prevent this cosmetic outcome, Dr. Leber utilizes facial fat grafting to add volume where the lid meets the cheek (termed the lid-cheek junction) under the orbital fat pockets. Volume is also restored in the lateral cheek and tear troughs to further emphasize an aesthetic of youthful fullness, as well as to blend the lid-cheek junction. Lax skin under the eyelash line is then removed, and the remaining skin and underlying muscle is tightened. The combination of adding volume to the hollow under the eyes and tightening the overlying skin and muscle creates a more youthful, smoother lid-cheek junction. Because the orbital fat pockets are unaltered, there are less complications and usually less scarring, bleeding, and bruising.

Patient Results

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What is Recovery From Eyelid Surgery Like?

Recovery from an eyelid lift can be surprisingly short, with some individuals returning to regular activities within a few days. Patients can expect mild bruising or swelling after surgery, which can be alleviated with ice packs. Oral pain medication can also be used to manage discomfort. An ointment is usually prescribed to prevent excessive dryness, and patients should cleanse their eyes daily during their recovery period. Most people return to work or their normal daily activities within seven to ten days. While the results of an eyelid lift can be noticed immediately, the final outcome generally improves as swelling subsides. After surgery, patients can enjoy a more alert and rejuvenated appearance around their eyes for more distinguishable eyelid contours. The cosmetic outcome from eyelid surgery can be extremely long-lasting, but patients can prolong their results by limiting unprotected sun exposure.

How Long Do Eyelid Surgery Results Last?

Since the procedure is designed to surgically correct drooping or descended tissue around the eyelids, most patients enjoy their blepharoplasty results for years—and even decades—into the future. Surgery will not stop the aging process, but those who undergo blepharoplasty will generally always look more youthful than they would have if they had never pursued the procedure. The best way to preserve the outcome of surgery is to protect your eyes from the sun, refrain from smoking and tanning beds, and nourish the area around your eyes with high-quality skincare products. If you experience the formation of wrinkling or deep creases in the future, non-surgical treatments like BOTOX® Cosmetic and/or dermal fillers can be performed to “touch up” your results.

What Will My Blepharoplasty Scars Look Like?

Scarring is inevitable with any surgical procedure, but scars from eyelid surgery are often very well-concealed in the natural contours of the skin. For upper blepharoplasty, the scar will heal in the upper eyelid crease and should be virtually imperceptible to outside observers. Lower blepharoplasty typically utilizes incisions hidden in the lower lash line, resulting in no external scarring whatsoever. Dr. Leber will walk you through where you can expect your blepharoplasty scars after he evaluates your needs in person. Fortunately, scarring after eyelid surgery can heal to very faint fine lines with proper care, and you will be provided with instructions on how to treat your incisions after surgery. Preventative measures like wearing sunscreen and sunglasses while outdoors, refraining from smoking, and using medical-grade skincare products can help diminish the visibility of your blepharoplasty scars.

Should I Know About Any Blepharoplasty Complications?

Every surgery involves the risk of potential complications, but choosing a board-certified plastic surgeon who has substantial experience performing blepharoplasty is the most effective way to maximize the safety of your procedure. Our medical team will always review your medical history and evaluate your concerns to help confirm that you are a good candidate for eyelid surgery. Nevertheless, blepharoplasty and cosmetic surgery overall may involve the risk of:

  • Infection
  • Bleeding
  • Complications from anesthesia
  • Temporary vision problems
  • Lower lid malposition
  • Dry eyes

Dr. Leber utilizes the advanced techniques he has learned throughout the years to reduce the likelihood of side effects and produce the best possible outcome. When you consult with him in person or during a virtual consultation, Dr. Leber will explain the benefits and risks of eyelid surgery in further detail to help you make an informed decision about whether to pursue the procedure.

How Much Does Blepharoplasty Cost?

The cost of blepharoplasty generally depends on which procedure was pursued, as well as whether both eyelid regions were treated. That said, the price of eyelid surgery generally ranges between $3,500 and $7,000. The details of your treatment plan will ultimately determine the total cost of your procedure, and a consultation with Dr. Leber is the best way to achieve an accurate cost estimate based on your needs. Rest assured that a member of our team will provide you with a breakdown of your blepharoplasty expenses after your concerns are evaluated in person. If preferred, we accept plastic surgery financing from CareCredit® for individuals who wish to pay for their treatment in more manageable installments. Qualified patients often find that the low- to no-interest payment arrangements offered by CareCredit® can make cosmetic surgery more affordable. If you have any other questions about the cost of eyelid surgery, please don’t hesitate to contact our practice.

Is Eyelid Surgery Covered by Insurance?

Insurance providers usually do not cover blepharoplasty expenses due to its classification as a cosmetic procedure; however, certain cases of eyelid ptosis may qualify for coverage under some medical insurance policies. This condition is characterized by drooping tissue in the lids, often causing the upper lids to rest on the lash line. When ptosis is severe, the droopy upper lids may obstruct a patient’s line of sight. If lax skin is interfering with your scope of vision, eyelid surgery may be deemed a medical necessity and meet the requirements for potential insurance coverage. Every policy differs, so be sure to contact your insurance provider to learn the full scope of benefits you are entitled to.

Can I Get an Eyelid Lift Without Surgery?

Non-surgical eyelid surgery alternatives, such as cosmetic injectables, will not replicate the results of blepharoplasty, but certain treatments can temporarily erase signs of aging in the eyes and brow. If volume loss under the eyes is your main concern, hyaluronic acid dermal fillers like JUVÉDERM® and Restylane® can be adept at restoring fullness to hollow tear troughs and temples. These high-quality products work to plump regions of the face that show indications of a volume deficit, with the hyaluronic acid-based composition of these fillers offering an almost immediate improvement in the appearance of sagging or sunken facial planes.

Alternatively, wrinkles and fine lines that frame the eyes can be diminished with injectable neuromodulators, such as BOTOX® Cosmetic and Dysport®. These products work to smooth crow’s feet, frown lines, brow creases, and other wrinkles that often develop due to the formation of facial expressions. By temporarily relaxing the facial muscles that produce these wrinkles, BOTOX® Cosmetic and Dysport® can soften expression lines and provide patients with a younger-looking complexion. Injectable treatments can be very effective at refreshing the face, but the scope of what can be accomplished is limited and results will eventually fade without touch-up treatments. Surgical blepharoplasty is considered the best solution to achieve long-lasting enhancement for a range of aging concerns in the eyelids. Dr. Leber can make a recommendation on the ideal treatment for your needs after meeting you in a consultation.

Will Eyelid Surgery Affect My Vision?

Temporary vision changes immediately after surgery can be expected, but most patients find their vision returns to normal after a few days. Your eyes may be red and swollen after the blepharoplasty procedure, which can lead one’s eyesight to become slightly distorted. Blurred vision is usually a common reaction. Blurriness should dissipate as your eyes continue to heal and our team will give you extensive instructions on what you can expect during the recovery period.

Sensitivity to light may also occur following blepharoplasty, and we encourage you to avoid very bright or fluorescent environments immediately after surgery. Dr. Leber advises patients to protect their eyes from the sun by wearing sunglasses whenever outside. It’s important to keep in mind that while blepharoplasty is able to widen one’s line of sight by addressing hooding, the procedure is not designed to achieve clearer eyesight.

Are There Complementary Procedures to Eyelid Surgery?

Complementing blepharoplasty with additional facial plastic surgery procedures is a popular option for some patients who would like to achieve more comprehensive results for the same recovery time as a lone procedure. Eyelid surgery can address the area immediately surrounding the eyes, but it cannot smooth or lift excess skin in the brow. A very common treatment plan involves a joint procedure combining blepharoplasty and brow lift surgery to attain a more energetic look in the entire upper face. The eyes should look more refreshed while an appearance of tiredness, anger, or stress conveyed by the brow should be improved.

A facelift can also be a beneficial addition to eyelid surgery. Many patients who exhibit aging in the eyes also experience jowls or sagging skin along the jawline, making them perfect candidates for an eyelid lift plus facelift procedure. Those who experience a lack of volume around the cheeks and mid-face may also consider facial fat grafting with their eyelid surgery, which uses your own tissue as a natural filler to enhance fullness in the face and restore more youthful contours. Dr. Leber often uses facial fat grafting when performing lower eyelid surgery to reintroduce volume where the lid meets the cheek, preventing a hollowed or skeletal look. This all depends on your needs and the concerns you wish to improve, and Dr. Leber will discuss all your options with you when he meets you in person.

Alternatives to Eyelid Surgery

Eyelid surgery can be an excellent way to rejuvenate and brighten the eyes, but the procedure may not be the best treatment option for all of patients’ concerns. In some cases, signs of aging that are making the eyes look older may be better addressed with brow lift surgery. A brow lift can target drooping eyebrows and sagging skin along the upper face, causing frown lines and horizontal forehead creases. While the procedure doesn’t treat the eyelids, results from a brow lift tend to provide a brighter expression overall. Combining blepharoplasty and brow lift surgery is also a common treatment plan for patients who are bothered by both drooping brows and puffy eyelids. Don’t hesitate to contact Dr. Leber to discuss your concerns and identify the best procedure(s) to achieve your goals.

Additional Eyelid Surgery FAQs

Will my vision change after eyelid surgery?

After blepharoplasty, it’s common for the eyes to feel swollen, tender, or sensitive to light. Temporary changes to your vision, such as blurriness, are normal and should subside naturally as swelling resolves and you continue to recover from surgery. Your eyes may also be covered upon leaving our practice to protect them immediately after your procedure. Dr. Leber and our team will show you how to apply warm compresses following blepharoplasty to help alleviate soreness and swelling.

Will eyelid surgery fix hooded eyes?

Yes, upper blepharoplasty can be an excellent solution to repair hooded eyelids. “Hooding” refers to a common condition in which drooping, excess tissue sags below the lash line or even interferes with a patient’s field of vision. Eyelid surgery can recontour the eyelids and smooth the area by removing excess skin and repositioning displaced fat, allowing patients to restore their complete line of sight and enjoy a brighter, more alert appearance.

When can I wear makeup again after eyelid surgery?

You should avoid wearing makeup until Dr. Leber confirms that it’s safe to apply cosmetics again, a period that ranges from 7 to 10 days. That said, it’s generally recommended to wait two to three weeks after your procedure to help ensure your incisions are fully healed. While this timeframe varies from patient to patient, it’s important to protect your eyes from dirt, makeup, and other impurities during the healing process to reduce the risk of infections and other complications.

What’s the difference between blepharoplasty and ptosis repair?

Blepharoplasty is considered an aesthetic procedure primarily performed for cosmetic reasons. Although eyelid surgery can address hooding for patients dealing with drooping eyelid skin, most patients pursue the procedure to look younger and more refreshed. In contrast, ptosis repair is more designed to correct weakened musculature in the eyelids that may be preventing patients from fully opening their eyes. This condition, referred to as “ptosis,” occurs when the levator muscles are too weak to support the upper eyelids and can lead to a sleepy or fatigued look.

Does male blepharoplasty differ from female blepharoplasty?

Blepharoplasty uses the same general techniques for male and female patients, but each procedure is performed with a patient’s unique goals and anatomic distinctions in mind. The goal of eyelid surgery is to achieve results that look natural and youthful; therefore, Dr. Leber ultimately personalizes blepharoplasty according to your individual needs and aesthetic desires.

For more information on eyelid surgery, or if you would like to schedule a consultation with Dr. Leber, please contact us today.