Is Blepharoplasty (Eyelid Surgery) Right for You?

By Larissa Biggers
June 15, 2020
woman with eyes closed

Droopy, sagging upper eyelids and bags under the eyes can be natural parts of the aging process, but they can also negatively affect your self-confidence. If the appearance of your eyes concerns you and you’ve tried nonsurgical options, you may want to consider blepharoplasty, also referred to as eye lift or eyelid surgery. It may also be an option if sagging eyelid skin is making it harder for you to perform daily activities. “If a patient has excess skin or droopy upper eyelids, an upper lid blepharoplasty is usually the most effective treatment,” said Amy Fowler, MD, an oculofacial plastic surgeon at Duke Eye Center of Winston-Salem.

Cosmetic Eyelid Surgery Helps You Look Better


Blepharoplasty is a cosmetic procedure typically performed to improve the appearance of the eyes. With age, eyelid skin stretches, muscles weaken, and fat under the eyes becomes more prominent. The result can be eyes that look tired or older. Upper blepharoplasty removes excess eyelid skin to give your face a more rested look. Lower lid blepharoplasty can be done to remove under-eye bags. Laser skin resurfacing is often performed at the same time to help smooth out under-eye wrinkles, stimulate collagen, and improve skin texture. “The goal of cosmetic eyelid surgery is not to drastically change your appearance,” explained Dr. Fowler. “It is to make your eyes look more rested and youthful.” Cosmetic eyelid surgery performed solely to improve appearance is not covered by insurance.

Medically Necessary Eyelid Surgery Helps You See Better


When weakened upper eyelid muscles cause droopy eyelids to obscure peripheral vision, everyday tasks like reading or driving can be difficult. Some people develop a persistent brow ache from constantly using their forehead muscles to raise their eyelids. In such cases, upper eyelid blepharoplasty with ptosis repair (surgery to raise the height of the eyelid) may be recommended. Upper lid blepharoplasty and ptosis repair may be covered by insurance if deemed medically necessary.

Options for Eyelid Surgery


There are three types of blepharoplasty. The right one for you depends on your individual needs. These procedures are often done under local anesthesia or minimal sedation in an outpatient surgery setting. Upper and lower eyelid surgery with laser skin resurfacing takes about 90 minutes in total.

  • Upper blepharoplasty removes excess eyelid skin and fat from the upper eyelid with the goal of a more youthful upper eyelid shape.
  • Lower blepharoplasty removes fat pads from under the eyes to diminish under-eye bags. Excess skin removal and laser resurfacing or chemical peel resurfacing can be performed at the same time.
  • Upper and lower blepharoplasty combines the two surgeries. If needed, they can be performed at the same time.

Choosing a Surgeon for Your Blepharoplasty


If you’re considering blepharoplasty, look for a doctor who specializes in the procedure. For example, Dr. Fowler said, “It’s the surgery I perform most often.” As an oculoplastic surgeon, she is board-certified in ophthalmology and oculofacial surgery. She completed an ophthalmology residency and additional fellowship training in plastic and reconstructive surgery on the eyes and face.

How Long Do Blepharoplasty Results Last?


While nothing can stop the aging process, the results of blepharoplasty tend to last. In general, Dr. Fowler said, people are happy with their appearance for many years following the procedure.