Eyelid Surgery – Blepharoplasty

Eyelid Surgery

Aging is a complex dynamic process in the face that produces numerous structural changes. The plastic surgeon needs to understand and address these changes in each patient in order to produce a natural appearing youthful eyelid surgery result that is tailored to each individual.

In the region of the eye, or what is termed the orbit, structural changes occur in the bone, fat, muscles, ligaments and skin. In the youthful eye, the lid opening is long with graceful arcs. As we age, the this opening becomes foreshortened and rounder, the eye sits farther back in the orbit, the lids may droop, fat may bulge, and the skin becomes redundant. Each patient is different and each eye must be evaluated for what needs to be done during the eyelid surgery to restore a youthful appearance.


Blepharoplasty is a global term meaning eyelid surgery. Blepharoplasty can be performed on the upper lid alone, the lower lid alone, or on both eyelids together. In the past, eyelid surgery may have meant removing excess skin and fat leaving an operated appearance. However, the modern blepahroplasty is designed to restore the youthful beauty of the eye. Eyelid surgery procedures are done in our AAAHC certified surgery center.

Upper Eyelid Blepharoplasty

The upper lid that may show signs of aging by a variety of means. There may be shortening and rounding of the lid margin, excess skin may have developed, there may be bulging of the upper lid fat pads, and there may be redundancy of superficial lid muscle or sagging of the lid position. Aging changes may also be associated with lowering of the eyebrows in many patients. Eyebrow lowering may cause the aging changes they see in the lids. It is important to identify the problems if a youthful, natural, pleasing eyelid surgery result is to be achieved.

The aging of the upper lid may even interfere with the peripheral vision. If this can be demonstrated medically, third party payers may even cover portions of the expenses for the eyelid surgery.

An upper blepharoplasty is performed either under intravenous sedation or local anesthetic depending upon the individual procedure necessary. A curvilinear incision in the normal upper lid crease gives the surgeon access to the anatomical structures relevant to the procedure. Some may be tightened, some may be repositioned, and others may be reduced in size or volume. The excess skin is then tailored and the skin is closed with tiny sutures. Youthfulness of the lid is restored and a natural, graceful sweep to the lid is created. This eyelid surgery may be performed alone or it may be combined with other facial rejuvenation procedures to improve the youthfulness of the entire face.

Lower Eyelid Blepharoplasty

The lower lid may show similar characteristic aging changes as the upper lid. There may be shortening and rounding of the eyelid margin, excess skin may have developed, there may be bulging of the lower lid fat pads, and there may be redundancy of superficial lid muscle or sagging of the lid position. Many patients complain that these changes make them look sad or tired.

Lower lid blepharoplasty is usually performed under intravenous sedation. Some patients may only need a hidden incision inside the lid while in others an incision just below the eyelashes is made. The eyelid surgery will improve the look of the lower lid by removing excess skin, tightening the muscle surrounding the lid, repositioning the outer part of the lid, and / or removing or repositioning excess fat. In many cases, the eyelid surgery can be performed in combination with a laser resurfacing to help eliminate wrinkles.