EVMS Ear, Nose & Throat Surgeons
Facial Plastics

Eyelid Surgery (Blepharoplasty)

Eyelid Surgery (Blepharoplasty)

The eyelid is usually one of the first areas to show signs of aging. The eyelids develop excess skin and fat, bags, pouches and/or wrinkles that may cause‌ both cosmetic and functional (impaired vision) problems. Blepharoplasty may be performed to remove excessive skin and protruding bags from the eyelids providing you with a refreshed and more alert appearance. This procedure cannot alter dark circles of fine lines and wrinkles around the eyes (crows feet). It will not change sagging eyebrows, however, we occasionally will recommend a browlift procedure in conjunction with a blepharoplasty provide the most complete eye rejuvenation. Upper lid blepharoplasty may be performed for cosmetic and/or functional reasons. Some patients have such excessive hooding of their upper eyelids, that their field of vision becomes compromised and the surgery may be covered by insurance carriers. Lower lid blepharoplasty is generally considered to be cosmetic surgery and is not covered by insurance carriers.



Upper eyelid blepharoplasty may be performed under local anesthesia or intravenous sedation. Lower eyelid surgery may be performed under intravenous sedation or general anesthesia. If a browlift is performed in conjunction with the blepharoplasty, general anesthesia is recommended. 

Incisions for upper eyelid blepharoplasty are created in a crease on the upper eyelid and are easily concealed with makeup within a few weeks. Excess skin from the upper eyelid is removed and excess fat may be removed as well to help contour the upper eyelid. 

Incisions for lower eyelid blepharoplasty may be performed on the inside surface of the eyelid where they are completely hidden or just under the eyelash line or sometimes in both areas. The placement of the incision will depend on the goals of the surgery and whether skin will have to be excised from the lower eyelid in order to achieve the optimal result. Excess fat may removed or repositioned to fill in the “tear trough” area. When an external incision is required, this is often carried into the crows feet area in order to tighten the eyelid that has become excessively lax. External lower eyelid incisions are strategically placed and meticulously repaired in order to minimize the appearance of the healed scar.



Post-operative eyelid swelling will occur after surgery, and the eyelids may be completely closed for a short time. Light ice packs over the eyes will help to minimize subsequent bruising and swelling. For the first few days it is best to relax with your head elevated. Occasionally, the conjunctiva (pink part of the eye) will swell as well causing temporary irritation, tearing and blurry vision. These effects are generally short lived and often respond to topical steroid drops and lubrication of the eye with ointments. Within 2 weeks following surgery most patients will be able to return to full activity levels. Contacts may be used again 5 days after surgery.