Blepharoplasty

Yes, it is very common and often recommended to address both upper and lower eyelids in a single session. This provides the most comprehensive rejuvenation of the eye area, requires only one recovery period, and is typically more cost-effective than two separate procedures. The combined surgery usually takes 1.5-2 hours. Your surgeon will evaluate both sets of lids and recommend whether treating both or just one set will best achieve your goals.

Upper blepharoplasty scars are placed within the natural crease of the eyelid and become virtually invisible within 2-3 months, even without makeup. Lower blepharoplasty scars, when placed just below the lash line, heal to a fine line that blends with the natural texture of the lower lid. Transconjunctival lower blepharoplasty leaves no external scar at all, as the incision is inside the lid. Eyelid skin heals exceptionally well due to its thinness and excellent blood supply.

Upper blepharoplasty may be covered by health insurance when drooping eyelids significantly obstruct your field of vision. This is typically documented through a visual field test (perimetry) performed by an ophthalmologist, which measures the degree of visual obstruction with and without the excess skin taped up. If the test shows clinically significant impairment, insurance may cover the functional portion of the surgery. Lower blepharoplasty is almost always considered cosmetic and is not covered. Consult your insurance provider and surgeon's office for specific policies in your country.

Blepharoplasty removes excess skin and fat from the eyelids themselves, while a brow lift elevates the position of the eyebrows. In some cases, what appears to be upper eyelid drooping is actually caused by a descended brow pushing skin down onto the lid. A thorough evaluation will determine whether blepharoplasty, a brow lift, or a combination of both is needed. If the brow is the primary issue and only blepharoplasty is performed, results may be suboptimal because the root cause is not addressed.

Upper blepharoplasty results typically last 5-10 years, after which skin laxity may gradually recur due to continued aging and gravity. Some patients elect to have a touch-up procedure after this period. Lower blepharoplasty results tend to be longer-lasting, often 10-15 years or more, particularly when fat repositioning techniques are used. Healthy lifestyle habits, consistent sunscreen use, and good skincare can help extend the longevity of results. The surgery can be safely repeated if needed.

The goal of blepharoplasty is to make you look like a refreshed, more rested version of yourself, not to fundamentally change your eye shape or appearance. A conservative, experienced surgeon removes only the amount of skin and fat necessary to achieve a rejuvenated look without altering your natural eye characteristics. Over-aggressive surgery that removes too much tissue can lead to a hollow, startled, or unnatural appearance. This is why choosing a skilled, conservative surgeon is paramount.

It depends on the cause of the dark circles. If they are caused by herniated fat pads creating shadows (bags), blepharoplasty with fat repositioning can significantly improve them. If the darkness is caused by a deep tear trough (hollow groove), fat grafting or filler may be more appropriate. If the darkness is primarily due to hyperpigmentation (excess melanin in the skin), it is better treated with topical treatments, chemical peels, or laser therapy. Many patients have a combination of these factors, and your surgeon will identify the contributing causes and recommend the appropriate treatment plan.

Most surgeons recommend avoiding contact lenses for 1-2 weeks after surgery to allow the eyelids to heal and to minimize irritation. During this time, you should wear glasses instead. Once your surgeon confirms that healing is progressing well, you can resume contact lens wear. If you experience persistent dryness (a common temporary side effect), your surgeon may recommend lubricating drops to make contact lens wear more comfortable during the healing phase.