Blepharoplasty (Eyelid Lift)(Upper and Lower Eyelid Surgery)
Refresh the eye area by reducing heavy upper-lid skin and under-eye bags while preserving natural expression and eyelid function.
What Is Blepharoplasty?
They say the eyes are the windows to the soul, but they are also the first area to show signs of aging. Over time, the delicate skin around the eyes stretches, muscles weaken, and fat pads bulge forward. This creates heavy, hooded upper eyelids and prominent puffy "bags" under the eyes, often causing you to look exhausted, sad, or older than you are, no matter how much sleep you get.
Cosmetic blepharoplasty can reduce these changes. For the upper lids, Dr. Jowett conservatively removes skin that obscures the natural crease. For the lower lids, fat may be repositioned or selectively removed to soften bags and the lid-cheek transition. Pigment, visible vessels, and some causes of dark circles require different treatment.
The procedure is frequently performed under local anesthesia with light sedation, offering a remarkably fast recovery and dramatic, eye-brightening results.
Why Choose Dr. Jowett for Blepharoplasty?
Operating around the eye requires careful planning to protect vision and preserve eyelid function.
Preserving Eye Function
Dr. Jowett's reconstructive eyelid practice informs a conservative cosmetic approach that accounts for eyelid closure, blink mechanics, and corneal protection.
Hidden Incisions
Upper eyelid incisions are meticulously placed within the natural eyelid crease. Lower eyelid fat is often removed from inside the lid (transconjunctival approach), leaving absolutely no visible scar on the skin.
Avoiding the "Hollow" Look
Rather than aggressively cutting out all fat, which can create a sunken, aged appearance, Dr. Jowett uses modern fat-repositioning techniques to fill tear troughs and create a smooth, youthful contour.
Blepharoplasty Results
- Reduces Under-Eye Bags: May reduce prominent bulges and the shadows that contribute to a tired appearance.
- Clears Hooded Upper Lids: Excises the heavy, excess skin that droops over the eyelashes, making the eyes look larger and brighter.
- Smooths Tear Troughs: Blends the eyelid seamlessly into the cheek by repositioning fat to fill deep hollows.
- Restores Makeup Application: Creates a smooth, visible upper eyelid platform, making it easy to apply eyeshadow and eyeliner again.
What the Evidence Shows
Cosmetic eyelid surgery and paralytic eyelid surgery share the same anatomy. The goals are different.
- A cosmetic blepharoplasty removes extra skin and fat while protecting blink and lid support.
- Serious complications are uncommon but include hematoma and vision threat. Hemostasis and patient selection matter.
- If the lid already cannot close, this is not a cosmetic page. See reconstructive eyelid surgery.
- Dry-eye risk is judged mainly from symptoms, ocular history, and eyelid anatomy. Tear-film breakup and Schirmer testing used on their own have performed poorly as predictors of dryness after surgery.
- Lower-lid laxity, scleral show, a prominent globe, or negative-vector anatomy can raise the risk of lid retraction or ectropion, so conservative skin removal and lateral canthal support are considered in those patients.
- For the upper lid, skin-only excision that spares the orbicularis muscle has been associated with less incomplete closure than adding muscle removal, and pooled trial data suggest upper blepharoplasty tends to reduce dry-eye symptoms relative to baseline rather than create them.
- In prospective patient-reported data, improvements in satisfaction with appearance and in how patients appraised their own aging were present at six months and remained stable at twelve months; natural aging continues afterward.
- Sudden severe eye or orbital pain, a rapidly tense or bulging orbit, new double vision, or any loss of vision after eyelid surgery is treated as an emergency, because retrobulbar hemorrhage is rare but can threaten sight.
Recovery After Eyelid Surgery
Eyelid surgery is usually an outpatient procedure performed under local anesthesia with or without sedation.
The first week
Bruising and swelling are typically greatest in the first several days, and skin sutures are commonly removed around five to seven days. Cold compresses, head elevation, and activity restriction are standard early instructions.
Ocular surface care
Generous lubrication is used while the lids settle. Mild incomplete closure and transient dryness, grittiness, or reflex tearing are common early and usually improve within about a week, though baseline dry eye can prolong them.
Social downtime
Most reported social downtime is roughly one to two weeks, with residual swelling and incision maturation continuing over weeks to months. Individual recovery varies with the procedure performed, anatomy, and healing.
Blepharoplasty Consultation
Eyelid surgery may reduce hooding or lower-lid bags, but it does not correct every cause of dark circles, eyelid droop, brow descent, or facial aging. Recovery and the degree of change vary by procedure and patient.
During your consultation, Dr. Nate Jowett evaluates eyelid anatomy, brow position, closure, ocular-surface symptoms, skin quality, and goals before discussing whether upper blepharoplasty, lower blepharoplasty, brow treatment, another option, or no surgery is appropriate.
Common questions
Questions Patients Ask
Will upper blepharoplasty lift a low eyebrow?
Not directly. Removing eyelid skin can reveal or occasionally accentuate brow descent. The brow and eyelid are evaluated together to determine whether blepharoplasty, brow lift, ptosis repair, or a combination best matches the problem.
Can blepharoplasty worsen dry eye?
Dryness and irritation can temporarily increase, particularly when baseline dry eye or incomplete closure is present. Conservative skin removal, ocular-surface optimization, and postoperative lubrication help reduce risk.
How long does recovery take?
Bruising and swelling are usually most visible during the first one to two weeks, while incision maturation and subtle swelling continue for months. Individual recovery varies by procedure, anatomy, and healing.
Is eyelid surgery ever done for vision rather than appearance?
Yes. When excess upper-eyelid skin obstructs the upper field of vision, surgery is documented as a functional procedure using visual-field testing, eyelid margin measurements, and photographs. Cosmetic eyelid surgery addresses appearance and is documented differently. The same operation can serve both purposes, which is why the examination establishes early which problem is being treated.
Will blepharoplasty fix an eyelid that actually droops?
Only if the droop is skin. A low eyelid margin caused by the lifting muscle is ptosis, and blepharoplasty alone does not correct it. Significant ptosis is generally addressed with ptosis repair, often combined with blepharoplasty in the same operation, because treating the skin alone in that setting is a common reason people need revision.
What is the difference between upper and lower eyelid surgery?
They are distinct operations with different techniques and different risks. Upper surgery addresses excess skin and, when present, herniated fat and mild lid droop, and can be functional or cosmetic. Lower surgery addresses under-eye fat prominence and the lid-cheek junction and is primarily cosmetic. Having one does not commit a patient to the other.
Will there be a visible scar?
Upper-eyelid incisions are placed in the natural crease so the mature scar is generally inconspicuous. Lower-lid fat can often be addressed through the inside of the lid, which leaves no external incision, while a skin-pinch or external approach leaves a fine lash-line scar. Healing varies between individuals and no scar can be promised to be invisible.
What are the most serious risks of eyelid surgery?
Most problems are minor and temporary, including bruising, swelling, chemosis, and transient dryness. The complications that matter more are lower-lid malposition such as scleral show, retraction, or ectropion, which is why lid laxity is assessed and canthal support is used when indicated. Retrobulbar hemorrhage is rare but can threaten vision and is treated as an emergency.
Answers are general and individualized at consultation.
Medical References & Evidence-Based Guidelines
- Experience With the Gold Weight and Palpebral Spring in the Management of Paralytic Lagophthalmos. Terzis JK, Kyere SA. Plast Reconstr Surg. 2008;121(3):806-815. PMID: 18317130.
- Lower Eyelid Management in Facial Paralysis. Jowett N. Facial Plast Surg. 2023 Feb; 39(1):47-52. PMID: 36564035.
- Evidence-based medicine: Blepharoplasty. Drolet BC, Sullivan PK. Plast Reconstr Surg. 2014;133(5):1195-1205. PMID: 24776550.
- Simplifying Blepharoplasty. Zoumalan CI, Roostaeian J. Plast Reconstr Surg. 2016;137(1):196e-213e. PMID: 26710052.
- Functional considerations in aesthetic eyelid surgery. Jindal K, Sarcia M, Codner MA. Plast Reconstr Surg. 2014;134(6):1154-1170. PMID: 25415085.
- Safety Considerations in Blepharoplasty: A Comprehensive Review. Taghioff SM, Munkwitz SE, Quan H, et al. J Craniofac Surg. 2026. PMID: 42555303.
- Functional and Aesthetic Outcomes After Upper Blepharoplasty: A Systematic Review and Meta-analysis of Randomized Control Trials. Todorov D, Mitchell S, Al-Hashimi M, et al. Aesthet Surg J. 2025;45(6):554-562. PMID: 40152471.
- Assessment of Patient Satisfaction With Appearance, Psychological Well-being, and Aging Appraisal After Upper Blepharoplasty: A Multicenter Prospective Cohort Study. Domela Nieuwenhuis I, Luong KP, Vissers LCM, et al. Aesthet Surg J. 2022;42(4):340-348. PMID: 34791033.
- Blepharoplasty complications. Lelli GJ Jr, Lisman RD. Plast Reconstr Surg. 2010;125(3):1007-17. PMID: 20195127.
- The value of tear film breakup and Schirmer's tests in preoperative blepharoplasty evaluation. McKinney P, Byun M. Plast Reconstr Surg. 1999;104(2):566-9; discussion 570-3. PMID: 10654706.