What Is a Blepharoplasty?

Eyelid Surgery to Correct Sagging or Drooping Eyelids

Blepharoplasty, also known as eyelid surgery, is a surgical procedure to improve the appearance of the eyelid. The skin of the eyelid is thinner than other areas of the face, and it tends to show the first signs of aging. Eyelids that sag or droop can affect peripheral vision and make daily activities more difficult.

Woman on surgery table for blepharoplasty surgery
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Blepharoplasty removes excess skin and fat and tightens the muscles and tissues of the eyelid. It reduces the skin that droops into the visual field to improve peripheral vision.

Types of Blepharoplasty

There are two types of blepharoplasty: functional and cosmetic.

Functional Blepharoplasty

A functional blepharoplasty removes the excess skin that obscures your field of vision. If the procedure is determined to be medically necessary, it may be covered by medical insurance. Testing your visual field with a Humphrey Visual Field Analyzer will determine how much vision is affected.

Cosmetic Blepharoplasty

Cosmetic blepharoplasty can be performed on either the upper or lower eyelid, or both. Depending on the type of lower eyelid blepharoplasty, either excess skin in the lower eyelid is removed, or redistribution or removal of excess fat is performed.

You should have realistic expectations before undergoing a blepharoplasty. While the procedure can improve the appearance of your eyelids, it does not dramatically alter your face.

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Click Play to Learn All About Droopy Eyelid Surgery

This video has been medically reviewed by Bryan M. Wolynski, OD.

Candidates for Blepharoplasty

If you are considering a blepharoplasty, you should be in good overall health and not smoke, not have any serious eye conditions, and not have facial tissue and muscle that are unhealthy.

How to Fix Hooded Eyes

Not everyone is a good candidate for blepharoplasty, but there are other ways to improve the appearance of hooded eyes:

  • Botox injections can help lift the eyebrow, improving the appearance of hooded eyes.
  • Dermal fillers can help lift the eyebrow and tighten the skin around the eye.
  • The prescription eye drops UPNEEQ (oxymetazoline hydrochloride ophthalmic solution) can help lift droopy eyelids.
  • Radiofrequency treatments use electromagnetic current to tighten the skin and lift the eyebrows.
  • Thread lifts are temporary sutures that slightly lift the eyebrows.

Procedure

Blepharoplasty usually is performed in an outpatient setting and requires local anesthesia and sedation. The procedure can take anywhere from 30 to 60 minutes, depending on whether you have the procedure on both the upper and lower eyelids.

If your upper eyelids are being operated on, the incision lines are typically made along the natural crease lines of your eyelids. Once the incisions have been made, fat deposits and excess skin are removed. A strip of the orbicularis oculi muscle surrounding the eyelids may also be removed to deepen the lid crease.

If you have surgery for the lower eyelids, an incision may be made either just below the lower lash line or on the inside of the lower eyelid. Depending on the method, excess skin in the lower eyelid is removed or fat is redistributed or removed.

After the procedure, your incisions are closed with either removable sutures, skin adhesives, or surgical tape.

Recovery

After blepharoplasty, you will be given specific instructions, including for the medications you should apply or take orally and a date and time when you should see your surgeon for a follow-up examination. Your healthcare provider will also inform you of any symptoms or signs you should watch for, which would mean you should follow up sooner.

Healing

You may experience some swelling, bruising, irritation, or dry eyes, but if these symptoms occur, they are generally very mild. Most of the swelling subsides within two weeks. You will not be able to wear contact lenses or eye makeup for two weeks after surgery.

Your stitches will usually be removed by the third or fourth day after surgery. It may be recommended that you wear dark sunglasses for the next two weeks to protect your eyes from the sun and wind. You can return to work in a few days to a week but will need to avoid exercise and strenuous activities for at least two weeks.

Potential Risks

Blepharoplasty is usually very well tolerated. After the surgery, there may be swelling and bruising around the surgical site. This will eventually subside on its own.

Complications are not common but may include infection, a granuloma, reaction to anesthesia, and double or blurred vision. Your eyes may experience irritation and dryness due to a temporary change in tear distribution.

Although rare, another potential risk is retrobulbar hematoma, an accumulation of blood behind the eyeball. This condition is considered a medical emergency as it can lead to blindness if not treated.

Your scars from a blepharoplasty will usually be well-concealed and will fade with time. Make sure to talk to your healthcare provider about any concerns related to your specific symptoms and any possible complications that may occur.

Summary

Blepharoplasty is a surgical procedure used to improve the appearance of the eyelids. Eyelids that droop into the visual field can be treated using this procedure to improve vision, which can be life-altering.

A Word From Verywell

If your eyelids droop or distort your vision, seek a consultation with your eye doctor to see if blepharoplasty is an option. While every procedure has risks, blepharoplasty is generally well-tolerated and can dramatically improve vision.

Frequently Asked Questions

  • Can you fix hooded eyelids?

    Yes, hooded eyelids—when excess skin sags and folds down from below the brow bone—can be corrected with a surgical procedure known as blepharoplasty. The procedure removes excess skin and fat and tightens the muscles and tissue of the eyelid.

  • How much does a blepharoplasty cost?

    The fee runs around $5,000, depending on where you live. According to the American Society of Plastic Surgeons (ASPS), in 2020, surgeons charged $4,120 to perform eyelid surgery, on average—but that is just the surgeon’s fee. Other fees can include hospital or surgical facility costs, anesthesiology fees, and postoperative prescription medication. 

  • Is hooded eyelid surgery covered by insurance?

    It depends. If sagging skin on the eyelids obscures your field of vision, your insurance plan may cover all or part of the surgery. This is known as a functional blepharoplasty.

    If hooded eyelids are only a cosmetic concern and do not hinder your vision or cause other problems, it is considered cosmetic surgery and not typically covered by insurance.

    Before having the surgery, talk to your healthcare provider and insurance company to determine if your plan will cover any part of the procedure. 

  • What is a good age for blepharoplasty?

    Anyone with fatty deposits under the eyes or sagging and drooping eyelids could consider blepharoplasty. People age 40 to 65 typically undergo this procedure for functional or cosmetic reasons.

  • How long does a blepharoplasty last?

    The results of surgery typically last many years. Lower eyelid surgery rarely requires revisions, but upper eyelid surgery may need another treatment around seven years later.

  • Will blepharoplasty get rid of wrinkles?

    Blepharoplasty is not intended to eliminate wrinkles. Lower eyelid blepharoplasty can eliminate some under-eye wrinkles if there is excess skin. The procedure will not remove crow's feet or any other wrinkles around the face.

5 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. American Society of Plastic Surgeons. Eyelid surgery.

  2. Bhattacharjee K, Misra DK, Deori N. Updates on upper eyelid blepharoplasty. Indian J Ophthalmol. 2017;65(7):551-558. doi:10.4103/ijo.IJO_540_17

  3. American Society of Plastic Surgeons. Eyelid surgery recovery and results.

  4. Stanford Medicine. Blepharoplasty.

  5. American Society of Plastic Surgeons. How much does eyelid surgery cost?

Additional Reading

By Blyss Splane
Blyss Splane is a certified operating room nurse working as a freelance content writer and former travel nurse. She works as a freelance content writer for healthcare blogs when she's not spending time with her husband and dog.

Originally written by Natalie Kita