Blepharoplasty Demystified: Upper vs. Lower Eyelid Surgery Explained
Blepharoplasty, also known as eyelid surgery or an eyelid lift, is a powerful solution for those looking to address signs of aging around the eyes. Whether you’re dealing with droopy upper eyelids or persistent under-eye bags, this surgical procedure can rejuvenate your look and, in some cases, even improve your vision.
At Stratus Plastic Surgery, we often help patients understand the subtle—but important—differences between upper and lower blepharoplasty. Let’s break it down so you can determine which approach might be right for your needs.
What Is Blepharoplasty?
Blepharoplasty is a surgical procedure that targets the delicate tissue around the eyes. As we age, skin loses elasticity, fat redistributes, and muscles weaken—leading to common concerns like:
Hooded or sagging upper eyelids
Under-eye puffiness or bags
Obstructed peripheral vision
A tired or aged appearance
Depending on where these issues occur, upper or lower blepharoplasty—or a combination of both—may be recommended.
Upper vs. Lower Eyelid Surgery: What’s the Difference?
| Feature | Upper Blepharoplasty | Lower Blepharoplasty |
|---|---|---|
| Target Concerns | Hooded lids, excess skin, mild brow droop | Under-eye bags, hollowing, fine lines |
| Incision Location | Natural upper eyelid crease | Just below lash line or inside lower lid |
| Fat Management | Removal or repositioning of fat pads | Repositioning fat to fill hollows and reduce puffiness |
| Recovery Time | 7–10 days | 10–14 days |
| Best For | Patients with sagging skin impairing vision or appearance | Patients concerned with puffiness or deep tear troughs |
Each procedure is customized based on your facial anatomy and aesthetic goals.
How to Know Which Is Right for You
During your consultation, we’ll assess:
The position of your eyelids and brows
Skin elasticity
The presence of fat deposits or hollows
Your overall facial symmetry and proportion
If drooping brows contribute to your upper eyelid concerns, we may also recommend a brow lift in combination with upper blepharoplasty to achieve a more complete and natural-looking result. You can read more about combining facial procedures in our guide to addressing the aging face.
The Procedure: What to Expect
Upper Blepharoplasty
An incision is made in the natural upper lid crease. Through this, we remove or reposition fat and trim excess skin. Muscle tightening may also be performed for a refined contour.
Lower Blepharoplasty
There are two main approaches:
Transconjunctival: Incision inside the lower lid—ideal for fat removal or repositioning without visible scars.
Subciliary: Incision just below the lashes—used when skin tightening is also needed.
We smooth out puffiness, reduce hollowness, and create a natural transition from lid to cheek.
Recovery and Aftercare Tips
Swelling and bruising are normal and typically peak within the first few days. Here's how to support healing:
Use cold compresses for the first 48 hours
Keep your head elevated, especially when sleeping
Avoid strenuous activities and heavy lifting for at least a week
Use prescribed eye drops or ointments as directed
Follow all post-operative care instructions from your surgeon
Stitches are usually removed after 5–10 days, and most patients feel comfortable returning to normal activities by week two.
Long-Term Results and Benefits
When performed by a board-certified plastic surgeon, blepharoplasty offers lasting improvement. Some of the key benefits include:
A more awake and refreshed appearance
Improved vision in cases where upper lid skin obstructs sight
Better definition in the eyelid crease and lower eye contour
Results that last 10 years or more, depending on skin quality and aging
For some, pairing blepharoplasty with a facelift or mini facelift can further enhance their facial appearance and provide a more comprehensive transformation.
Is Combined Eyelid Surgery Right for You?
If both your upper and lower lids show signs of aging, addressing them together can deliver the most cohesive outcome. A comprehensive facial assessment during your consultation will determine whether a combined approach—or pairing eyelid surgery with treatments like a brow lift or facial fat transfer—makes sense for your goals.
Want to explore how eyelid surgery compares to other facial rejuvenation options? You may be interested in non-surgical facelift alternatives for a less invasive approach.
Refresh Your Look, Starting with Your Eyes
Blepharoplasty is more than just a cosmetic procedure—it’s a confidence boost and, in some cases, a functional necessity. If you’re ready to explore whether upper, lower, or combined eyelid surgery is right for you, schedule a consultation at Stratus Plastic Surgery today.