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Eyelid Surgery

by Paul S. Howard, MD, FACS


The plastic surgery procedure to correct saggy eyelids is called a Blepharoplasty.  This operation is known for giving people a more youthful and rested look by removing the excess skin and fat around the eyes.  This operation may be performed on the upper eyelids and lower eyelids separately, at the same time, or in conjunction with another procedure (face lift or brow lift).  You must realize it is impossible to repair every wrinkle and remove every line around the eye, but this surgery can be one of the most gratifying procedures a patient can have.


The procedure is performed on an outpatient basis under local anesthesia with oral sedation, lasting approximately 1 1/2 hours, unless accompanying another procedure.


The incisions for blepharoplasty are made after an anesthetic is injected into the eyelid area.  The incisions are placed in the natural crease of the eye for the upper blepharoplasty and just below the lower lashes for a lower blepharoplasty.


In certain cases, a lower eyelid blepharoplasty may be performed without a skin incision, the so-called Transconjunctival Blepharoplasty.  Most lower blepharoplasties require blending of the eyelid/cheek skin and addressing the "tear trough" deformity.  The transconjunctival blepharoplasty is reserved for those people with normal skin, no significant skin sagging, and only fat bags requiring removal.  An incision is made inside the lower eyelid on the conjunctiva to gain access to the fat bags only.  Although this relatively new procedure may obviate the need to remove sutures and give a scar-less result, the recovery period, swelling, and discoloration may be similar to the "routine" blepharoplasty with skin incisions.



Eyelid Lift Before and After Photo by Dr. Paul Howard Blepharoplasty Before and After Picture by Dr. Paul Howard
















Photos above are before and after of upper and lower eyelid blepharoplasty




Eyelid Lift Surgery Before and After Picture by Dr. Paul Howard Eyelid Lift Before and After Picture by Dr. Paul Howard
















Photos above are before and after lower eyelid blepharoplasty



Eyelid Surgery Procedure

The eyelid surgical procedure is an out-patient procedure performed in the privacy of Dr. Howard’s office.  The procedure takes a little more than an hour to perform. 


Incisions are made in the crease of the eyelid for upper eyelid surgery and just under the eyelashes for lower eyelid surgery. The incisions for eyelid surgery are designed to blend in with the eye’s natural structure.  The eyelid incisions are closed with a combination of absorbable and removable sutures. All of the removable sutures will be removed within a few days after surgery.  The absorbable sutures will dissolve in one to 3 weeks



Eyelid Surgery Recovery

After your eyelid surgery, an ointment will be placed on your incisions and cold compresses will be applied.  It is important to keep your eyes hydrated with the specified eye drops post-operatively and to keep cold compresses applied as much as possible the first 48 to 72 hours following surgery.  Cold compresses may still be necessary for up to a week following surgery.  You must wear sunglasses when outside of your home to protect your eyes from the sun and eye strain until you are healed. 



Eyelid Surgery Costs

The cost for eyelid surgery varies depending on if you require upper and/or lower blepharoplasty. Prices begin at $3000.


It is extremely rare for insurance to cover this procedure for upper eyelids.  Insurance will only cover this procedure if the patient has significant “visual field” obstruction.  Your eye doctor must perform a “visual fields” test documenting this obstruction.  The results of this test will be submitted along with photos and a letter from the doctor recommending the procedure to be covered as “medically necessary” under the terms of your health insurance contract.  The terms of your insurance contract are between you and your health insurance carrier.  Many health insurance contracts specifically state blepharoplasty as a non-covered procedure.  Please refer to your health insurance contract for details regarding coverage.


"Wow!  I have youthful eyes again.  Everyone used to ask me why I was so tired.  I wasn't tired, I had bags under my eyes!  Thanks Dr. Howard for your masterful work."

Stated by one of Dr. Howard's recent patients