Eye Lift Surgery: Procedure, Results and Costs

What is Eye Lift Surgery?

Eye lift surgery is medically known as blepharoplasty. It’s one of the most common aesthetic procedures performed in the U.S. and involves altering the upper and lower eyelids.²

Doctors use many techniques when approaching an upper or lower blepharoplasty. However, no concrete data prove that one approach is superior to the other.

Blepharoplasties focus on removing excess skin and fat around the eye area. Most doctors use a conservative approach to avoid complications.

What Can Eye Lift Surgery Fix?

Some people get an upper blepharoplasty to improve their vision. Droopy eyelids can get in the way of a person’s eyesight, and an eye lift can fix that. Improved eyesight can also result in fewer vision-related headaches.

Eye lifts can also fix aesthetic issues like:

• Puffiness
• Eye bags
• Excess skin
• Fine wrinkles

An eye lift will not remove crow’s feet or deeper wrinkles around the eye area.

Who is a Candidate for Eye Lift Surgery?

People who are in good physical and mental condition qualify for blepharoplasty. Those with poor eyesight due to droopy eyelids are also good candidates. People who want to improve the appearance of eye bags or puffiness around the eyes also qualify for the procedure.

Doctors may opt for a more conservative surgical approach for people with glaucoma or dry eyes. These conditions increase the risk of complications during recovery. Doctors may also ask a person to take a Schirmer’s test to confirm if they have dry eye.⁵

A Schirmer’s test involves placing a strip of filter paper on the lateral commissure, the outer corner of the eye where the upper and lower eyelids meet. If the eye’s moisture doesn’t spread over a 5 mm distance on the paper in 5 minutes, it indicates dry eye syndrome.

The doctor might have to treat this syndrome first before performing blepharoplasty. Otherwise, this may exclude someone from getting the procedure done.

If a person has had LASIK surgery, they need to wait 6 months before proceeding with an eye lift surgery. This allows their blink reflex to return to normal.

Eye Lift Procedure: What to Expect

Blepharoplasties are performed under local or general anesthesia. It largely depends on the doctor’s preference and surgical plan.

Before an upper blepharoplasty, a doctor evaluates certain features of the eyelid, including:

• Definition and visibility of crease
• Degree of pretarsal show (distance between the lash line and skin fold in a neutral gaze)
• Height of eyelid fold
• Volume of eyelid fold
• Contour of eyelid fold

The condition of these features determines the approach the doctor uses during the procedure.

Lower blepharoplasties have two main approaches: transcutaneous and transconjunctival.² 

A transcutaneous approach involves an incision in the skin where crow’s feet lines naturally occur. It is then deepened into the muscle. A transconjunctival approach is a simpler and faster technique involving an incision in the conjunctiva (inside the eyelid).

Doctors will always aim to preserve as much tissue as possible to balance the volume loss that comes with aging.

Preparing for Surgery

The doctor will gather a person’s complete medical history, which includes:

• Past cosmetic procedures (especially around the eye area)
• Existing eye conditions
• Existing cardiovascular conditions
• Current medications and supplements

The doctor will also study a person’s facial features and get to know their aesthetic preferences. This allows them to identify factors that may increase the risk of postoperative complications.

They will also assess the positioning of the brow and cheek during an upper and lower blepharoplasty, respectively. These features influence the upper and lower eyelids, so it’s common to consider them during any procedure involving the eyes or the area around the eyes.

After the consultation, the doctor will take preoperative photos of the eyes. These photos capture the eyes from different angles and positions, including:

• Front view
• Lateral view
• Three quarters to the side
• A close-up
• Eyes closed
• Eyes open, looking upward
• Eyes squinting

Doctors customize each surgical plan according to the person’s present features and their desired outcome. The plan is only complete once the doctor and person have agreed. 

During Surgery

The doctor will identify where the upper eyelid crease rests on each eye during an upper blepharoplasty. This helps them determine where to place the incision. It also tells them how much excess skin to remove while keeping enough tissue for normal eyelid closure.

Some cases call for removing a small amount of the orbicularis oculi muscle. This is the muscle surrounding the upper and lower eyelid. The removal can help refine the contour of the eyelid.

Once the procedure is done, the doctor sutures the incision. After the area heals, the scar will be less visible because of the incision’s placement in the eyelid crease.

Doctors can perform a lower blepharoplasty with a transcutaneous or transconjunctival approach. However, a study among American oculoplastic surgeons showed that more doctors prefer the latter course.³

A transconjunctival approach involves placing an incision inside the lower eyelid. The doctor repositions the orbital fat instead of removing it completely. Some will excise a small amount if the situation calls for it. 

Due to the incision placement, the scar won’t be visible after healing. This approach creates a smoother contour in the upper face. It also reduces the chances of the skin around the eyes darkening.

After Surgery

After surgery, it’s normal to experience bruising around the eyes. Doctors recommend applying cold saline compresses during the first 48 hours. 

Dry eye syndrome is another common experience, and it can persist longer than 2 weeks in 11% of patients.⁵ Doctors usually prescribe artificial tear drops to ease this side effect.

After surgery, the person should have someone drive them home. They should also ask someone to help them around the house during the first 2 days after surgery.

It’s normal to experience side effects during the first few weeks of healing. These include:

• Constipation
• Mild pain
• Swelling of lids
• Tightness of lids
• Dryness
• Itching
• Burning
• Excessive tearing
• Light sensitivity
• Blurred or double vision
• Difficulty closing eyes during sleep

Healing is a slow process, although some side effects will gradually improve within a few days. The doctor will likely prescribe pain medication. Do not take aspirin unless your doctor approves it.

Keep the incisions clean with soap and water. Doctors also recommend checking the area for signs of infection every day. During the first several days, sleep with the head slightly elevated at 45 degrees to minimize swelling. 

Activities should be kept at a minimum during the first 5 days. Wearing contact lenses and performing strenuous activities are prohibited during the first 2 to 3 weeks.

A person can resume reading and watching TV 2 to 3 days after surgery, while work can resume in 2 weeks. Sutures are usually removed 5 to 7 days post-op.

To avoid constipation, doctors recommend walking as soon as it’s possible to do so. It can also reduce swelling and lower the risk of developing blood clots.

It’s normal for scars to look pink for at least 6 months after surgery. Avoid exposing them to the sun for at least a year and always wear sunblock with a minimum of SPF 30. Face makeup is allowed once the sutures are removed.

Call the doctor immediately if you experience any of the following symptoms:

• Increased swelling, bruising, and/or redness
• Increased pain
• Any side effects from the prescribed medication (rash, nausea, constipation, etc.)
• Oral temperature over 100.4°F
• Yellow or green discharge from incisions
• Foul odor from incisions
• Uncontrollable bleeding from the incisions
• Loss of feeling or motion

Risks of Eye Lift Surgery

Complications from an eye lift procedure are minimal, especially if the doctor’s approach was conservative. Common risks include:

• Increased inflammation
• Scarring
• Dry eye syndrome
• Infection
• Corneal trauma during surgery
• Eyelid asymmetry
• Abnormal orbital skin pigmentation

Many of these risks can be prevented through preoperative planning and surgical technique. The significance of these complications also lessens after appropriate management. 

More severe complications of blepharoplasties include:

• Retrobulbar hematoma or hemorrhage. Blood pools in the space behind the eye. A rare complication with a 1 in 2,000 to 1 in 25,000 chance of occurring.⁵ It can lead to vision loss if not treated immediately.
• Post-blepharoplasty lower eyelid retraction (PBLER). A rare complication of lower blepharoplasty. The lower lids are pulled down after healing, resulting in vision problems.
• Eyelid malposition. Incorrect positioning of the upper or lower eyelid. More common in lower blepharoplasty procedures.

Eye Lift Surgery Outlook and Success Rates

Regardless of a person’s age, blepharoplasties have a high success rate. A 2020 study showed a 96.7% success rate among young people and 97.4% among older people.⁷

Most people who’ve had an eye lift surgery to fix the bagginess under their eyes have expressed long-term satisfaction with their results. Some have also reported an improvement in their quality of life.

In a separate study in 2018, 128 people were monitored for 6 months after their blepharoplasty procedures. Over 107 reported a very high satisfaction rate by the sixth month.¹ None of these people developed serious complications.

Summary

An eye lift surgery is also called blepharoplasty. The surgical alteration of the upper or lower eyelid is meant to address issues like puffiness, droopy eyelids, or bagginess under the eyes.

Ideal candidates for this procedure are people who are in good physical and mental condition. People with droopy eyelids, puffiness, and/or bagginess around the eyes are also suited for this procedure.

Blepharoplasty has a high success rate. Manageable complications from the procedure are minimal and can be avoided through careful preoperative planning and surgical technique. More serious complications rarely occur.