Eyelid Surgery (Blepharoplasty)
As we age, the thin, delicate skin of the eyelids can gradually stretch and sag. Drooping skin on the upper or lower lids may be caused by factors such as aging, genetics, lifestyle habits, and sun exposure. Over time, the muscles around the eyes can also weaken, making it harder to support excess skin. Eyelid surgery is a safe, minimally invasive procedure designed to rejuvenate the eye area, enhance your appearance, and improve your field of vision—often in a single procedure.
Also known as blepharoplasty or an eye lift, eyelid surgery is one of the most commonly performed cosmetic procedures for both men and women. In addition to making you look tired or older than you feel, sagging eyelid skin can interfere with peripheral vision, particularly in the upper and outer areas of the eyes.
Understanding the Anatomy Involved
Eyelid surgery may be performed on your upper lids, lower lids or both depending on your areas of concern. If droopy upper eyelids are preventing you from opening your eyes completely, or sagging lower lids are exposing the whites of your eyes, an eyelid procedure may be right for you. By removing excess skin, muscles or fat from your lids, this procedure can bring alertness to your eyes while improving upon your vision. Reasons you may consider undergoing eyelid surgery include:
- The natural folds of your eyelids are obscured by hooded skin
- Loose skin on the upper eyelids has begun to stretch over your lash line
- You have vision problems related to overhanging eyelids
- Permanent bags or puffiness under your eyes
- Drooping lower lids have exposed the whites of your eyes
- Excess eye skin causes you to look permanently fatigued, stressed or angry
- You are unsatisfied with the appearance of your aging eyes
While there are a handful of aesthetic concerns eyelid surgery can address, it is essential to have realistic expectations about the outcome of your surgery. This procedure cannot dramatically alter dark circles, fine lines and wrinkles around the eyes or sagging eyebrows. Furthermore, a cheek lift can vastly improve the end result of an eyelid lift. Though eyelid surgery is often performed on its own, Dr. Pu may also recommend a brow lift (forehead lift), facelift (rhytidectomy) or skin resurfacing treatment to be completed in conjunction with your eyelid surgery to achieve your desired results.
Benefits of Eyelid Surgery
Eyelid surgery, also known as blepharoplasty, is a very popular cosmetic procedure in Omni Plastic Surgery Seattle. Here are some of the benefits of eyelid surgery:
- Reduction of under-eye bags: Eyelid surgery can help reduce the appearance of under-eye bags, which can make you look tired and aged.
- Tightening of loose skin: As we age, our skin loses elasticity, which can cause sagging around the eyes. Eyelid surgery can tighten loose skin, giving you a more youthful appearance.
- Improvement of vision: In some cases, excess skin around the eyes can impair vision. Eyelid surgery can remove this skin, improving both appearance and vision.
- Boost in confidence: If you’re self-conscious about your eyes, eyelid surgery can boost your self-confidence and make you feel more comfortable in social situations.
Whether you’re considering upper eyelid surgery, lower eyelid surgery, or both, it’s important to consult with a qualified and experienced board-certified plastic surgeon Dr. Lee Pu. He can help you understand the benefits and risks of the procedure and determine whether it’s right for you.
Eyelid Surgery Procedure
Eyelid surgery is performed on an outpatient basis, and will typically take less than three hours to complete provided it is the only procedure being performed. Most patients will only require local anesthesia to ensure their comfort during the operation; however, general anesthesia may be utilized if the correction needed is more intricate or if a more invasive cosmetic procedure is being performed simultaneously.
The techniques used during your procedure will vary depending on whether your upper lids, lower lids or both are being treated. The incision placement for eyelid surgery is designed to be concealed within the natural structures and folds of your eyelids to ensure there will be no noticeable scars after you have healed from your procedure. During an upper eyelid procedure, a small incision is placed along the natural eyelid crease where excess skin, fat and muscle is carefully removed. Lower eyelid surgery will place the incision just below your eyelashes. Your surgeon will then trim away or reposition excess skin and fat in the area and tighten the lower eyelid muscle to repair the region.
Book Your Consultation
We will review your medical history to better understand your overall health. Our doctor will discuss your goals and help you understand what options may be available and what to expect from treatment.
What to Expect During Your Consultation
During your initial in-person consultation at Omni Plastic Surgery Seattle, our expert staff will examine you and go over your complete medical history. You may be asked questions concerning your vision, tear production, use of corrective lenses and your overall goals for the outcome of your procedure. Factors including your age, skin type, ethnicity and degree of vision obstruction will be evaluated when developing your surgical plan. You can expect an open and honest discussion with your surgeon where you will mutually determine the type of techniques indicated for your procedure, the type of anesthesia, as well as the inherent risks and costs associated with your operation.
Results & Recovery
The results of your eyelid surgery are designed to be long-lasting, and for some patients may even last a lifetime. However, your eyelids will not be immune to the effects of aging after your procedure. As you continue to age, your brow may droop or descend over time and cause the skin to re-accumulate over your upper lids once again, in which case a brow lift may be necessary to maintain your results. Most patients are delighted with the outcome of their eyelid surgery and enjoy the benefits of improved visual function and a more rested, youthful appearance for years to come.
After your eyelid surgery procedure, you will be able to return home the same day to recuperate from the operation. Patients should expect some mild discomfort during their initial recovery period. However, this pain is usually easily tolerated with over-the-counter pain medications and should subside within a few days of the procedure. Bruising and swelling will generally subside in about 10 to 14 days, at which point you may feel comfortable returning to work or resuming normal activities. The scars from your procedure may take several months to entirely fade but should be undetectable due to their strategic placement.
Eyelid Surgery Repair
Dr. Lee Pu is an ASPS board certified plastic surgeon experienced at correcting the eyelid problems of other surgeons because eyelids are his specific area of highest specialization. If you are referred to Dr. Lee Pu due to a problem after an eyelid surgery, it does not necessarily mean that anything was done wrong by the first surgeon.
With the human body, no one can ever be certain of the outcome. Nonetheless, patients still must deal with the correction of less than stellar results. The specific corrective procedure is dependent upon the specific problem. Below are some examples of eyelid surgery problems and their corrections.
Please note that because of the added difficulty of reoperation, the usual cosmetic surgeon’s fees could be higher when correcting problems due to prior surgery performed elsewhere.
Entropion Repair
In entropion, the eyelid is turned inwards toward the eye, and the eyelashes disturb the eye, causing tearing and disruption. The correction requires outpatient surgery of the eyelid, and in some cases could be performed with the CO2 laser, allowing for minimal to no bruising, and a quicker recovery.
Ectropion Repair
In ectropion, the eyelid is turned outward, showing the pink conjunctiva lining of the eyelid. The eye could be irritated and have excessive tearing. Outpatient lower lid reconstruction with support of the lid to prevent recurrence is the procedure of choice.
Ptosis Repair
Ptosis is a condition when the eyelid does not open fully. This can obstruct vision. Ptosis can be present since birth, or can occur following trauma, cataract surgery, or due to aging. Surgical repair is performed as an outpatient, and the eyelid level is corrected painlessly with the patient under local anesthesia. The CO2 laser could be used or surgical removal of the excess skin. Patients can usually return to their normal activities in about a week.
⚠ Skin Cancer of the Eyelid
Basal cell carcinoma is the most frequently seen skin cancer of the eyelid. It is typically biopsied in the office to confirm the diagnosis. Surgical removal of the cancer is performed as an outpatient. If necessary, the eyelid is reconstructed using local flaps. In most cases, the outcome is excellent, and there are minimal or if any scars. Other skin cancers are usually curable, and the aesthetic result can be superb.
There are two very significant factors in the management of eyelid skin cancers—complete removal and reconstruction. Complete removal of the tumor is essential to minimize the possibility of recurrence, which is even more difficult to manage. In most cases, Dr. Lee Pu will work with a highly skilled dermatologic surgeon who removes the tumor using a special procedure (“Mohs technique”) to assure total removal. On some occasions, Dr. Lee Pu may remove the tumor and request that a pathologist check the tissue margins (“frozen section”) to be sure the tumor has been completely removed.
Once the tumor has been removed, reconstructive surgery is almost always necessary. Many exceptional techniques are offered to reconstruct almost any surgical defect. The operation is specifically catered to the defect that is present after the removal of the tumor. With every technique, the goals remain the same: to reconstruct the eyelid and ensure proper function, to protects the eye, to preserve vision, and to create a satisfactory cosmetic appearance.
Every form of therapy for eyelid skin cancer will leave behind some sort of scar. However, Dr. Lee Pu makes every effort to always minimize scarring and obtain the best cosmetic results. After surgery, the healing process could take six months to one year. After the wound has healed, follow up with Dr. Lee Pu or the referring physician is necessary to ensure that the skin cancer is not recurrent.
FAQ’S
Blepharoplasty can effectively rejuvenate the appearance of your eyes by removing excess skin and fat, which can make you look younger. On average, it can take 5-10 years off your face by reducing signs of aging like sagging and puffiness around the eyes. However, the results depend on factors like your skin type, age, and lifestyle, and while the procedure can significantly improve your appearance, it won’t stop the natural aging process.
To determine if you need upper or lower blepharoplasty, consider your specific concerns: upper eyelid blepharoplasty is for sagging or drooping skin on the upper lids, which can affect vision and appearance, while lower eyelid blepharoplasty targets puffiness, dark circles, or sagging below the eyes. A consultation with Dr. Lee Pu will help determine areas of concern.
Choosing between a brow lift and an eyelid lift depends on your concerns. A brow lift addresses sagging eyebrows and forehead wrinkles, which can also improve the appearance of hooded eyes, while an eyelid lift focuses on removing excess skin and fat from the upper or lower eyelids. In some cases, combining both procedures may be the best approach.
Hooded eyes often result from excess skin or weakened muscle on the upper eyelids. At Omni Plastic Surgery Seattle, Dr. Pu corrects this by performing upper eyelid blepharoplasty, where excess skin, fat, and sometimes muscle, are removed or repositioned along the natural crease. This lifts the fold that’s been pulling over the lash line, opening your eyes and improving both appearance and peripheral vision if that skin was obstructing it. Proper technique ensures the result looks natural, not overdone, and maintains eyelid function.
Blepharoplasty is done on an outpatient basis and typically lasts less than three hours if only eyelids are treated. If performed in conjunction with other facial procedures, it may take longer. Incisions are placed in natural creases or under the lash line, so scars are discreet. Anesthesia (local or general) is used depending on the complexity and patient comfort.
Yes, in many cases. If sagging upper eyelid skin hangs over the eyelid margin, it can block part of your field of vision, especially the upper or outer peripheral vision. By removing the overhanging tissue, blepharoplasty can restore unobstructed vision. Omni Plastic Surgery Seattle highlights this as one of the dual benefits: cosmetic enhancement and functional improvement. But it’s important your surgeon confirms whether the skin is indeed impinging on vision during consultation.
Eyelid surgery can treat the upper eyelids, lower eyelids, or both, depending on your concerns. Upper lid work addresses drooping or hooded skin over the lash line. Lower lid surgery targets puffiness, bags, and sagging under the eye, sometimes tightening the muscle and repositioning fat. If either lid’s appearance interferes with your aesthetic or causes functional issues, surgery can help restore alertness, rejuvenate the eye area, and reduce the tired look.
Recovery begins the same day; you’ll go home and rest. Expect mild discomfort, swelling, and bruising for several days. By 10 to 14 days, much of the bruising and swelling will subside, and many patients feel comfortable returning to work or light social activity. Incisions may take months to fully fade, but they are concealed along natural creases. The scars are usually undetectable with time and proper care. Full, long-term results emerge as residual swelling resolves.
Eyelid surgery can produce long-lasting improvements. Especially for lower lids, the results may last a lifetime. For upper lids, benefits may endure 5–7 years or more, depending on skin elasticity, aging, and sun exposure. But the eyelid skin continues aging, so in some cases, additional non-surgical maintenance (e.g. lasers, fillers) or secondary adjustments may be considered later to keep the rejuvenated look.
Yes. Often, eyelid surgery is combined with adjunct procedures like a brow lift, facelift, or skin resurfacing to achieve fuller facial rejuvenation. Because droopy brows may contribute to excess upper lid skin, performing both together helps improve longevity and ensures a harmonious upper face contour. We may recommend these additional procedures depending on your unique anatomy and goals.
As with any surgery, risks include bleeding, infection, asymmetry, dry eyes, eyelid retraction, or visible scarring. Overcorrection or removal of too much tissue may lead to difficulty closing the eyes. Dr. Lee Pu emphasizes customizing each surgery and employing careful techniques to reduce risks. Your pre-op evaluation, following post-op care instructions, and choosing an experienced surgeon help minimize complications and ensure safe, satisfying results.