What Is Blepharoplasty? Your Complete Guide to Eyelid Surgery

If you're researching blepharoplasty, the first thing worth knowing is that it treats a very specific problem. Eyelid surgery works on the lids themselves, on the loose skin and the small pads of fat above and below your eye. It won't raise your brows or smooth the fine lines at the outer corners, and understanding that boundary early keeps your expectations honest.

Interest keeps climbing. Blepharoplasty volume rose 13.4 percent worldwide in 2024 compared with the year before, according to ISAPS. Growth like that usually means people are finding out that a fairly modest operation can change how rested they look.

At Palm Beach Cosmetic Surgery in West Palm Beach, FL, board-certified cosmetic surgeon* Dr. Michael Sistare matches the eyelid technique to what your anatomy is doing rather than to one standard approach. This guide covers what blepharoplasty treats, how the upper and lower procedures differ, and how candidacy is decided. You'll also find what preparation involves, what recovery really looks like, and how results, risks, and cost play out.

Key takeaways

• Blepharoplasty is the medical term for eyelid surgery. It removes excess skin, muscle, and fat on the upper lids, the lower lids, or both.
• Upper eyelid surgery treats hooding, and it can restore part of the upper field of vision when skin hangs low enough to block it. Lower eyelid surgery treats bags and puffiness.
• Lower eyelid surgery uses one of two routes. The lash line handles excess skin. An incision inside the lid suits fat alone.
• Most eyelid surgery can be done under local anesthesia in the office, so you're numb but awake. Only the inside-the-lid lower approach typically needs twilight or general anesthesia.
• Swelling and bruising ease over roughly 10 to 14 days, and upper-lid bruising is usually minimal unless you take blood thinners. Upper eyelid surgery here starts from $3,500.

What is blepharoplasty, and what can it actually treat?

Blepharoplasty is surgery on the eyelids that removes redundant skin. Depending on what you need, it also trims or tightens muscle and conservatively removes excess fat behind the lid. You'll see it called eyelid surgery, an eye lift, or simply a bleph, and all of those names point to the same operation.

The reason this area changes first comes down to tissue. Eyelid skin is the thinnest on your body, so it stretches sooner than skin anywhere else. As connective tissue loses elasticity and the thin wall holding fat in place weakens, that fat drifts forward and the skin above it folds.

Here's what that looks like in the mirror. On the upper lid, excess skin gathers into a hood that can rest on your lashes, and some people end up lifting their brows all day just to see comfortably. On the lower lid, forward-shifting fat creates the pouches most people call bags.

Upper eyelid surgery isn't only cosmetic. When redundant skin hangs far enough to block the top or outer edge of your field of vision, removing it can give part of that field back. Surgeons measure this beforehand rather than guessing, which is why some upper-lid cases qualify as medically necessary.

What blepharoplasty won't do is just as worth knowing:

• It doesn't lift a low or heavy eyebrow. That's a brow position problem. A brow lift repositions the eyebrows, which is what that procedure is actually for.
• It doesn't erase crow's feet, the fine lines that fan out from the outer corner of the eye.
• It doesn't add new volume to the midface or the cheek beneath the eye, though when the area just under the eye is hollow, fat removal can be combined with fat transfer from another area of the body.
• It doesn't correct true ptosis, where the lifting muscle has weakened and the lid margin sits low.

That last distinction matters more than it sounds. Blepharoplasty adjusts skin and fat. Ptosis repair tightens or advances the muscle that raises the lid, and telling the two apart is what the exam at your consultation is for.

Which type of blepharoplasty is right for you?

The answer depends on which tissue is causing the problem, not on your age or on what a friend had done. Upper and lower eyelid surgery are built around different anatomy, and the lower lid alone has two distinct routes in.

Upper blepharoplasty

Your surgeon marks a conservative amount of skin along the natural crease of the upper lid and removes it. A small amount of muscle or fat may come out too, when it's contributing to the heaviness. Because the incision follows a fold your eye already makes, the line tends to disappear as it matures.

This is the version most often done under local anesthesia. You're numb, awake, and home the same day, usually within about an hour of starting.

Lower blepharoplasty through the lash line

When the problem is loose skin or lax muscle rather than fat, the incision goes just below the lower lashes. From there your surgeon can lift and support the tissue and trim the excess skin. This approach is designed for loose skin rather than bulging fat. Support at the outer corner can be tightened at the same time with a canthopexy, which helps the lower lid hold its shape.

Sutures for this approach are non-dissolvable and come out at a follow-up visit rather than melting away on their own.

Lower blepharoplasty through the inside of the lid

If the main issue is a fat pocket and your lower-lid skin is still reasonably tight, the incision can be placed inside the lid. Nothing is cut on the outside, so there's no external scar and typically no stitches either. Excess fat is removed conservatively, so the lid looks smoother without looking hollow.

This is the one eyelid technique that generally calls for twilight or general anesthesia rather than local numbing. Dr. Sistare performs upper blepharoplasty, canthopexy, and both lower-lid approaches. Cases involving true ptosis repair, entropion or ectropion correction, or Asian upper blepharoplasty are referred to a dedicated oculoplastic surgeon.  

Combining eyelid surgery with other procedures

Eyelid surgery pairs naturally with other facial work, and combining is common rather than unusual. A brow lift is considered when a descending brow is part of what's creating the hood. Upper or lower blepharoplasty is also frequently added to a neck lift or facelift, sometimes alongside full-face CO2 laser resurfacing.

Whether that makes sense for you is a conversation, not a rule. Doing more in one sitting means one recovery instead of two, which some people want and others don't.

Are you a good candidate for blepharoplasty?

Candidacy comes down to three things. What your eyelids are doing, how your general health looks, and whether what you want is something this operation can deliver. Age is a weak predictor on its own, and while most patients are over 40, healthy adults are commonly evaluated from around 30 onward.

The strongest candidates have loose upper-lid skin, upper-lid fullness, lower-lid bags, or a persistently tired look that doesn't match how they feel. Good general health matters because healing does. So does knowing this refines the eye area rather than restructuring your face.

Certain conditions don't automatically rule you out, but they change the conversation and sometimes the plan. Be ready to talk through:

• Dry eye, especially burning, grittiness, or watering you already deal with day to day
• Glaucoma, retinal disease, or any other ongoing eye condition
• Thyroid disease, particularly when it causes the eyes to protrude
• Diabetes, high blood pressure, or circulation and clotting problems
• Every medication and supplement you take, including blood thinners, fish oil, and vitamin E
• Smoking or vaping, and any previous eye or eyelid surgery

Dry eye deserves a note of its own. Eyelid surgery slightly increases how much of the eye surface is exposed, so existing dryness can get worse before it settles. It's manageable in most cases, and treating it before surgery is easier than treating it after.

The in-person exam is where this gets sorted out. Your surgeon checks where the lid margin sits relative to the pupil, how well the lifting muscle works, and how much skin and fat you have. Brow position, lower-lid laxity, and whether your eyes close fully all get assessed too, and tear production may be tested if dryness is a concern.

That exam is also how a surgeon separates three problems that look identical from across a room: extra skin, a genuinely drooping lid, and a low brow. Each has a different fix, and treating the wrong one disappoints no matter how well the surgery goes.

Teresita, a patient at our West Palm Beach office, described her first consultation visit:

"First visit for a consultation with Dr. Sistare was amazing. The staff was incredibly nice and the office had a feeling of being home, with couches in the waiting room. Dr. Sistare has a great bedside manner, is very easy going and very informative."

Researching this carefully before committing is the right instinct. One exam usually answers more than a week of reading.

How do you prepare for eyelid surgery?

Preparation starts at the consultation and ends with a quiet house and a ride home. Very little of it is complicated, though the medication and nicotine pieces both need lead time.

Your consultation

Your consultation at Palm Beach Cosmetic Surgery takes place in person at the West Palm Beach office, and that's deliberate. Eyelid assessment is hands-on. Skin tone, lid laxity, brow position, and how your eye closes are things a surgeon needs to see and feel.

This visit isn't only your surgeon evaluating you. It's equally your chance to evaluate him and decide whether the answers sound like someone you'd trust with your eyes. Nothing has to be decided that day.

Bring a full list of your medications and supplements, plus your history of eye conditions, prior surgery, and any dryness or tearing. If you've saved photos of results you like, or done your own reading, bring those too. There's nothing to apologize for in arriving prepared, and it tells your surgeon exactly what you're picturing. Photographs are usually taken for planning, and visual-field testing is added when the case may be functional rather than cosmetic. 

Medications and supplements

Aspirin, ibuprofen, naproxen and other anti-inflammatories thin the blood enough to increase bruising. So do several common supplements. Vitamin E is the one people miss, since it often hides inside a daily multivitamin. The others are fish oil and supplemental levels of garlic, ginseng, ginkgo, and turmeric. Alcohol thins the blood too, so plan to skip it for two weeks before surgery and two weeks after.

Most surgeons ask you to stop these roughly two weeks ahead. One firm exception: never stop a prescribed anticoagulant or antiplatelet medication on your own. That call belongs to your surgeon and the doctor who prescribed it, working together.

Smoking and nicotine

Nicotine narrows the small blood vessels that feed healing tissue, which is the wrong thing during the weeks your incisions are closing. ASPS recommends stopping four to eight weeks before surgery, and vaping and other nicotine products are treated the same way.

Quitting on that timeline is genuinely hard. It's also one of the few variables here that sits entirely in your hands.

The first days at home

Arrange for an adult to drive you home and stay with you the first night. Plan on a quiet three or four days after that, with easy meals ready, dark sunglasses within reach, and pillows for keeping your head elevated.

Set up somewhere comfortable to sit upright, since lying flat makes swelling worse. Ointment will blur your vision early on, so this isn't the week for fine print.

What happens during eyelid surgery, and what does recovery look like?

Eyelid surgery is an outpatient procedure performed right in the office, and you go home the same day. Total surgical time varies, but roughly an hour is typical, followed by a short stretch in the recovery suite.

The day of surgery

Most eyelid surgery is done under local anesthesia. You're numb, awake, and aware of pressure rather than pain, which surprises people who expected to be put under. The inside-the-lid lower approach is the exception that generally uses twilight or general anesthesia.

Incisions follow the plan from your consultation. Excess skin comes out where it needs to, excess fat is removed conservatively, and everything is closed with fine sutures. The internal lower approach often needs none at all.

The first few days

Expect puffy lids, some dryness or watering, light sensitivity, and blurred vision from the ointment. Swelling rather than bruising is the main complaint. It tends to settle downward onto the lower eyelid, so expect some puffiness under the eye even if only your upper lids were treated. None of that means something has gone wrong. It's the ordinary early phase, and it looks worse than it feels.

Bruising is usually minimal after upper eyelid surgery unless you take a blood thinner such as aspirin. Prescription pain medication is rarely needed for more than about three days, and many people stop sooner.

Aftercare for days one through three follows a simple rhythm:

• 20 minutes of heat, then 20 minutes of cold pressure, repeated roughly every two hours while you're awake
• Head elevated whenever you're resting or sleeping
• Preservative-free saline eye drops once an hour for the first few days, with ointment as prescribed
• Dark sunglasses outdoors, and no rubbing or pressure on the lids
• No bending at the waist, heavy lifting, or straining

Weeks one and two

Upper-lid stitches typically come out around the one-week mark. Lash-line sutures on the lower lid are non-dissolvable and are removed at a visit too, while the internal approach usually has nothing to take out.

Swelling and bruising ease substantially over 10 to 14 days, which is when most people feel ready to be seen. In a 2025 study, patients whose upper blepharoplasty removed skin alone returned to work in about 8 days on average. Desk work and public-facing work land differently on that scale, and makeup, contact lenses, and swimming generally wait until the two to three week mark.

Having someone to ask matters during this stretch. Patients here are given Dr. Sistare's personal cell number, so recovery questions go straight to him rather than into a queue. Garments, recovery essentials, and every follow-up visit are included in the surgeon's fee.

The months that follow

Residual swelling settles slowly, and the eye area keeps refining well past the point where you look normal to everyone else. Incision lines stay slightly pink or firm for a while before fading. If scar care comes up, silicone products start about six weeks after surgery, once incisions are fully closed.

Most people find the second half of recovery uneventful to the point of being boring. That's exactly what you want it to be.

What results, risks, and costs should you expect from blepharoplasty?

Realistically, blepharoplasty makes the eye area look less hooded, less puffy, and less tired. The upper-lid crease becomes more defined, bags smooth out, and when skin was blocking your view, some of that field comes back. It doesn't change your facial structure, and it doesn't remove crow's feet or dark circles on its own.

Longevity of your results

Upper eyelid results commonly hold for five to seven years and sometimes far longer. Lower eyelid surgery rarely needs repeating, because the fat that created the bags doesn't return the way skin laxity can. What continues is ordinary aging, so the result ages with your face instead of reverting. Sun exposure is the factor most within your control. A daily broad-spectrum sunscreen protects the tone and texture of the thin skin your result is displayed on.

Risks worth knowing

The vast majority of people go through eyelid surgery without any real trouble. A 2026 review pooling 42 upper blepharoplasty studies put the complication rate at 5.2 percent, and most of what that number captures is temporary and resolves on its own.

The effects worth understanding are dryness or a gritty feeling that can linger a few weeks, and some difficulty closing the eyes fully early on. Mild asymmetry is common as swelling comes down unevenly, and scars take months to settle. Less common are bleeding under the skin, infection, or a lower lid that pulls down and needs correction.

Careful patient selection, conservative skin removal, and honest disclosure of your medications and eye history keep these numbers low. Every one of those is something you and your surgeon can influence long before the day of surgery.

Warning signs worth a call

Some symptoms are worth a phone call rather than a wait-and-see. Contact your surgeon promptly for pain your medication isn't controlling, bleeding that keeps going, swelling that increases rather than decreases, fever, drainage, or any change in your vision.

Sudden vision loss, severe pressure behind the eye, or rapid one-sided swelling should be treated as an emergency. These are genuinely rare, and knowing the short list is what makes the first two weeks feel manageable.

Orchid, whose sister had surgery at our West Palm Beach office, described the follow-up care:

"The post-opt experience was very good. He answered all her questions, he gave clear a detailed instructions and was readily available by phone to answer any questions."

Cost and financing

Cost depends on whether you're having upper, lower, or both, and on what else is done at the same time. Upper eyelid surgery at our West Palm Beach office starts from $3,500, or roughly $96 a month with financing. Lower and combined eyelid surgery are quoted for your specific case at consultation.

One thing that isn't an extra line item here: garments, recovery essentials, and all of your follow-up visits are included in the surgeon's fee. The genuine additional costs are the ones handled by another doctor, meaning lab work and any medical clearance appointment before surgery.

To keep the timing your decision rather than your budget's, we offer flexible financing through Cherry, CareCredit, and Alphaeon Credit. Pre-qualifying doesn't affect your credit. Insurance is a separate question and generally applies only to upper-lid surgery that's medically necessary, where documented visual-field testing shows skin is obstructing your sight.

Conclusion

The boundary we started with is the thing most worth carrying away. Blepharoplasty is precise work on the lids themselves, and knowing it treats skin and fat rather than brow position makes the decision much clearer. What's left is matching the right technique to your anatomy, and that's a question with a real answer.

Looking at real patients whose starting point resembles yours tends to be the most useful next move, so browse the eyelid surgery photo gallery before anything else. After that, an exam is where the guesswork ends and someone finally tells you which of those three look-alike problems you actually have.

Dr. Sistare is candid about what eyelid surgery can reach and what it costs, because a decision this personal deserves clear information rather than a pitch. That's the whole idea behind Palm Beach Cosmetic Surgery: confident, natural-looking results made reachable right here in Florida. Our West Palm Beach office is reachable at 561-499-9000 whenever you have a question.

Frequently asked questions

What does blepharoplasty do?

Blepharoplasty removes excess eyelid skin, muscle, and fat to reduce upper-lid hooding and lower-lid bags. The result is an eye area that reads as more rested and open. It doesn't correct crow's feet, dark circles, or a sagging eyebrow on its own.

Is blepharoplasty the same as an eye lift?

"Eye lift" is the everyday name for blepharoplasty, so in most conversations they mean the same thing. The term is looser than it sounds, though, and some people use it for ptosis repair or a brow lift instead. Those are different operations, and we refer ptosis repair to a dedicated oculoplastic surgeon.

What is the difference between upper and lower blepharoplasty?

Upper blepharoplasty treats excess skin, and sometimes muscle or fat, through an incision hidden in the upper-lid crease. Lower blepharoplasty treats bags and laxity beneath the eye, working either through the lash line or the inside of the lid. They address different anatomy, which is why many people have one and not the other.

Can blepharoplasty improve blocked peripheral vision?

Yes. When redundant upper-lid skin hangs low enough to obstruct the upper or outer edge of your field of view, removing it can reduce that obstruction. Surgeons document this with visual-field testing beforehand, which also matters if you're pursuing insurance coverage.

Is blepharoplasty performed under local or general anesthesia?

Most eyelid surgery can be done under local anesthesia, meaning you're numb but awake and comfortable throughout. The transconjunctival lower approach, where the incision goes inside the lid, generally requires twilight or general anesthesia.

How long does eyelid surgery take?

Total surgical time is usually about an hour, varying with whether one set of lids or both are treated. It's an outpatient procedure right in our office, so you go home the same day. We coordinate ahead of time so someone is available to drive you.

Is blepharoplasty painful?

Most patients describe soreness and pressure rather than real pain, and eyelid surgery is one of the more comfortable cosmetic procedures. Prescription pain medication is typically needed for only about three days. Cold compresses and head elevation do much of the work after that.

How long do swelling and bruising last after blepharoplasty?

Swelling and bruising ease substantially over roughly 10 to 14 days, which is when most people feel ready to be out again. Upper-lid bruising is usually minimal unless you take a blood thinner such as aspirin. Swelling rather than bruising is the main complaint, and it settles downward onto the lower eyelid even when only the upper lids were treated. Residual swelling keeps refining for several months afterward.

When can I return to work after eyelid surgery?

Most people return to work within one to two weeks, with desk jobs coming back sooner than public-facing ones. How much bruising you have is usually the deciding factor rather than how you feel. Strenuous activity, bending, and heavy lifting wait longer.

When can I wear contact lenses after blepharoplasty?

Plan on about two weeks without contact lenses, and the same goes for eye makeup. If your eyes still feel dry or irritated then, wait a little longer and check with your surgeon first.

How long do blepharoplasty results last?

Upper eyelid results commonly last five to seven years or considerably longer, and lower eyelid surgery rarely needs repeating. Your lids keep aging naturally, so the look evolves gradually rather than reverting. A stable weight helps preserve what you get, and so does limiting sun exposure and wearing a daily broad-spectrum sunscreen.

Will insurance cover blepharoplasty?

Cosmetic eyelid surgery is self-pay and isn't covered. Insurance may cover upper-lid surgery when documented visual-field testing shows redundant skin is meaningfully obstructing your sight, subject to your plan's criteria. For the cosmetic side, our office offers financing through Cherry, CareCredit, and Alphaeon Credit so the cost spreads across monthly payments.

*Disclaimer: The specialty recognition identified herein has been received from a private organization not affiliated with or recognized by the Florida Board of Medicine. Financing terms vary by credit approval. This content is for educational purposes only and does not constitute medical advice. A consultation with a qualified board-certified surgeon is required to determine the best treatment plan for your individual needs and any questions you may have about a medical condition or procedure.