Blepharoplasty

Blepharoplasty

Blepharoplasty

Blepharoplasty, also known as eyelid surgery, is one of the most advanced techniques in plastic surgery, offering the opportunity to refresh and rejuvenate the eye area. By removing excess skin, reshaping the structures of the eyelids, and redistributing fatty tissue, blepharoplasty restores a youthful and revitalized appearance to one of the most critical areas of the face.

Eyelid Changes Due to Aging

As aging progresses, the skin of the eyelids becomes weaker and loses its natural elasticity. The muscles around the eyelids lose their tone, while fatty tissue may protrude, creating “bags.” These changes, combined with natural phenomena such as eyebrow ptosis and impaired fluid circulation, can create a tired and aging appearance. Usually, this is manifested by noticeable lines, wrinkles, and puffy eyelids, making the face appear older. Plastic surgeons use blepharoplasty to address these concerns, helping patients regain a natural, refreshed, and revitalized look.

Upper Blepharoplasty

Upper blepharoplasty addresses excess skin of the upper eyelids and fatty tissue, and may also involve lifting the lacrimal gland when it has descended. The incision is meticulously placed within the natural crease of the upper eyelid, allowing access for removing excess skin and redistributing fatty tissue, as well as suspending the lacrimal gland if necessary. After healing, the scar is located within the natural crease and is practically invisible.

Lower Blepharoplasty

Lower blepharoplasty involves removing excess skin from the lower eyelids, addressing excess fatty tissue and the depression under the eye (tear trough). Additionally, this procedure may be combined with canthoplasty or canthopexy to support the lower eyelids. The surgery is performed through a hidden incision from the inside of the lower eyelid (transconjunctival), allowing access for removing excess fatty tissue. An external incision can be made just below the lash line for redistributing fatty tissue, removing excess skin, and supporting the lower eyelid. The procedure can also be combined with other facial surgeries, such as facelifts, brow lifts, or other treatments like liposuction of the neck or facial volume restoration with fat transfer.

Ideal Candidates

Ideal candidates for blepharoplasty are those who have changes in the eyelids that negatively affect their appearance or cause functional issues. These candidates typically include:

  • Individuals with visible signs of aging, including lines, wrinkles, and sagging skin on the eyelids due to aging.
  • Individuals with excess skin in the upper eyelids, causing visual impairment.
  • Individuals with under-eye bags due to protruding or excess fatty tissue, creating a tired or aged look.

Preoperative Instructions

Preparation before blepharoplasty includes an important step — the preoperative consultation. During this session, the surgeon will thoroughly evaluate your eyelids, assessing changes caused by aging and other factors. The consultation includes:

  • Assessing the condition of the eyelids, including wrinkles, sagging skin, fatty tissue, and overall state.
  • Listening to the patient’s expectations and concerns about the outcome of the procedure.
  • Detailed explanation of the procedure, including the steps, methods, and applicable techniques for your case.
  • Instructions for preoperative preparation, including recommendations about quitting smoking and medication restrictions:
    • Quit smoking ideally 6 weeks before and 2 weeks after surgery.
    • Avoid sun exposure, as it can affect scar quality and healing.
    • Postpone surgery if experiencing a cold or infection, in consultation with the surgeon and anesthetist.
    • Refrain from aspirin and anti-inflammatory medications, as they can increase bleeding and bruising risk.

Use this consultation to ask any questions about the procedure, recovery, and expected results. The preoperative consultation ensures you are well-informed and feel secure about the surgery and its outcomes.

Summary of the Procedure

After arriving at the hospital, checking in, and putting on surgical attire, you will be taken to the operating room. The surgeon will use local or general anesthesia as required. The procedure involves making precise incisions to remove or redistribute skin and fatty tissue. Specific techniques vary for upper and lower eyelids, with special consideration for patient needs (including canthoplasty or canthopexy for additional support).

Postoperative Care and Recovery

  • After the procedure, you will be monitored in the recovery area until fully alert and stable, then transferred to a patient room. Discharge occurs once recovery is satisfactory, with instructions for at-home care and follow-up appointments.
  • Postoperative discomfort is minimal and manageable with pain medications and anti-inflammatory treatments for the first 24 hours. Eye drops help prevent dryness, and cold compresses reduce swelling and bruising, which typically resolve within 7–15 days, depending on individual healing characteristics. Stitches are removed after approximately 5 days. Final results are generally evident within 1–2 months as swelling fully resolves and incisions fade. Patients are encouraged to gradually return to regular activities, avoiding bending, lifting, or vigorous exercise in the first week. Makeup is discouraged for five days, and sun protection is essential.

Potential Complications

While complications from blepharoplasty are rare, patients must be aware of their possibility. These may include:

  • Ectropion (outward turning of the eyelid)
  • Inflammation or infection
  • Asymmetry
  • Scarring (varies by patient)
  • Wound dehiscence
  • Injury to the eye
  • Anesthetic complications

Conclusion

In today’s era, the plastic surgeon is the ideal beauty consultant for both women and men seeking to maintain or enhance a youthful, attractive appearance. Do not hesitate to contact Plastic, Reconstructive, and Aesthetic Surgeon Mr. Daskalakis for any questions about blepharoplasty or any other plastic surgery concerns you may have.

References

Hollander MHJ, et al. Functional outcomes of upper eyelid blepharoplasty: systematic review (2019)  https://pubmed.ncbi.nlm.nih.gov/30528286/

Vasović DD, et al. Comprehensive Evaluation of Quality of Life following Upper Eyelid Blepharoplasty: A Prospective Analysis (Medicina, 2024) https://www.mdpi.com/1648-9144/60/3/500?

Viscardi JA, et al. Upper blepharoplasty is the gold standard procedure to treat dermatochalasis… (2025). https://link.springer.com/article/10.1007/s00266-025-04657-7?