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Eyelid and Brow Surgery

Eyelid Surgery (Blepharoplasty)

When we talk to each other, the most important social skill is eye contact. As we look at one another in conversation, the eyes and surrounding areas (brows and the upper and lower eyelids, also known as the lower “peri-orbital” region) are automatically perceived by the other person. Eyelid surgery is a procedure designed to achieve a more rested and youthful appearance around the eyes by removing excess skin causing eyelid hooding or “bags” that can contribute to a stressed, tired, or aged look. Follow the links below to learn more about the blepharoplasty procedure.

What is Blepharoplasty?

Eyes that look tired, or eyelids that appear droopy or puffy, often create the appearance of being tired or of an advanced age. To help combat this perception, a multimodal approach is used to accurately determine which treatment or procedure is best, either alone or in combination with other procedures. Blepharoplasty, commonly referred to as eyelid surgery, is designed to improve the appearance of aging eyes and/or drooping lids and correct the features contributing to such a look. In addition to its cosmetic benefits, blepharoplasty can also be performed for functional reasons—our Charleston plastic surgeons, Craig Rowin, MD and Ram Kalus, MD, offer eyelid surgery to rejuvenate the aesthetics of the eyes as well as restore the full field of vision for patients whose eyesight may be obstructed by sagging eyelid skin, particularly peripherally. To learn what you can achieve with blepharoplasty, take a look at our before-and-after photos.

Types of Eyelid Surgery

Over time, genetics, sun exposure, and the natural aging process can cause the skin around the eyes to lose elasticity and result in a sagging appearance. While these factors affect both eyelids in different ways, blepharoplasty is a personalized cosmetic surgery that can be performed on the upper and/or lower eyelids to achieve your aesthetic goals.

Upper Blepharoplasty

Upper blepharoplasty involves removing excess skin and possible fibers, as well as bulging fat deposits, tightening the skin and redundant tissue in the upper eyelids. Lax musculature can also be tightened to correct a condition known as upper eyelid “hooding,” wherein the upper eyelid begins to droop into an individual’s line of sight. The incision for upper blepharoplasty is typically placed along the natural fold of the eyelid for inconspicuous post-surgical scarring.

Lower Blepharoplasty

Below the eyes, the aging process often leads to dark circles as well as puffy or baggy eyelids. Lower eyelid surgery can address these concerns by tightening lax skin, excising redundant tissue, and recontouring fatty deposits under the eyes to improve the look of puffiness or “eye-bags.” This procedure utilizes an incision on the lower lash line, allowing for discreet and natural-looking improvement. If there is no need to remove extra skin and the primary concern is fat bulging or “bags,” this can sometimes be corrected through an internal incision without any need for an external scar. This procedure is referred to as a “trans-conjunctival” approach.

Who is a Good Candidate for Eyelid Surgery?

Candidates for eyelid surgery typically want to get rid of a tired, older appearance by removing excess skin or fatty deposits below the eyes, above the eyes, or both. Ideally, an eyelid surgery candidate will be in reasonably good health as blepharoplasty is a major surgery. Patients should also be realistic about their goals and expectations for the procedure. The best way for someone to determine if they are a suitable candidate for blepharoplasty is to schedule a consultation with one of our plastic surgeons.

How is the Eyelid Surgery Procedure Performed?

At the start of the upper blepharoplasty procedure, an incision is made along the natural eyelid crease. Our plastic surgeon then removes excess skin and possibly some muscle fibers, along with any excess or bulging fat. Similar techniques are used in lower blepharoplasty to eliminate puffiness or bagginess, with the incision made just below the lower lash line. Depending on whether you are undergoing upper or lower eyelid surgery respectively, or pursuing both procedures, blepharoplasty usually takes less than three hours at Roper Hospital-Mount Pleasant and is an outpatient procedure. We are also able to perform some upper blepharoplasty procedures right in our office. The results are long-lasting, but individuals are still susceptible to the natural effects of aging.


What is Recovery Like After Blepharoplasty?

We start all patients on Arnica Montana a few days before surgery to help reduce bruising and swelling. After surgery, patients are instructed to take it easy and focus on getting plenty of rest to help facilitate the recovery process. Depending on whether your surgery was combined with adjunctive procedures, the healing period associated with blepharoplasty is generally one week until sutures and Steristrips (tiny Band-aid type adhesives) can be removed. You may feel bruising, swelling, tightness, or tenderness for the first few days following surgery, but these sensations are normal and should subside as healing progresses. While complications after blepharoplasty are rare, adhering to our plastic surgeons’ post-operative instructions can help accelerate the recovery period and minimize the risk of adverse events arising. Once swelling has completely settled (two to three weeks) and a more stable outcome is realized, patients typically are delighted with their rejuvenated appearance and can appreciate a more youthful aesthetic in the upper face overall.

Will I Have Scars After Eyelid Surgery?

The possibility for scars after blepharoplasty does exist, but the chances of major scarring are minimal, especially in the hands of a qualified plastic surgeon. The incisions made in this procedure are usually placed in the crease (upper blepharoplasty) or under the lash line (lower blepharoplasty), leaving little opportunity for noticeable scars. In rare cases when scars are visible, they tend to fade within six months and become virtually undetectable.

How Long Do Eyelid Surgery Results Last?

The longevity of results will vary upon the extent of treatment and whether the procedure was performed on the upper or lower eyelids; however, eyelid surgery results are generally long-lasting. In fact, the results of lower eyelid surgery can typically last a lifetime. Because the forehead skin tends to sag as we age, upper blepharoplasty results may not always last quite as long, but this effect can be mitigated with a good skin care routine, non-surgical techniques, and/or brow lift surgery (see below to learn more about the forehead brow lift procedure).

Are There Non-Surgical Alternatives to Eyelid Surgery?

Some patients who are interested in reducing the appearance of fine wrinkles and lines around the eyes may be better suited for non-surgical injectable treatments like BOTOX® Cosmetic or Juvéderm® rather than eyelid surgery. In addition, other energy-based options exist, such as radiofrequency microneedling and lasers to help reduce periorbital wrinkling and achieve a smoother, more youthful appearance.

While these methods have proven effective for less severe cases, eyelid surgery is specifically designed to rejuvenate the skin and tissue around the eyes, making it the more appropriate choice for most. Additionally, since blepharoplasty is a more intensive procedure, it is typically able to treat larger amounts of skin and tissue, as well as produce results that last much longer. Furthermore, a non-surgical equivalent of blepharoplasty has yet to be developed.

How Much Does Eyelid Surgery Cost?

Like all cosmetic surgeries, the cost of blepharoplasty is calculated based on the overall complexity and length of the procedure. While the total price is generally affected by your geographic location as well as the expertise of your plastic surgeon, your cost estimate for eyelid surgery will ultimately be determined by:

  • Whether you are undergoing upper and/or lower blepharoplasty
  • Whether additional procedures are performed in conjunction with eyelid surgery

Although the overall expense of the procedure is unique to each individual, our practice understands that cost is a major consideration when researching treatment options. In addition to accepting an array of payment methods, we offer plastic surgery financing through CareCredit® to make it easier for patients to bring the cost of treatment into budget. This highly reputable healthcare lending company offers qualified applicants a range of flexible payment plans with low monthly installments to make surgery more affordable. If you have any other questions about the cost of blepharoplasty, or financing options, please don’t hesitate to reach out to us today.

Forehead Brow Lift

A descending forehead can create a worried and even angry look. With a few strategically placed incisions, the brow may be lifted to provide a more desirable appearance. To achieve even more dramatic results, this minimally invasive surgery is often performed in conjunction with blepharoplasty (eyelid surgery).

If you are interested in more information on blepharoplasty (eyelid surgery) or brow lift, contact us today.

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