Eyelid surgery (Blepharoplasty)

What is Eyelid surgery?

An Eyelid lift, or Blepharoplasty surgery, removes excess skin from the upper and/or lower eyelids, giving you a more refreshed, rested, and youthful look.

While Eyelid lifts are one of the most popular procedures, it is important to remember that your eyelids are part of your overall facial anatomy and, as such, a good Eye lift surgeon will be helping you determine which procedure (or procedures) will help you best address your specific concerns.

What problems does an Eyelid surgery address?

I have extra skin on my upper eyelids. -a Baltimore patient

Patients who request an eyelid lift often present the following symptoms:

• crowded (hooded) eyes
• outer corner of eye is lower than inner corner
• sagging upper eyelid (ptosis)
• drooping lower eyelids
• bags under the eyes

The Eyelid procedure is requested by not only aging patient, but also patients who are in their twenties. Many of these patients have the outer corner of the eye situated at a level below that of the inner corner. Some describe this as a puppy dog look. They often request an almond shaped eye. Others (often of Asian heritage) request a widening of the eye. In the mid to late thirties the skin on the eyelids relaxes and becomes thinner. The cheek and the eyebrow also descend, giving a crowded look to the eyes. As these parts of the face descend, they tend to pull the outer corner of the eye down.

How is Eyelid surgery performed?

The eyelid procedure can be performed under local sedation as well as under IV sedation.

Type of anesthesia

• local anesthesia in the office
• IV sedation or General anesthesia

If you elect to have the procedure under local anesthesia, I will ensure that the area is numbed enough so that you do not feel anything. This local experience is comparable to having a dental procedure. If you prefer to be asleep, I use IV sedation, a milder form of anesthesia compared to General anesthesia.

Surgical technique

Surgical technique is typically as follows:

1) Upper eyelid surgery

During eyelid surgery, the upper lid is corrected through an incision made in the natural crease to remove excess skin, reposition fat, and tighten muscle.

2) Lower eyelid surgery

The lower eyelid incision is generally made just below the lower lash line.

Alternative treatment: Brow lift instead of an Upper eyelid lift

Often times I prefer to treat sagging upper eyelids with a Brow lift since drooping eyelids are usually a result of a sagging brow. Lifting the brow is often the most natural way to bring the eyebrows and lids back to where they were in their youthful state. You can get some idea if you might benefit from a brow lift by looking in the mirror and raising your upper brow 1/2 inch on each top side. To read more about my thoughts on why some patients benefit more from a brow lift than an eyelid lift, please read this blog post.

Can I get a Brow lift AND an Upper eyelid lift?

If there is excessive eyelid skin, you may need both procedures. However, I prefer to perform the Brow lift first, as more than 90% of the time, this procedure is effective in lifting the upper eyelids to a youthful position. I typically only perform the Upper eyelid lift if the Brow lift does not completely correct the ptosis of the upper lids.

What are the preoperative requirements?

Pre-op requirements depend on the type of anesthesia you choose during your eyelid consultation. During your consult discuss if the Brow lift is an alternative treatment to the Upper eyelid surgery. Get more than one opinion if the answer is not clear to you. General pre-op instructions are:

• Eyelid procedures performed under local anesthesia do not require pre-operative clearance. You may also eat a light breakfast before your surgery.
• Patients with procedures under IV sedation (or General anesthesia) are required to get a medical clearance 30 days prior to surgery. This includes a History and Physical (H&P), as well as a CBC blood test.
• Quit smoking 3-4 weeks prior to surgery
• Stop taking multivitamins, herbals, and aspirin two weeks prior to surgery
• Schedule a pre-op appointment with your surgeon to review the surgical plan and discuss risks associated with the procedure. The Informed Consent document should also be discussed at this appointment.
• If your procedure is under IV anesthesia (or General Anesthesia) you should not drink or eat anything (NPO) after midnight prior to surgery.

What is posterior Eyelid surgery recovery like?

• use a cold compress to reduce swelling the first few days
• no driving for 3-4 days
• out of work for at least 7 days
• sleep with your head elevated for the first week
• Expect to have bruising for the first 10 days. Many people wear sunglasses during this period if you must go out in public.
• You may have residual swelling for up to 4 months.

What are the risks and possible complications?

As with any surgery, there are risks and complications that can arise following an Eyelid lift. Possible concerns include:

• swelling and bruising
• dry eyes
• infection
• unfavorable scarring
• sensitivity to light
• difficulty shutting the upper eyelids completely

How much does an Eyelid lift procedure cost?

The Upper Eyelid lift procedure is less expensive if performed under local anesthesia because there are no hospital or anesthesia fees. Having local anesthesia is comparable to having a dental procedure. If performed under local anesthesia, the upper eye lift procedure is $2,300. If the procedure is performed under IV sedation in the main operating room, the total cost is approximately $3,200. Total cost includes surgeon's fee, operating room fee, and anesthesia fees. All post op office visits are also included in the total cost.

Eyelid Surgery Options	2022 Price
Upper eyelid surgery under local anesthesia	$2,300
Upper eyelid surgery under iv sedation	$3,200

Can I finance my Eyelid surgery?

Yes, we work with a number of finance companies so that you can have a low, affordable, monthly payment. Please call our office at 410-494-8100 or see our financing section for more information.

Modified on 07-31-2022 | by Dr. Ricardo L. Rodriguez
Board Certified Plastic Surgery, ASPS Member