What is blepharoplasty and why is it done?

Blepharoplasty, also called eyelid surgery, is a kind of cosmetic surgery that aims to remove extra skin around the eyes and repair droopy eyelids. Why do our eyes drop after a while? Because as time goes on and we get older the muscles around our eyes that are in charge of supporting eyes get weaker. It causes that excess fat to collect up and down eyes and leads to the eyebrow to sag and drop. So, we see bags under the bags.  

Sagging skin around the eyes not only makes you look older but also can reduce side vision especially in upper and outer parts. So, blepharoplasty can help to reduce these problems. 

Sometimes the sagging and drooping of eyes are so serious that may prevent individuals from opening their eyes completely. In this case, blepharoplasty comes to help by removing the excess tissue. However, it is not the only reason for getting this surgery. Actually, blepharoplasty makes you younger and you see more alert since it repairs bags, drops and sagging skin. 

What is blepharoplasty and why is it done

Iran – Theran , Lavasani ST , IN front of shahid aghaei ST , Nami Building, NO 118 , Unit 7


How you prepare for blepharoplasty

First, you need to visit an ophthalmologist and then a plastic surgeon. The surgeon will talk to you about :

You will be asked some questions about previous surgeries, present conditions, and general body health. Also, you will be questioned about dry eyes, eye allergies, circulatory problems, diabetes, thyroid, etc. what you take such as special medication, supplements, alcohol, drugs, and tobacco. 

A talented and committed surgeon definitely will ask you about your motivation for getting blepharoplasty to know that will it really work for you, if not he/she will recommend you stop thinking about it. 

After consultation with the surgeon you will undergo:

A blepharoplasty examination includes a tear production test, and eyelid parts measuring.

A vision examination

Photography from different parts of the body will be taken. They will help to plan surgery by assessing long term and immediate effects.

These were the surgeon’s pre-surgery stuff. How about you? You will be asked to:

  • Stop taking warfarin, naproxen, naproxen sodium, and ibuprofen since they increase bleeding. Some other medications and herbal supplements that can increase bleeding need to be stopped. You should take only those medicines that your surgeon approves.
  • Smoking is forbidden! You should quit it at least 3 months before blepharoplasty
  • And, plant for someone to drive you home and stay with you for the first night after the surgery.
How you prepare for blepharoplasty

How is blepharoplasty done?

If the surgeon does the procedure for both upper and lower eyelids, it usually takes about 2 hours. He/she injects a painkiller around the patient’s eyes to use local anesthesia and you are given oral sedation. 

In the case of all four eyelids, the surgeons usually do the procedure on the upper lids first. 

Anyway, in the first step, the surgeon cuts along the natural lines of the eyelids. Then, he separates the skin from the beneath through the cuts and removes the excess fat and skin. Now it turns that the surgeon closes the cuts. She /he does it with very small stitches. If there are stitches on the upper lids, they will stay for 3 to 6 days. 


The lower lids may not need the stitches. It depends on the technique. The surgery on these eyelids is possible to be done by several techniques. One technique is that the surgeon makes a cut inside the lower eyelids to remove the excess fat. That cut is so small that you won’t see it. Then he/she will soften fine skin lines. He/she uses C02 or erbium laser to do that.

Another technique for blepharoplasty is that the surgeon makes a cut long margin of the eyelash. Then, he/she removes the excess skin, fat and slack muscle. The cut line won’t stay. It will fade in a short time.

If the surgeon does double eyelid surgery, he/she makes a crease in the upper eyelid to create wider and larger looking. This procedure is more popular in East Asia.

Some people have darker skin tones and external incisions usually leave a visible scar. A transconjunctival method that is a recent technological advancement is used typically for these people and is accepted norm. In this blepharoplasty method the surgeon cuts and removes lower eyelid adipose tissue in a way that no visible scar is left, but he/she does not remove excess eyelid skin. 

 Regardless of any technique, the last step may be the recommendation of laser resurfacing by the surgeon. 

Blepharoplasty Recovery

Blepharoplasty Recovery

Compared with other cosmetic surgeries eyelid lift has a short recovery. The staff will take you to the recovery room right after the surgery and will monitor you for side effects. If there is not any complication, you will go there on the same day.

At home, you should rest for a few days. You will experience some pain and swelling, but your doctors already recommend you how to manage them with some medications such as ibuprofen.

Some short time side effects after this surgery are blurry vision and sensitivity. They normally last for 2days, but if it takes more than that call your doctor.

You can’t wear contact lenses for 2 weeks after blepharoplasty. Make sure that you have an alternative such as prescription glasses.

Some candidates think that they need to cover during recovery time, but it is not necessary. However, the first day your surgeon will put gauze on your eyes to protect the concerned area.

Keep in mind:

  • Avoid strenuous activities and exercises
  • If you have nausea let your doctor know that.
  • Avoid sneezing, vomiting, and coughing as much as possible. They raise blood pressure and lead to bleeding in the surgical area.
  • Do not blend at the waist.
  • Do not lift items heavier than 2.3 kilograms 2 weeks after blepharoplasty.
  • Rest and sleep with your head raised. Your pillows should be 2 or three for 2 weeks. 
  • You may feel eyes swollen and bruised after eyelid surgery especially in the early morning, but it will get better after 2 or 3 weeks. 
  • If you want to take a shower after blepharoplasty you must keep your neck down and you cannot take a full shower before your surgeon’s permission. You need to wash below the eyes gently with wipes.

You should wash the areas gently and keep them clean all the time. After a few days, you will visit the surgeon to remove the necessary stitches. 

Who is a good candidate for eyelid surgery?

People who want anti-aging treatments look for blepharoplasty. Skin sagging naturally happens as part of aging. But, some people find it bothersome. Bags under the eyes are another reason for candidacy. 

However, this surgery is not done just for cosmetic reasons. Some people get a candidate for blepharoplasty because they have vision problems, especially when looking upwards due to sagging skin.

Regardless of any reason, a good candidate for getting blepharoplasty are those who do not smoke. Also, they are in good general health and do not suffer from chronic illnesses that may interfere with recovery and the procedure. 

The last important thing is that a good candidate for blepharoplasty is the one that has realistic expectations. As an example, you can’t expect it to change your eyebrows look. That’s why it is usually done in conjunction with other cosmetic surgeries such as eyebrow lifts. 

Blepharoplasty possible side effects and risks

An eyelid lift is a type of surgery and is not excluded from some side effects that accompany the different types of surgeries. Like with other types of cosmetic surgeries, keep in mind that, it takes almost a year post-surgery to blepharoplasty reveals its full benefit.

Other side effects include:

  • Bruising
  • Scarring
  • Swelling
  • Double vision
  • Eye itching
  • Inability to close the eyes
  • Damage from excessive sun exposure
  • Muscle damage

Generally, if this surgery is done with safe hands, it is a safe surgery.

Blepharoplasty pros and cons

  • This surgery wipes out puffs around the eyes and reduces eye bags. It also removes all fine lines that usually generate around the outer edges of the eyes. It reduces hooded skin around the upper eyelid. 
  • Blepharoplasty makes your eyes seem younger and your face refreshed and healthier.
  • It repairs some vision problems and improves peripheral vision since it removes the fat that blocks the eye. It changes the drooping eyelid that expands the sightline.
  • The scars due to the blepharoplasty hide in the eyelid creases, so they are unnoticeable. 
  • It eases tension in bro muscles and provides comfort to the forehead. 
  • It takes time for the surgery to show the results.
  • It will lead to some side effects such as bruising and swelling and you may see some asymmetry in the eyes.
  • You will experience itching and dryness after blepharoplasty. But, you can cure them with some medications and drops.
  • Tiny whiteheads are other side effects that can be removed with fine needles.  

What are the alternatives to blepharoplasty?

If you do not want to go under the blepharoplasty knife to correct baggy and saggy skin that surrounded your eyes, there are some other alterations, too.

  • Laser skin resurfacing

This method involves the use of laser treatment and stimulates collagen production. Laser skin resurfacing reverse sun damage and problems caused by age around the eyes. Though this method is less intrusive, it is more time taking. The results may not be as dramatic as eyelid surgery.

  • Thermage

This method is almost a new one. In this method, the radiofrequency waves are transmitted onto the skin. These waves smoothen out wrinkles and creases and tighten the skin. Thermage needs minimal downtime. The results do not last for a long time and are not so dramatic.

  • Fillers

Botox and dermal fillers can be injected to treat drooping and sagging around the eyes. It helps to pull up the skin and produce a more youthful look. But, the results are temporary and need repetition. Also, it does not work for deep depression.

Dr. Salahi performs hundreds of abdominal and thoracic surgeries, abdominal lipatomics, lipomatic abdominal surgery, thighs and arms, breast prosthesis and minimally invasive surgeries and is one of the top-ranked doctors in Tehran in cosmetic surgery. They specialize in cosmetic surgery.


Blepharoplasty costs

Cost is one of the crucial factors for blepharoplasty candidates to decide on getting eyelid surgery. Though the cost of this surgery varies according to the type of technique etc., in general, it is not as expensive as other types of cosmetic surgeries and it is relatively low.

The average cost for a blepharoplasty is between 2000 dollars to 7000 dollars. The lower eyelid surgery costs almost 2.400 and upper costs around 2100 dollars. In fact, lower eyelid surgery has a higher price than the upper. These fees were declared by ASPS in 2004 and normally it will be higher now. 

Additional costs include:

  • Anesthesia: between 400 to 600 dollars
  • Surgical suit fee: usually about 500 to 800 dollars
Blepharoplasty costs

Iran – Theran , Lavasani ST , IN front of shahid aghaei ST , Nami Building, NO 118 , Unit 7


Who is a qualified blepharoplasty surgeon?

Finding a qualified surgeon for this procedure is of great importance since eyes are the most delicate parts of the body and have an extremely complicated structure. 

To find a good surgeon, you need to know the difference between an ophthalmic plastic surgeon and cosmetic eyelid surgeons. The first one is a specialist in ophthalmology that took training in plastic surgery performance. The training courses are related to the eyes and their structures.

He/she is board certified by the ABO and undergoes rigorous training facial plastic surgery specialty which involves the eye specifically. Since he/she has taken special training in both blepharoplasty and ophthalmology then he/ she can be a qualified ideal surgeon for this procedure. 

However, despite your expectation, cosmetic plastic eyelid surgeon has not taken any ophthalmic knowledge and is not board certified by ABO. Though he/she has trained as a medical doctor may not have the additional ophthalmic knowledge and can’t be an ideal choice. 

Last but not least importantly, a good blepharoplasty surgeon is a committed one that you feel comfortable with. 

Blepharoplasty frequently asked questions

In general, the ideal age for this surgery is upper 35, but if you think that your eyes’ getting saggy or droopy run in your family, you can get it sooner. 

When the eyes are swollen or bruised the scars are apparent. This happens in the first days after the surgery. Then they start to heal and finally the scars become invisible. 

How you care about your eyes after the surgery also highly determines the visibility and permanency of the scars. So, you need to take adequate and qualified care in the post-surgery phase. 

As mentioned earlier, eyes are very fragile and sensitive organs and the blepharoplasty exposes some risks. Its safety first depends on surgeon expertise. Then, the hospital operational facilities and the skills of anesthesia have a special role. If the hospital is accredited, the surgery will have the highest safety standards. 

If you plan to choose a hospital abroad, you need to check its accreditation status, first. It ensures that in case anything goes wrong, you will get key life support in the operating room. That hospital will have qualified medical staff, too. All these factors will result in safe surgery and reduce the probability of risks and complications to the minimal. 

Some patients may have a much descended eyebrow. They will need to get a brow lift procedure to raise the brows before getting eyelid surgery. 

Some patients have puffy lower eyelids because of allergies. These patients cannot benefit from eyelid surgery.

The only painful thing that you may experience after this surgery is mild soreness. But, it can easily be reduced with medications. In general, there is not much discomfort with this surgery. 

  • Those people that their facial skin and eyelids are tight
  • Those who are under 18
  • Those who have a tendency to leave a scar after injury
  • Those who have other eye problems. Cataracts are one of them.

The first 3 or 4 days after the surgery you need to take small bites and eat soft foods. Yogurt, soft cheeses, soft bread, well-cooked vegetables, and tender meat can be your options. 

People who have saggy and droopy eyes skin look for blepharoplasty. Also, it is an option for those who suffer from some vision problems. 

blepharoplasty removes excess skin, fat, and muscles from the eyelids. It can be done only on upper eyelids, lower eyelids or both of them depending on the problem. 

Blepharoplasty is almost a safe surgery if it is done in safe hands. It is not as expensive as other cosmetic surgeries. 

Though it is not risky surgery blepharoplasty is capable of some side effects and complications. So, you need to consult with a qualified and committed surgeon before deciding on it. 

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