Blepharoplasty (Eyelid Surgery)
The eyes are often the first feature people notice — and the first area where age becomes visible. Drooping upper eyelids, under-eye puffiness, and excess skin that creates a perpetually tired or heavy expression are among the most common concerns our patients describe. Blepharoplasty — eyelid surgery — corrects these changes with precise, targeted techniques that restore a refreshed, alert appearance without altering the natural character of your eyes. At Dehesa Dermatology, eyelid surgery is performed with an attention to detail that reflects just how much subtlety this procedure demands.
If heavy upper lids or persistent under-eye bags have been affecting how you look and feel, schedule a consultation to learn what eyelid surgery can offer you.
Upper Eyelid Surgery
Upper blepharoplasty removes excess skin, and sometimes a small amount of muscle or fat, from the upper eyelid. The result is a more open, refreshed eye appearance — and in cases where overhanging skin is obstructing the outer field of vision, a measurable improvement in functional sight as well.
The incision for upper blepharoplasty is placed precisely within the natural crease of the upper eyelid, where it heals to a nearly invisible line. The procedure typically takes 45 to 60 minutes under local anesthesia with sedation and is one of the most straightforward outpatient surgeries we perform. Recovery is relatively quick, with most patients resuming normal activities within one to two weeks.
When upper eyelid heaviness is caused partly by a descended brow rather than excess eyelid skin alone, your surgeon may recommend combining upper blepharoplasty with a brow lift to address both contributing factors and achieve the most complete result.
Lower Eyelid Surgery
Lower blepharoplasty addresses the under-eye area — targeting puffiness caused by herniated fat pockets, loose or crepey skin, fine wrinkles, and the hollowing that can create persistent dark shadows beneath the eyes. The specific technique used depends on your anatomy and the nature of your concerns.
Transconjunctival Blepharoplasty
For patients whose primary concern is under-eye puffiness without significant excess skin, a transconjunctival approach places the incision entirely inside the lower eyelid — leaving no visible scar on the outside of the eye. This technique is ideal for younger patients or those with good lower eyelid skin quality who need fat repositioning or removal without skin excision.
External Lower Blepharoplasty
When excess or lax lower eyelid skin is a significant component of the concern, an external incision just below the lash line allows the surgeon to address both the fat compartments and the overlying skin. The resulting scar sits naturally in the shadow of the lower lashes and becomes imperceptible with healing.
Combining Blepharoplasty with Other Procedures
Eyelid surgery pairs naturally with a range of complementary procedures that address related concerns in the same surgical session. Upper and lower blepharoplasty are commonly performed together. Many patients also combine eyelid surgery with a brow lift to fully address upper facial aging, or with a facelift for a comprehensive facial rejuvenation. For skin texture and pigmentation concerns around the eyes, laser resurfacing can be performed at the same time to maximize overall improvement. Your surgeon will review all relevant options during your consultation so you can make an informed decision about your treatment plan.
Functional Blepharoplasty and Insurance
When drooping upper eyelid skin is severe enough to obstruct vision — a condition called dermatochalasis — upper blepharoplasty may qualify as a medically necessary functional procedure and may be covered in part by insurance. Documentation typically requires a visual field test performed by an ophthalmologist demonstrating functional impairment. Our team can guide you through this process and help determine whether functional coverage applies to your situation prior to scheduling surgery.
Frequently Asked Questions About Blepharoplasty
How long does blepharoplasty recovery take?
Most patients experience swelling, bruising, and some tightness in the first week following surgery. The majority of visible bruising resolves within ten to fourteen days, and most patients feel comfortable returning to work and social activities within one to two weeks. Residual swelling continues to settle over the following four to six weeks, and final results are visible by the six-week mark for most patients.
Will blepharoplasty leave visible scars?
For upper blepharoplasty, the incision is placed within the natural crease of the upper eyelid, where it heals to a fine, barely visible line that is completely concealed when the eyes are open. For lower blepharoplasty, external incisions are placed just beneath the lash line where they become imperceptible with proper healing. The transconjunctival approach leaves no external scar at all. Scar visibility also depends significantly on genetics, skin type, and adherence to post-operative care instructions.
Will my results look natural?
Yes — the goal of blepharoplasty is to restore a rested, refreshed appearance while preserving everything that makes your eyes look like yours. Over-resection of upper eyelid tissue or fat is a common cause of an operated or hollow appearance, which is why conservative, anatomy-respecting technique is essential. Your surgeon at Dehesa Dermatology will discuss exactly how much tissue removal is appropriate for your anatomy and will prioritize results that look natural rather than surgical.
Is blepharoplasty performed under general anesthesia?
Eyelid surgery is most commonly performed under local anesthesia combined with oral or IV sedation, making it one of the more comfortable and accessible outpatient procedures we offer. General anesthesia is used when blepharoplasty is combined with a facelift or other more extensive procedure during the same surgical session. Your anesthesia plan will be determined based on your overall procedure plan and personal health history.
How long do the results of blepharoplasty last?
Upper blepharoplasty results typically last ten years or longer before any recurrence of excess skin becomes noticeable — and some patients never feel the need for a repeat procedure. Lower blepharoplasty results for fat repositioning are generally long-lasting. The aging process continues after surgery, so skin quality, laxity, and volume changes will evolve over time — but you will always look more refreshed than you would have without the procedure.
Can blepharoplasty fix dark circles under my eyes?
It depends on the cause. Dark circles created by shadowing from under-eye puffiness or hollowing are significantly improved by lower blepharoplasty, which addresses the structural cause of that shadow. However, dark circles caused by pigmentation in the skin itself or thin, translucent skin that reveals underlying vessels are not corrected by surgery and are better addressed with skincare, laser treatments, or injectable fillers. Your surgeon will help identify the primary cause of your under-eye concerns during your consultation.
What is the difference between a brow lift and blepharoplasty?
Blepharoplasty removes excess eyelid tissue and fat — it does not move the brow. A brow lift elevates the position of the brow itself, which can reduce hooding of the upper eyelid when brow descent is a contributing factor. In many patients, both the brow and the upper eyelid are involved in creating a heavy or tired appearance, and combining both procedures produces the most complete result. Your surgeon will assess where your heaviness originates and advise accordingly.