Frequently Asked Questions
What is the difference between upper eyelid blepharoplasty and lower eyelid blepharoplasty?
Upper blepharoplasty addresses excess skin (dermatochalasis), redundant orbicularis muscle, and prolapsed orbital fat that causes hooding or heaviness of the upper lid, making the eyes appear tired or small. The incision is hidden within the natural upper lid crease. Lower blepharoplasty corrects under-eye bags (fat herniation), excess skin wrinkling, and tear-trough hollowing below the eyes. It can be performed via a transconjunctival approach (inside the lid, zero external scar) for fat-only correction, or a subciliary approach (along the lash line) when skin excision is also required. Many patients benefit from both procedures simultaneously.
Can blepharoplasty improve my peripheral vision as well as appearance?
Yes. When significant upper eyelid skin droops and obstructs the superior visual field, the procedure is classified as functional (medically indicated) blepharoplasty. A formal visual field test (Humphrey perimetry) is performed preoperatively to document the degree of visual obstruction. After removing the excess skin and muscle, patients report dramatic improvements in their upward and lateral visual fields, reduced eyebrow-lifting fatigue, and fewer tension headaches from chronically straining brow muscles. In many countries, functional blepharoplasty with documented visual field impairment qualifies for insurance or medical reimbursement.
How is upper lid surgery different from a ptosis repair (drooping eyelid correction)?
Blepharoplasty removes excess skin and orbital fat but does not address the levator palpebrae superioris muscle — the specialized muscle responsible for lifting the eyelid margin itself. Ptosis (blepharoptosis) is a drooping of the lid margin caused by levator muscle weakness or dehiscence, and requires a separate internal or external levator advancement to re-elevate the lid margin. Many patients present with combined ptosis and dermatochalasis; your surgeon will assess both simultaneously and address each component with the appropriate technique for an optimally opened, symmetrical eye.
Where are the incisions placed, and will scars be visible?
For upper blepharoplasty, the incision is placed precisely within the existing natural upper lid crease — typically 7 to 10 mm above the lash line. When the eye is open, the incision is completely hidden within the fold; when closed, it blends invisibly into the natural crease shadow. For lower blepharoplasty via subciliary approach, the incision runs 1 to 2 mm below the lower lash line, and the resulting fine scar typically becomes imperceptible within 3 to 6 months. Transconjunctival lower blepharoplasty leaves absolutely no external scar.
How long will my eyes be swollen after eyelid surgery, and when can I return to work?
Bruising (periorbital ecchymosis) and swelling peak on days 2 to 3, then steadily subside. Most patients are comfortable returning to desk-based office work wearing sunglasses at 7 to 10 days, once sutures are removed. Social activities become comfortable around 10 to 14 days. Residual subtle firmness or pinkness along the incision continues to refine over 8 to 12 weeks. Cold compresses, head elevation at 30–45 degrees, and arnica supplementation significantly accelerate the visible healing timeline.
Will blepharoplasty cause dry eye syndrome, and how is it prevented?
Aggressive resection of the anterior lamella (skin and muscle) or orbital fat can reduce tear film stability and transiently reduce blink reflex, causing dry eye symptoms in the early post-operative weeks. Conservative tissue excision — adhering strictly to the principle of "remove the minimum needed" — is the key preventive measure. A pre-operative Schirmer's tear test and dry eye history are obtained from all patients; those with pre-existing lacrimal dysfunction are counselled appropriately. Preservative-free lubricating eye drops are prescribed for 4 to 6 weeks, and complete resolution of transient dry eye is seen in the vast majority of patients.
When can I wear contact lenses and eye makeup after eyelid surgery?
Contact lenses must be avoided for the first 2 weeks after surgery, as inserting and removing lenses can stretch the delicate healing incision line and introduce bacteria near the surgical site. Eye makeup (mascara, eyeliner, eyeshadow) should be avoided until all sutures are removed and the incision is fully sealed — typically 10 to 14 days. Once cleared, apply and remove makeup with extreme gentleness, avoiding vigorous rubbing, for at least 6 additional weeks while the scar matures and full collagen remodeling occurs.
