Am I a Candidate for Upper or Lower Eyelid Surgery?

Deciding whether eyelid surgery is right for you starts with your anatomy, symptoms and goals. This guide explains candidacy, alternatives and questions to discuss at consultation. For Dr. Smith’s procedure details, current recovery instructions and all-inclusive fee ranges, see eyelid surgery in NYC.

How does eyelid lift surgery work?

Eyelid lift surgery, also known as blepharoplasty, is a cosmetic procedure that rejuvenates the appearance of the upper and/or lower eyelids by removing or repositioning excess or drooping skin, fat, and muscle. The surgery can effectively address issues such as drooping eyelids, puffiness, and wrinkles, resulting in a more youthful and refreshed appearance. The procedure can be done on the upper eyelids, lower eyelids, or both.

The process begins by meeting with Dr. Darren Smith to discuss your specific concerns, desired outcomes, and any potential risks or complications. Having advanced fellowship training in aesthetic surgery and craniofacial surgery, Dr. Smith has deep experience with eyelid lift surgery. On the day of the surgery, you will be given either local or general anesthesia to ensure comfort and safety throughout the procedure.

Depending on the targeted area (upper or lower eyelids), the surgeon will make carefully placed incisions. For upper eyelid surgery, the incision is typically made within the natural crease of the eyelid, making it less visible. In the case of lower eyelid surgery, the incision is usually made just below the lash line or on the inside of the eyelid, which also helps to minimize visible scarring. Dr. Smith then removes or repositions excess skin, fat, and muscle to achieve the desired eyelid contour. In some cases, the surgeon may also tighten the surrounding muscles and tissues to provide additional support and enhance the overall outcome. The incisions are then closed with fine sutures (or often left to heal on their own if inside the eyelid).

How painful is eyelid lift surgery?

Dr. Smith plans anesthesia and postoperative care around the procedure. After upper blepharoplasty, the fine surface sutures and Steri-Strips can feel itchy or irritating until they are removed at the day-five visit. Lower blepharoplasty through an incision inside the eyelid generally involves no external stitches to tend to or remove.

Mild irritation can occur during recovery; severe or increasing pain is not expected. Severe or increasing eye pain, sudden or worsening vision changes, rapidly increasing swelling or a bulging eye need immediate assessment. Call the practice immediately at 212.633.0627. If your vision changes or you cannot reach the team promptly, go directly to the nearest emergency department. Do not wait for your scheduled follow-up or a return call.

How should I plan recovery after upper or lower eyelid surgery?

Dr. Smith sees patients on day five after upper or lower blepharoplasty; after upper eyelid surgery, he removes the Steri-Strips and surface sutures at that visit. Most patients look presentable enough for office work at about one week. Light exercise can resume at two weeks, with non-contact exercise from four weeks and contact sports at six weeks, subject to clearance. Swelling and bruising vary and can be more noticeable when upper and lower surgery are combined. Use the Recovery Planner for the current activity schedule.

You can shower from the neck down immediately and get your face wet after 48 hours. Follow your individualized instructions and review the upper and lower eyelid recovery guidance when planning time away from work and activities.

Is eyelid lift surgery worth it?

Whether or not eyelid lift surgery is worth it depends on various factors, including your concerns, expectations, and overall health. While this is ultimately a personal decision, we can consider the benefits, potential risks, and alternatives to help you make the decision.

Some benefits of eyelid lift surgery include improved appearance, better vision, and long-term results compared to alternatives. These procedures can correct drooping or puffy eyelids giving the eyes a more youthful and refreshed appearance, enhancing self-confidence and overall satisfaction with one's appearance. Excessive eyelid skin or muscle laxity can obstruct vision. By removing the excess skin and tightening the muscle as necessary, a blepharoplasty can improve vision for those who experience this issue. Results can be long-lasting, but a fixed number of years cannot be promised for every patient. ASPS results guidance explains that natural aging continues and an additional operation may sometimes be needed. Discuss the likely durability and limits of your planned procedure with your surgeon.

Eyelid surgery has risks, and their likelihood depends on the procedure and patient. Swelling and bruising can occur during healing. Possible complications include infection, unfavorable scarring, asymmetry, dry eyes, difficulty closing the eyes, lower-eyelid malposition, or persistent pain. ASPS safety guidance also lists temporary or permanent vision changes and describes blindness as very rare. These outcomes should not all be assigned the same likelihood. Dr. Smith will discuss the risks relevant to your plan during consultation.

Alternatives to eyelid surgery include non-surgical treatments such as dermal fillers, Botox, or chemical peels, which can help reduce the appearance of fine lines and wrinkles around the eyes. They generally cannot achieve the same degree of improvement as eyelid lift surgery, but can be reasonable options for those who cannot or do not wish to have surgery. Minimally invasive procedures, such as AccuTite, may be an option between non-surgical treatments and blepharoplasty for carefully selected patients. Lifestyle changes can also contribute to a more youthful appearance. Examples include getting enough sleep, maintaining a balanced diet, and using sunscreen.

What is the best age for eyelid lift surgery?

The best age for eyelid lift surgery, also known as blepharoplasty, can vary greatly depending on individual factors, such as genetics, lifestyle, and personal preferences. There is no specific age that is the "best" for everyone. Instead, this is a highly individualized decision that depends on each person's unique circumstances, motivations, and goals when considering eyelid lift surgery.

Generally, candidates for blepharoplasty start considering the procedure in their late 30s, 40s or 50s when they begin to notice significant signs of aging around the eyes, such as sagging skin, drooping eyelids, or bags under the eyes. However, certain factors can influence a person's decision to undergo this surgery earlier or later in life.

Genetics: Some individuals may have a hereditary predisposition to develop sagging or drooping eyelids, which may lead them to consider eyelid lift surgery at a younger age. For instance, if a person in their 30s already experiences noticeable sagging in the upper eyelid, it may be appropriate for them to undergo the surgery at that time.

Lifestyle: Factors such as sun exposure, smoking, or high levels of stress can contribute to premature aging of the skin, including around the eyes. In such cases, a person might opt for eyelid lift surgery at an earlier age to address these issues and maintain a more youthful appearance.

Personal preferences and motivations: Ultimately, the decision to undergo blepharoplasty is a personal one. Some patients may prioritize addressing their aging-related concerns as soon as they become noticeable, while others may wait until the signs of aging have become more pronounced.

Who is not a good candidate for blepharoplasty?

While eyelid lift surgery can be a great way to achieve a brightened, refreshed appearance, it is not right for everyone. Some factors that might make someone a less than ideal candidate for blepharoplasty are discussed here.

Individuals with certain medical conditions, such as uncontrolled high blood pressure, bleeding disorders, and cardiovascular diseases, may face a higher risk of complications during and after the surgery. Additionally, people with severe dry eye syndrome or those with insufficient tear production may not be suitable candidates, as the surgery can exacerbate these conditions.

A good candidate for blepharoplasty should have realistic expectations about the outcomes of the surgery. Dr. Smith can help you understand what you can expect to achieve with this procedure during your consultation.

Blepharoplasty requires proper care and hygiene practices after the surgery to avoid complications such as infection, poor healing, and scarring. A person who is unwilling or unable to follow post-operative care instructions may not be a suitable candidate.

Smoking and excessive alcohol consumption can hinder the healing process and increase the risk of complications. A good candidate for blepharoplasty should ideally be a non-smoker or willing to quit smoking for a certain period before and after the surgery. Similarly, they should be able to refrain from excessive alcohol consumption during the healing process.

Previous eyelid surgeries: Individuals who have had multiple previous eyelid surgeries may not be suitable candidates for blepharoplasty, as the risk of complications and unsatisfactory results increases with each subsequent surgery.

Questions to bring to your eyelid consultation

Ask which concerns surgery can address, whether upper, lower or combined treatment fits your anatomy, how dry-eye symptoms or previous surgery affect your plan, and whether a less invasive option is appropriate. Dr. Smith will discuss the benefits, limitations and risks of your options. Review the eyelid surgery page before your visit, or request a consultation. The $500 consultation fee is applied toward any procedure you book.