Eyelid Surgery in NYC

Tired of your droopy eyelids making you look older or more tired than you are?

Eyelid surgery is a well-established way to address the sagging and puffiness that can make the eyes look tired.

Dr. Darren M. Smith is a board-certified plastic surgeon in Manhattan. He will explain what blepharoplasty can change about your upper and lower lids, and what it cannot.

Explore our gallery of real patient results. These before-and-after photos show outcomes of plastic surgery performed by Dr. Smith. Individual results vary.

Eyelid surgery, also known as blepharoplasty, is a surgical procedure that can address both functional and cosmetic concerns of the eyelids. There are different types of blepharoplasty procedures depending on the specific goals:

Eyelid surgery provides both functional and aesthetic improvements.

• It addresses impaired vision from excess skin weighing down the eyelids. By removing extra tissue, blepharoplasty lifts the eyelids to enhance one’s field of vision.
• Eyelid surgery achieves facial rejuvenation and a refreshed look. As skin loses elasticity with age, eyelids can take on a loose, tired appearance. Blepharoplasty contours the eyelid border for a more youthful, wide-eyed effect.
• Blepharoplasty can reduce under-eye bags and the shadows they create, but it does not reliably correct every cause of dark circles, including pigmentation. Dr. Smith will assess what is causing the concern before recommending treatment.

While everyone ages differently and at different rates, most patients undergoing eyelid surgery in our practice are between their mid-thirties and mid-sixties. Interest in the procedure typically develops as skin laxity develops in the upper lids and fat herniation becomes apparent in the lower lids.

All patients must be assessed for eye disease like dry-eye or glaucoma and systemic issues like diabetes, thyroid disorders, high blood pressure, or cardiovascular disease, as these can impact healing and safety.

Patients should discuss their full medical history with Dr. Smith. In some cases, we will consult with your ophthalmologist or primary care doctor as appropriate to ensure your safety during the procedure.

Realistic expectations are also important. While blepharoplasty relieves tired eyes and boosts confidence through a more youthful appearance, it cannot always completely erase dark circles or eliminate all signs of aging. We will discuss your desired goals and expectations during your consultation.

The best candidates for eyelid surgery will have some combination of skin excess, fat herniation and muscle laxity. These anatomical issues can be very effectively addressed with blepharoplasty. At the initial consultation, Dr. Smith will review the anatomical basis for your aesthetic concerns and discuss the best plan for your individual needs.

1. Initial Consultation

During the initial meeting, Dr. Smith examines the eyelids, reviews the medical history, and discusses goals to see if surgery is an appropriate option.

2. Surgical Planning

A tailored plan is devised based on each patient’s unique presentation and what they wish to achieve.

3. Selection of Technique

Technique selection depends on individual factors like skin quality and level of laxity. Options may include external, transconjunctival, or specialized modified procedures.

4. Anesthesia and Safety

When your procedure day arrives, local anesthesia, sedation, or general anesthesia will be administered. Anesthesia is provided by board-certified anesthesiologists.

5. Incision Placement

Incisions are carefully designed to sit in natural skin creases. In some cases the incision is placed inside the eyelid, so there is no external scar. Scars from external incisions fade over time but do not disappear completely.

6. Tailored Tissue Treatment

The tissue treated depends on your anatomy and goals. Upper blepharoplasty addresses excess upper-eyelid skin. Lower blepharoplasty addresses the fat contributing to under-eye bags; any additional skin treatment or eyelid support is planned separately.

7. Closure of Incisions

Dr. Smith closes upper-eyelid incisions with fine sutures and covers them with Steri-Strips. The internal lower-eyelid incision used in his usual transconjunctival approach does not require stitches.

8. Postoperative Care

Dr. Smith provides individualized instructions for keeping the eyes clean and lubricated, caring for the incisions and attending follow-up. The recovery section below explains his usual upper- and lower-eyelid protocol.

Upper and lower blepharoplasty recover differently, so it helps to take them one at a time. The guidance below describes Dr. Smith’s usual protocol for upper and lower eyelid surgery in his practice.

Upper blepharoplasty recovery

Upper eyelid surgery is generally the simpler operation, but the first few days can be more irritating. The incision sits on the outside of the upper eyelid, within its natural crease, so the stitches are on the surface.

Dr. Smith uses fine black sutures and covers them with thin white adhesive strips called Steri-Strips. Both stay in place until your day-five office visit, when he removes the strips and stitches.

Until then, the sutures can feel itchy or mildly irritating. Patients in Dr. Smith’s practice usually describe this as a nuisance rather than pain, and the irritation generally improves substantially after the stitches are removed.

Lower blepharoplasty recovery

Lower eyelid surgery is more complex surgically, but Dr. Smith’s usual internal-incision approach is often easier to recover from. With this transconjunctival technique, the incision is inside the lower eyelid. There is no external incision to tend to and no stitches to irritate you or remove.

Keep the eye clean and lubricated as directed by the practice. If your plan includes external skin removal or an additional eyelid-support procedure, Dr. Smith will explain any different incision care or recovery instructions.

Recovery timeline for upper, lower or combined eyelid surgery

• Day 5: Return to the office for follow-up. Upper-eyelid Steri-Strips and sutures are removed at this visit. Expect noticeable swelling and possibly bruising during these first days; these may be more pronounced when both upper and lower lids are treated.
• About one week: Most patients look presentable enough to return to an office setting. This does not mean all swelling has resolved or healing is complete.
• Two weeks: Light exercise can usually resume with Dr. Smith’s clearance.
• Four weeks: Gradually return to full non-contact exercise with clearance. Contact sports have a separate six-week milestone and require Dr. Smith’s approval.
• Showering: You may shower from the neck down immediately and get your face wet after 48 hours. Follow the practice’s instructions for protecting the incision and caring for the eyes.

These are typical milestones in Dr. Smith’s practice. Healing and any additional procedures may change your individual plan.

Eyelid surgery carries risks, including bleeding, infection, dry eye, difficulty closing the eyes and changes in eyelid position. Permanent vision loss is very rare, but it is a risk to understand before surgery. Dr. Smith reviews your individual risks during consultation.

Lower eyelid: ectropion

As healing tissue contracts, the lower eyelid can sometimes pull away from the eye or turn outward, a condition called ectropion. This can disturb the tear film and expose the eye’s surface, causing irritation and dryness. If untreated, significant exposure can damage the cornea and affect vision.

Upper eyelid: incomplete closure

If too much upper-eyelid skin is removed, the eye may not close fully. This is called lagophthalmos. The exposed eye surface can become dry and irritated and, if significant exposure is left untreated, vision can be affected. Difficulty closing the eye needs prompt assessment.

Bleeding behind the eye

Rarely, blood can collect behind the eyeball—a retrobulbar hematoma—and cause pressure that threatens vision. This is a surgical emergency and requires immediate assessment and treatment.

When to seek urgent help

Severe or increasing eye pain, sudden or worsening vision changes, rapidly increasing swelling, or a bulging eye after surgery 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.

Mild irritation can occur during recovery; severe or increasing pain is not expected. Pain is not the only warning sign of a problem.

Clinical background: American Society of Plastic Surgeons: eyelid surgery risks and hospital guidance on urgent symptoms after blepharoplasty.

Dr. Smith’s usual all-inclusive price ranges are:

• Upper blepharoplasty: approximately $6,000–$12,000.
• Lower blepharoplasty: approximately $10,000–$20,000.

These ranges include surgeon, facility, anesthesia and follow-up fees. Where your procedure falls within the range depends on your anatomy and the anesthesia plan. Your consultation provides an individualized quote.

If you are considering upper and lower eyelid surgery together, the combined plan and its cost will be discussed at your consultation.

Beyond basic blepharoplasty, certain supplementary procedures can further enhance eyelid rejuvenation:

Contact us today to discuss your aesthetic goals and medical suitability for eyelid surgery. Dr. Smith’s evaluation will assess your eyelids, medical history, and lifestyle to develop a surgical plan suited to your anatomy and your goals.

He will explain the options, what recovery involves, and the realistic range of results.

Take the first step by calling (212) 633-0627 or booking a consultation online. 

Dr. Smith’s practice is located at the Ritz Tower, 111 East 57th Street, Ground Floor, New York, NY 10022, in Midtown Manhattan. The office welcomes patients from across the five boroughs, the tri-state area, and well beyond.

Plan to return to the Manhattan office on day five for follow-up and, after upper blepharoplasty, removal of the Steri-Strips and sutures. If you are traveling for surgery, discuss this visit and any further follow-up before arranging your stay.