Types of Eyelid Surgery
The two primary types of eyelid surgery are upper and lower blepharoplasty.
Schedule onlineAn upper blepharoplasty uses an incision in the creases of the upper eyelid to remove skin and fat. A thin stitch is used to close the skin.
A lower blepharoplasty involves an incision just below the lower lash line. Alternatively, an incision may be made on the inside of the lower eyelid (transconjunctival technique). This provides the surgeon with access to the eyelid without any visible incisions, and it is typically used for patients who require changes to the fat.
Eyelid surgery may be combined with laser resurfacing of the eyelid skin to soften lines and wrinkles around the eyes.
Upper Eyelid Surgery
If your eyelids are always drooping, you may look tired or sad. Upper eyelid surgery may help restore a naturally youthful shape. The procedure aims to correct sagging, wrinkled, and loose skin to give your eyes a more open, refreshed appearance.
Lower Eyelid Surgery
If you’ve noticed puffy, sagging bags beneath your eyes, lower eyelid surgery might be a good option. As we age, herniated fat collects beneath the eyes, resulting in bags that become more noticeable over time. Puffiness and bags can occur in patients as young as their mid-twenties resulting in a prematurely aged appearance.
The Advantages and Disadvantages of Eyelid Surgery
Blepharoplasty surgery is considered low risk and offers long-lasting results, making it one of the most popular cosmetic surgical procedures.

Pros: Eliminates puffiness and bags under your eyes; Removes hooded skin from upper lids; Addresses any vision problems from heavy upper eyelids; Scars are hidden in the natural creases of your eyelids; If surgery is done under local anesthetic, there is less post-operative nausea and a shorter recovery time; Surgery usually takes under an hour; Recovery time is short, within one to two weeks; If your eyelids are obscuring your vision, surgery may be covered by insurance.
Cons: Some downtime after surgery, and you can expect swelling and bruising; You may need to have additional surgery, such as a brow lift; Some risk of bleeding and infection; Results aren’t permanent as the aging process continues – you may need another blepharoplasty after approximately 15 years; Slight risk of injuring your eye muscles; Correcting puffiness under the eyes may cause a more recessed, darker appearance in the undereye area – fat transfers and facial fillers may help; Removing too much skin during the surgery may interfere with closing your eyes.
Eyelid Surgery FAQs in TX
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How is blepharoplasty surgery performed?
Blepharoplasty can be performed on the upper or lower eyelids individually or both eyelids at the same time. During the procedure, the surgeon makes incisions in the crease of the upper eyelid and beneath or behind the lower eyelid. The placement of the incisions help hide scars after the area heals.
The surgeon marks the areas where excess skin and fat needs to be removed. Underlying muscle may also be removed or tightened with sutures.
The tissue is removed using surgical instruments, such as scalpels, cutting lasers, surgical scissors, and other specialized surgical devices. After the tissue is removed, the surgeon closes the incisions with sutures or tissue adhesives.
The surgeon carefully determines the amount of skin, muscle, and fat that needs to be removed, taking into account your facial muscle structure, eyebrow symmetry, and bone structure. If you have dry eyes, the surgeon may opt to remove less tissue and, in so doing, avoid exposing more of the eye to the air so that symptoms don’t worsen.
Optional Steps During the Procedure
Carbon dioxide (CO2) laser may be used to smooth wrinkles and lines around your lines, as well as to resurface the skin in the eyelid and eyebrow area.
A brow lift may be performed in conjunction with eyelid surgery. The procedure involves making an incision near the brow area and tightening the skin.
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How do you prepare for eyelid surgery?
Before undergoing eyelid surgery, you will need to have a thorough examination and discussion with your surgeon, to include the benefits, as well as the potential risks of the procedure. Your doctor provides pre-operative and post-operative instructions that you will need to follow closely. This will include any medication for pain relief, as well as measures to minimize discomfort, such as gauze, gel packs and artificial tears.
At the time of the consultation, your surgeon explains if the procedure requires local or general anesthesia. This usually depends on the complexity of the blepharoplasty and whether you are undergoing additional cosmetic procedures at the same time.
Before the day of the procedure (especially if it will be done under general anesthesia), you may need to:
- Stop taking blood-thinning medication, including non-prescription pain medications, such as ibuprofen and aspirin
- Eat a light meal the evening before the surgery
- Remove all makeup
- Refrain from eating or drinking anything after midnight
- Arrange for transportation to and from the surgical appointment
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How long is the recovery time?
Compared to other facial cosmetic procedures, the recovery time after blepharoplasty is relatively short. You may notice that bruising and swelling are worse on the day after the surgery. The swelling and the bruising quickly begin to go down after the first 24 hours.
During the first 48 hours after the surgery, you can use cool compresses to reduce the bruising and swelling. Light exercise, such as walking, helps accelerate healing, but you should avoid any strenuous activities.
Incision sites are covered with thin bandages, so you may not be able to see for the first five days or so. The sutures used for the procedure dissolve between four and seven days after the procedure. If your surgeon used non-dissolving stitches, they are removed seven to 10 days after the procedure.
You may experience red and bloodshot sclera (the whites of your eyes). You should not wear eye makeup or use skin care products in your eye area. If you wear contact lenses, you can use them again once the swelling has subsided.
You should be able to return to normal activities seven to ten days after the surgery. The majority of bruising and swelling should have disappeared after two weeks.
Your doctor will offer advice on pain medication that you can use to stay comfortable. In most cases, you will only need non-prescription pain relief. You can expect discomfort, but if you have severe pain or impacted vision, call your surgeon immediately.
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What are the risks and possible complications of eyelid surgery?
Dry eyes is one of the most common complications of eyelid surgery. This is typically due to not being able to close your eyes completely. This condition usually resolves within one to two weeks. You can use eye drops to keep your eyes moist. In some cases, the dry eye condition persists for more than two or three months and may require additional corrective surgery.
Other possible complications include:
- Infection of the eyelid
- Double vision
- Vision loss (due to retrobulbar hemorrhage)
- Noticeable scarring
- Incorrectly positioned eyelids
- Under- or over-correction
- Eyelid numbness
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How much does eyelid surgery cost? Does insurance cover the cost of blepharoplasty?
The cost of eyelid surgery varies. In TX, the average cost is $2,000 to $5,000. Surgeons charge different rates based on their experience, sub-specialty, and facility where the surgery is performed.
The starting cost for a basic upper eyelid surgery without fat removal is $2,000. More complicated eyelid surgeries that involve the upper and lower eyelids may cost $5,000, and this includes removal of fat. These estimates are for surgeon fees only, and There may be additional costs of $800 to $2,000 from the facility in TX.
In general, eyelid surgery is not covered by insurance, as it is considered a cosmetic procedure. The exception to this is if is a functional blepharoplasty to correct vision obstruction from sagging eyelids. In this case, prior authorization is typically required by insurance carriers. Your medical insurance may cover a portion of the cost.
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Who are the best candidates for eyelid surgery?
If you have drooping or sagging skin around your eyes due to aging, blepharoplasty may be a good option if you are in good health. For most people, eyelid surgery is performed for cosmetic reasons after the age of 40. This is when patients typically begin to notice the signs of aging around the eyes as their skin loses elasticity. While it may make a significant difference in your appearance, it is important to have realistic expectations.
An ideal candidate for a lower eyelid procedure has puffiness under the eyes. Puffiness can be hereditary, due to fluid accumulation, or related to aging.
If you are considering eyelid surgery, schedule a consultation with an experienced, qualified cosmetic surgeon to learn more about the procedure. The surgeon determines if you have any risk factors for complications associated with the procedure, such as dry eyes, diabetes, and thyroid eye disease. Health problems may mean that you cannot safely have the procedure.
Smoking delays the healing process, and it is considered to have an increased risk of complications following surgery. If you are a smoker, you may need to stop smoking for several weeks before the surgery.
Performing eyelid surgery on people of Asian descent is more difficult due to the unique structure of the eyelids. Therefore, this population is considered at higher risk of sub-optimal outcomes. If you are in this population, look for a surgeon who specializes in eyelid surgery for people of Asian descent.
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How long do the results of blepharoplasty last?
The results of eyelid surgery may last up to 10 to 15 years. The aging process will continue and, as with any cosmetic procedure, the results will not last indefinitely. You may need a subsequent eyelid surgery in the future.
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Which procedures are often combined with eyelid surgery?
Many patients will choose to address signs of aging by having several facial procedures at the same time. Eyelid surgery can be performed as a standalone surgery. However, it is often combined with a facelift (to address jowls and sagging) and/or a brow lift (for sagging and forehead wrinkles) for full facial rejuvenation.
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Are there non-surgical alternatives to eyelid surgery?
f you have concerns about eyelid surgery and would prefer a non-invasive alternative, injectables may offer temporary anti-aging benefits. Discuss your options with a qualified surgeon.
Alternatives to Upper Eyelid Surgery
Droopy eyelids may be improved with Botox® or Dysport® to raise the eyebrows. This involves making injections in the muscles that pull the eyebrows down. This costs around $500 to $600 in TX, and the effects last for four to six months. Fillers, such as Restylane® or Juvéderm®, may also help by raising the corners of the eyebrows to raise your upper eyelids. Expect to pay approximately $700 for this treatment, and the results may last six to 18 months.
Alternatives to Lower Eyelid Surgery
Lower lid puffiness can be addressed with fillers. Fillers create a smooth surface from the lower eye area to the upper cheeks. This is most effective if the patient has firm skin under the eyes with minor puffiness.
See below for a list of the top-rated eyelid surgery specialists in Houston, TX.
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Dr. Bartlett is amazing! She treats her customers like family. She does an amazing job. The front desk people are always so welcoming and friendly! Jamie...
Bailey C. on Robert Scott Yarish, Dr via Yelp
I went to see Dr Yarish based on a referral from a co-worker and it has been a really bad experience. I need to have an MRI done prior to scheduling surgery, however, getting the work order from the onsite team has been a nightmare. It has been exactly a week since the visit and I still don't have the paperwork. I was told that I would have it by Thursday, April 18th, I called and left a message April 18th with no call back, I called and spoke with someone Friday, Monday, and Tuesday. Yesterday I spoke with Nicole who said that she would have the "girls" send it tomorrow (Wednesday) morning AND IT STILL HASN'T BEEN RECEIVED. I called just now and was told they would have to look into it and call me back. On their website they talk about "we will treat you like the VIP you are." I have been treated like an after thought. Their services are too expensive for their customer service to be so very bad! Would not recommend this "medspa". Very disappointing but lesson learned; I will go elsewhere to get the work that I need.
Bobbi Tevay on Robert Scott Yarish, Dr via Google Reviews
My experience from my first consultation for my breast implant replacement with Dr. Yarish and his staff was wonderful. They made me feel very comfortable and they were very professional. Dr. Yarish’s expertise in plastic surgery made me confident that I was making the right decision with my larger replacement size. I was so pleased with my results after surgery! Thank you Dr. Yarish!
Lori Conklin on Robert Scott Yarish, Dr via Google Reviews
RUN!!!
Surgery date: September 26, 2023
Please save yourself the heartache and go elsewhere. HORRIFIC experience following a neck lift procedure with Dr Robert Scott Yarish at Town and Country Plastic Surgeons + Medspa here in Houston. I should’ve known when my consult and surgery day was 4 days apart AND THEN- morning of surgery, surgeon comes in and opens my gown and starts touching my breast, as if they were about to do a breast procedure
Excessive skin excised, indention and puckering on the lower jaw, horrible pixie ear, scars are horrendous in front and behind my ears and on one side, I’m experiencing pain that feels like pulling and a burning sensation at times, my platysma bands in the center looked extremely large and protruding from being sewn together (kenalog was injected bc I was told it could be scar tissue, but now, there’s loose skin afterwards) and the scars in the back of my head are so awful and still painful, in which I believe is a result of missed stitches. I could barely lay on my back because of the pain it was causing. When going to the office I was told by the surgeon that they were ingrown hairs in my scar. I could feel the stitches - they clearly were not hairs.
I was told by another very reputable surgeon that, “my neck looked skeletonized” from the excessive liposuction.
This other surgeon also asked me how Dr Yarish treated my MRSA just from looking at the photos. I then remembered Dr Yarish asking me why I had “all those pimples on my face” and come to find out, it was Staph according to this doctor.
Dr Yarish wanted to fix pixie ear and the indention on the side of my face and said we may have to go up a little higher because there wasn’t enough skin. When I asked about symmetry on the other side, I was told that there wasn’t a guarantee and we could address that later. He wanted to do this procedure IN THE OFFICE, not the surgery center (free of charge) but I was told by other reputable surgeons not to touch ANYTHING for at least 6 months, so I said I wanted to wait. I was terrified at this point. Dr Yarish made it well known to me through personal text and in person of his displeasure of me speaking with another plastic surgeon. As a result, I have been basically blamed for a lot of issues I am now experiencing.
I have had consultations for repair that have ranged in price from $40-$185k.
Unfortunately, I posted this as a warning on fb and to get referrals for another experienced facial plastic surgeon.
This followed with their consultant, Ada Burrell posting under my comment to try and discredit the validity of my claims or bully me. Actually, a lot of their staff has joined these groups since.
Soon after, I was contacted via text from
the Director, Diane Van Sant. Her solution was to have Dr Yarish’s business partner and fellow surgeon Dr Erica Bartlett do a revision at no extra cost. When I declined, she offered a refund. I did decline the refund, because I’m now looking at thousands of dollars more to correct the damage that he’s done.
Mentally, it’s just been crippling.
They don’t care about you, they just want to shut you up. I am now an after thought and Dr Yarish is making videos juggling implants while my life has been turned upside down.
M B on Robert Scott Yarish, Dr via Google Reviews