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 VA
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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 VA, 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 VA.
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 VA, 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 McLean, VA.
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Patient Testimonials
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I am so traumatized that I don’t know where to begin. I was never told that after surgery, as a BC patient, you are handed over to staff and don’t see dr again. The problem is that the staff doesn’t have answers, so they mostly said “I don’t know” to questions or gave incorrect info. Even something as simple as asking whether Dr Diacono has hospital privileges at VHC was not answered. I was trying to combine my revision with another cancer surgery at VHC. Victoria replied with an “I don’t know.” When I asked Dr D about scar care, his response was “Everyone scars differently.” This left me bewildered because I wanted to be taught scar care, but no one wanted to teach me. Finally, my husband asked the front desk to schedule me w/ Dr D but instead I was given Gretchen. She gave me 5 min of her time. Without asking permission, she ripped off the tape & earplug in my belly button and said I "didn’t need it anymore". I was perplexed because Dr D said I’d need to wear it for 6 wks, Victoria said 4 wks, and now Gretchen pulled it off after 2 wks. It turns out she was wrong because my belly button has morphed into a slit. I am horrified. Removing the plug early was a mistake on Gretchen’s part. I deserve a nice belly button too. I sent a text asking for post op care, and was told they had gone over everything. I am horrified because that’s not true at all. Why would I ask for help if I had answers? I didn’t know that as a BC patient, I was not entitled to help or answers. I lost trust in Gretchen and didn’t want to meet her again, so the staff ghosted me. I even sent a text saying I was concerned about my flaps and that I was having stomach pains, but NCPS did not respond. Having to find a new PS because Dr D did not want to address my concerns was so stress-inducing that I’m still traumatized from it, plus some of my scars are textured and atrophic. It's awful. I am literally the nicest person on the planet and not demanding, I deserve nice results too. Earlier I made an appt w/ the aesthetician to discuss hair removal. But when I arrived for the appt I was told she didn’t come in that day. I was not called in advance to reschedule nor offered an apology. They didn’t want me as a BC patient, and they didn’t want me as a cosmetic client! The reconstruction is supposed to be the uplifting part so that the BC patient can put the trauma of treatment behind them, but my experience here was traumatic, and now I’m in perpetual stress because I never had an uplifting end to cancer. No one at NCPS was on my side. The statement "You are not alone" is just a cutsy thing they say to sound like they care. There is no substance to it. I am ashamed of myself for not being smart enough to get a second opinion. I put my trust in Dr D because he told me his wife is Greek. I assumed that meant he would treat me the way Greeks treat other Greeks. Not only did that not happen, he didn’t even treat me the way a dr should treat a patient. 1. Dr D told my husband he would have his atty email me to go over the picture policy, but it’s been almost one month and we haven’t heard. Could you please have the lawyer email me the policy? 2. Please inform BC patients up front, care is handed over to staff after surgery in case they want to go elsewhere. 3. Instead of ghosting BC patients, please let them know you’d prefer they go elsewhere for their care. The stress of having to find a new PS last minute has been unbearable. 4. Please empower your clinical team to answer the BC patient’s questions. If they don’t know, please empower them to get the answer from the surgeon. 5. Some of the staff are repulsed by BC patients. The treatment made me rotund and ugly, and the staff are used to aesthetic clients. Please don’t force staff to meet with BC patients if they don’t want to. Their lack of interest in helping me has been devastating. 6. Gretchen feeling comfortable lying to a BC patient was the tipping point in being forced to seek care elsewhere. I would like an email apology from Gretchen for lying to me. Please no gaslighting!
Despina on Mark Venturi, Dr via Google Reviews
I was sent to Dr. Diacono for my mastectomy and delayed DIEP. He is a nice man, but his staff doesn't have training in interacting with breast cancer...
Desi L. on Mark Venturi, Dr via Yelp
I have been working with NCPS for a few months now and have been thoroughly pleased with their practice. I met with Dr. Venturi over the summer to consult regarding my bilateral mastectomy with two phases of reconstruction - tissue expanders during treatment, followed by implants upon completion. He is definitely all business, but he knows exactly what he's talking about and is a meticulous artist with his skills and training. My sutures healed beautifully and the expansion process has been very smooth. He was able to preserve my entire chest tattoo as well, which was so healing, losing my breasts was difficult enough, but to be able to keep that part of my identity really meant a lot to me. Dr. Venturi is really only present for the surgery, after that I have seen his PAs Jess and Gretchen, who are absolutely lovely. They are well trained, have been able to answer all of my questions and ease any concerns I have had, and even with a tricky expander port due to fluid accumulation, they've been able to fill with no issues at each appointment. They are also just fantastic humans with so much empathy. The women at the front desk are always able to find me an appointment when needed, and everyone is so pleasant each time I visit. I really look forward to completing my treatment and coming back for the expander-to-implant swap because I know that Dr. Venturi and his team will take great care of me.
Lindsey Shaver on Mark Venturi, Dr via Google Reviews
The front desk ladies are all very friendly and professional. Unfortunately there are nurses there who don’t care for patient health and getting a doctor to see you is impossible. Having an infection of the incision line and letting the nurse know meant nothing. I called again and made another appointment to see Dr Venturi. After 45 minutes I left to head back to work. I drove 1 hour 35 minutes to get to the appointment. No respect for patient time or discomfort of sitting and waiting with a fever and infection.
Paris Djafari on Mark Venturi, Dr via Google Reviews