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 NY
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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 NY, 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 NY.
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 NY, 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 New York, NY.
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I had not one but two rhinoplasty surgeries done by doctor Thorn. Biggest mistake of my life. I was 18 and full disclosure my dad asked me if I wanted to go to Angelia Jolies rhinoplasty surgeon and wait 6 months or go to Dr. Thorne and not wait (clearly if I’m writing this review 13 years later I made a huge mistake going to Dr.Thorn). I was dumb young impatient and made the unfortunate decision to go to Charles Thorn. Ladies for the love of god DO NOT GO HERE FOR RHINOPLASTY. I repeatedly told him I wanted the bump on my nose gone. 2 surgeries later it’s still there. GO TO ANOTHER PLASTIC SURGEON!
Darlene Alterman on Charles H. Thorne, Dr via Google Reviews
I have always had very large ears. They don't stick out, they were just very long and my earlobes were quite large as well. It was virtually impossible to...
P M. on Charles H. Thorne, Dr via Yelp
An absolutely wonderful, thorough, detailed consultation. I went to Dr Thorne because he is known for being honest, trustworthy, caring, and detailed. Unlike many of the “bling bling” social media-obsessed surgeons and their “sales teams,” he takes a great deal of time to meet with patients and advise them appropriately. In my case, he astutely noted that it’s much better for me to wait a few years until I’m older to do some work on my face. Other surgeons are very quick to want to operate on people who don’t really aesthetically need surgery yet. I was so impressed with Dr Thorne. I look forward to being a full patient later on. I also noted that everyone coming in for checkups looked truly amazing! A very boutique and bespoke experience. Thank you!
Jason Noble on Charles H. Thorne, Dr via Google Reviews
Five stars is not nearly enough for Dr. Charles Thorne, the man who gave me my life back. My story is as follows. In the beginning of 2020, I had a deep plane facelift with a “triple board”, 5 star facial only surgeon in Orange, CT. I had the beginning of slight jowling, (the only thing that bothered me). Although he did a good job on my jowls, my ears went from small, unattached to horrific, pulled down pixie ears that looked glued to my face. As if that were not bad enough, the worst possible thick,red, ropey scars around them. My tragus was flat, (I didn’t even know what a tragus was prior to a lift but once it is gone you will know because you will look weird). The original doctor did 3 rounds of steroids which made the scars flatter but wider. My sideburn hair was gone so I will need a hair transplant there. The scars under my hairline were also thick and lower than he told me it would be. I had makeup tattooed there but it did not help much to cover the scars. I looked fine from the front IF my hair was in front of my ears. If the wind blew I looked like a freak. I had to cover the scars with tons of makeup but you could still see them. I declined vacations with friends even though I told them I had a fl. My life consisted of work, reading, netflix and googling reasons why bad face lifts happen. In my case too much skin was removed as well as too much tension. I decided to try and find someone to give me a scar revision. I was told I would need a mini lift or a V-Y plasty (that would leave a 1-2 inch scar along your cheek to jawline) After spending hundreds and hundreds of dollars (more like thousands) on consultations, I found either the surgeons don't want to fix someone else's mess, or they don't KNOW how. But I did notice the look of horror when they examined my ears. A couple of doctors had even suggested going back to the original doctor. My original doctor said he will need to do a redo mini lift and it will only cost me $1K for the local anesthesia (Of course I had to pay for hotels, not to mention a couple of weeks off work) Well the same thing happened, I should have known if he didn't do it right the first time he doesn't know what he's doing. I spent thousands on lasers that did nothing to help the scars. Then I came across Gia and another woman's review of Dr. Thorne and how he did their revisions (for other issues and other doctors) and they were happy. Looking at Dr. Thorne’s instagram, I noticed doctors commenting on how brilliant he is. I felt hope for the first time in 3 years. Dr. Thorne is incredible. He fixes ears that were bitten off by a dog, or mangled in an accident or children born with deformed ears. Check his work out. Dr. Thorne suggested against a V-Y plasty (which was how my original doctor wanted to fix it for a 3rd time.) due to the scar it would leave along my jawline.
Fast forward, I had my surgery 8 months ago (a pixie ear revision but with a slight facelift.) My ears are like almost like they were prior. The thick scars all around my ears are mostly gone and He removed a ton of scar tissue to give me back my tragus. He even pulled up the scars along my hairline near my neck so they look much better. My friends & family could not believe the difference. How he did this without making me look like Joan Rivers I don’t know. My face came out even better than I thought possible. I think it came out even better than the doctor thought possible. A revision is not as simple as a facelift. A 3rd revision takes real talent and many doctors just can’t do it. Make sure when considering a facelift you look at ears, scars, tragus and not just the jaw line. If hair is covering those areas in the after picture that is not a good sign.
He is also honest and told me I do not need my eyes done yet.
Linda C on Charles H. Thorne, Dr via Google Reviews