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 NC
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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 NC, 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 NC.
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 NC, 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 Raleigh, NC.
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Patient Testimonials
Read real reviews from the Anzolo community
I had ptosis repair and upper blepharoplasty with Dr. Mettu and my experience was fantastic. I had done an abundance of research prior to even scheduling my initial consultation. At that point, I was anticipating having multiple other consults etc... Dr. Mettu’s bedside manner is wonderful, his office is spotless, and he is meticulous in his work. I was so wowed with my initial appointment that I proceeded to schedule surgery. The surgery went exactly as planned. Dr. Metttu was also very attentive during my post-operative period and patient with all of my questions. Now, I am 4 months later loving my new set of eyes! I would without hesitation fully recommend Dr. Mettu for any eye procedures.
Laura Yarger on Pradeep Mettu, Dr via Google Reviews
I brought my mother in law in for a lower bleph and was amazed by not only Dr. Mettu's professionalism and kindness, but also by his technique and knowledge! My mother in law does not speak English and they made her feel very comfortable with the procedure, made sure she asked questions, & gave her so much knowledge on the procedure, technique, risks, etc. I was there with her for all her appointments and knew a lot already about the procedure as I had done extensive research before but still even with all my research, Dr. Mettu taught me more about the procedure! Just shows how much he cares to take the time to make sure his patients are fully informed. They made sure to do thorough eye exams as well which made me feel comfortable in knowing they truly cared. They were also very transparent about pricing and didn't add in any sneaky hidden fees which is always appreciated. Overall, I would recommend Dr. Mettu to literally anyone, it was such a great experience not just for me, but also my mother in law! I saw a comment reviewing with low stars because the environment was "awkward" and "unwelcoming" and I truly disagree. Dr. Mettu and his staff are serious, but friendly and they were very kind to us. Looking for an office with a better "vibe" can not only cost you more money, but also your procedure so always prioritize the more important things!!!
I also want to note, if you're thinking about a blepharoplasty, please make sure you are seeking an ocuplastic surgeon. I've seen horror stories about a lower or upper bleph gone wrong and it is because they don't see an ocouplastic surgeon!! Dr. Mettu is truly the best and the results speak for themselves!
Jas Anahis on Pradeep Mettu, Dr via Google Reviews
I was referred to Dr. Mettu by my primary eye doctor.
My low review rating is based on how this office makes you feel.
Dr. Mettu's office is inside a medical complex, with many other specialists. Not a single other one requires you to text to be allowed inside. I find that very off putting and unwelcoming to his patients. I know they say it is to deter "salesman or soliciting" but it is also deterring of patients. You want your office to feel like a welcome place to sit and wait.
Again, his office is the ONLY one in that building that does it. So it is his own personal issues causing that, apparently no other specialist in the building feels the need to have a waiting room, but NOT use it.
Upon actually meeting him and his office employee who also did my check-in, I did not feel anything but awkward and I am not an awkward person....
First of all, they wear masks, which is fine, if that makes them feel better, no problem.
The PROBLEM is that they act literally afraid of their shadows. Staying 4ft away or more....
When being afraid to be near your patients for eye / vision evaluations affects them properly doing those, that is an issue.
It made me feel incredibly uncomfortable. I was unable to properly do my eye evaluations due to them trying to stay as far away from a human as possible.
I have no input on if Dr. Mettu can do procedures correctly or not, but I do know that he and his office worker/assistant make you feel very uncomfortable. I think he could do a good job, or at least well enough, but he needs to work on his patient bedside manner.
Working in the medical field personally, I am not sure why they act so impersonal and afraid of patient contact, because that goes with the actual job that you have chosen.
I would not personally go back to this location and have since told my primary eye doctor of my opinion and why I have chosen to NOT use this specific office.
Also they are VERY and I mean almost ridiculously intense on their MANY office rules and practices. They have pages of it for you to read and sign. It really is another red flag and makes me think that possibly Dr. Mettu has some sort of OCD.
M. Kat on Pradeep Mettu, Dr via Google Reviews
I am very pleased with the results of my eye operation performed by Dr Mettu. He is a skillful surgeon with a great support staff. His attention to detail is reassuring, but his communication skills are outstanding. You will always receive a response to a call or text before and after surgery. I heartily recommend Dr Mettu.
Wayne Anderson
New Bern, NC
Wayne Anderson on Pradeep Mettu, Dr via Google Reviews