Eyelid
Upper Eyelid Blepharoplasty
Upper eyelid surgery to remove excess hooding skin (and fat) — functional (visual-field) or cosmetic, with the incision hidden in the lid crease.
Medically reviewed by Tamara R. Fountain, MDOculoplastic SurgeonLast updated June 2026
Part of our complete guide to Blepharoplasty (Eyelid Surgery) — this page covers upper eyelid blepharoplasty in depth.
Upper Eyelid Blepharoplasty
Upper eyelid blepharoplasty (upper eyelid surgery) removes the strip of excess skin — and, when present, the herniated fat — that accumulates over the eyelid crease with age. The result is a more open, rested eye and, when heavy skin has been obstructing vision, a wider field of view. Incisions are hidden within the natural upper-lid crease and typically fade to a fine, well-concealed line in the crease.
Functional vs. Cosmetic
Upper blepharoplasty sits at the intersection of function and aesthetics:
- Functional (reconstructive): When redundant upper-lid skin (dermatochalasis) hangs over the lashes and blocks the superior visual field, surgery is medically indicated — documented with a formal visual-field test and photographs, and frequently covered by insurance. (When performed at the same time as ptosis repair, however, the blepharoplasty portion is always considered cosmetic and is not covered.)
- Cosmetic: When the goal is to refresh a tired or hooded appearance without a functional deficit, the procedure is elective and paid out of pocket.
A drooping upper lid is not always excess skin. True ptosis (a low lid margin from stretching or weakness of the levator muscle/aponeurosis) is a different problem and is sometimes corrected at the same time. See also Brow Lift vs. Blepharoplasty.
What insurers ask for (functional coverage)
- Visual-field test performed untaped and with the lid/skin taped up (showing improvement)
- Margin reflex distance 1 (MRD-1) measurement
- Frontal and side photographs documenting the lid or skin position
- Documented symptoms (reading difficulty, brow fatigue, headaches)
Criteria vary by plan — confirm specifics with Dr. Fountain's office.
Are You a Candidate?
Good candidates for upper eyelid surgery typically have one or more of the following:
- Excess upper-eyelid skin that folds over the crease or rests on the lashes
- A heavy, hooded, or perpetually tired-looking upper lid
- Reduced side (peripheral) vision from overhanging skin
- A sense of heaviness or eye fatigue by the end of the day
Healthy adults with realistic expectations are generally good candidates. Dry-eye disease, thyroid eye disease, and brow or lid-margin position are assessed beforehand, since they shape the plan and because pre-existing dry eye can be worsened by skin removal — sometimes a ptosis repair or brow lift is combined for the best result. A careful pre-operative evaluation distinguishes true excess skin from a low brow or a drooping lid margin.
The Procedure
Procedure at a Glance
- Removes excess skin and, when present, herniated pre-aponeurotic fat
- Incision hidden in the natural lid crease; sutures removed at ~7 days
- Can be combined with ptosis repair or brow elevation
- About 45–90 minutes total; outpatient under local anesthesia with light sedation
Ready to discuss Upper Eyelid Blepharoplasty?
Schedule a consultation with Tamara R. Fountain, MD to learn if this procedure is right for you.
