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.
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 heal to a nearly invisible line.
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 levator-muscle weakness) is a different problem and is sometimes corrected at the same time. See also Brow Lift vs. Blepharoplasty.
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 — 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 30–60 minutes per side; outpatient under local anesthesia with light sedation
After marking the crease with the patient seated upright, the surgeon excises the measured skin ellipse, opens the orbital septum to address any prolapsed fat, achieves meticulous hemostasis, and closes with fine sutures. Conservative removal is essential — leaving enough skin for complete, comfortable eyelid closure.
BlepharoplastyPre/Post Comparison
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Before & After
Upper Blepharoplasty Before & After
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Recovery & Risks
Bruising and swelling peak around 48 hours and settle substantially over 1–2 weeks; most patients are presentable in public by 10–14 days, with the final result stable by about 3 months. Temporary dry eye, mild asymmetry, and lid swelling are the most common issues; serious complications such as retrobulbar hemorrhage are rare. For a full day-by-day guide, see Blepharoplasty Recovery.
- First 48 hours: swelling and bruising peak — cold compresses, head elevation, and rest.
- Week 1: sutures removed around day 7; bruising begins to fade.
- Weeks 2–3: most visible swelling resolves; makeup can usually cover residual marks.
- Month 3+: the final, settled result, with the incision maturing to a fine line hidden in the crease.
Patients of Asian heritage may prefer a technique that preserves or creates a defined crease — see Asian Blepharoplasty. To treat both the upper and lower lids together, see Four-Lid Blepharoplasty.
Frequently Asked Questions
- Is upper blepharoplasty covered by insurance?
- It may be when it is functionally indicated — meaning excess upper-lid skin obstructs the superior visual field, documented with a visual-field test and photographs. Purely cosmetic upper blepharoplasty is paid out of pocket. Note: when blepharoplasty is performed at the same time as ptosis repair, the blepharoplasty (skin) portion is always considered cosmetic and is not covered by insurance.
- What is the difference between upper blepharoplasty and ptosis repair?
- Upper blepharoplasty removes excess eyelid skin. Ptosis repair raises a low eyelid margin caused by weakness or stretching of the levator muscle. They address different problems and are sometimes performed together.
- Where is the incision and will it scar?
- The incision is placed within the natural upper-lid crease, so it heals to a nearly invisible line hidden in the fold of the lid.
- How long is recovery after upper blepharoplasty?
- Bruising and swelling peak around 48 hours and settle over 1–2 weeks; most patients are presentable by 10–14 days, with the final result stable by about 3 months.
- Will upper blepharoplasty remove my forehead lines or crow's feet?
- No — blepharoplasty addresses excess eyelid skin and fat. Forehead lines, brow position, and crow's feet are treated separately (brow lift, neuromodulators, or skin resurfacing), sometimes during the same visit.
- How long do the results last?
- Results are long-lasting — typically 10 years or more, and for many patients essentially permanent. The eyelids keep aging slowly, but the skin that was removed does not grow back.
Your Surgeon
Tamara R. Fountain, MD
Ophthalmology Partners, Ltd.
🏅 ASOPRS Fellowship Trained
Ready to discuss Upper Eyelid Blepharoplasty?
Schedule a consultation with Tamara R. Fountain, MD to learn if this procedure is right for you.