Are You a Good Candidate for Blepharoplasty?
Blepharoplasty (eyelid surgery) is a safe and effective procedure for most healthy adults. It’s often combined with a temporal brow lift or even a facelift for full periorbital rejuvenation. However, certain factors should be considered to ensure the best results and a smooth recovery.
General Candidacy Criteria
You may be a good candidate for eyelid surgery if you:
Have sagging upper eyelids that affect appearance or vision
Have under-eye bags, puffiness, or tear trough hollows
Are in good overall health and don’t smoke
Have realistic expectations about surgery and recovery
Are not currently on blood thinners or can safely stop them
Can avoid contact lenses and eye strain before and after surgery
Have not had any corneal surgery in the last 6 months
Don’t have chronically dry eyes.
Upper blepharoplasty, right true ptosis repair, lower transposition blepharoplasty and fat grafting to the brow and temples at 6 months post-operatively
Important Considerations
Medical and lifestyle factors to consider:
Chronic dry eye should be evaluated and managed by an ophthalmologist before surgery, as it may worsen post-op symptoms.
Laser vision correction (LASIK, PRK) should be scheduled at least 6 months before or after eyelid surgery.
Contact lenses should be avoided for 4 weeks before and after surgery to protect the healing eyelid tissues.
Blood thinners should be stopped one week before surgery with your doctor’s guidance.
Smoking significantly delays healing and increases the risk of complications.
Patients must quit smoking one month before and after surgery.
Red: incision lines; Yellow: fat pockets
What to Expect from Eyelid Surgery
I typically perform both upper and lower blepharoplasty, ptosis surgery and temporal brow lift under local anesthesia with sedation for maximum comfort and safety, as well as a fast recovery.
Upper and Lower Blepharoplasty
Incisions:
Upper eyelid: Hidden in the natural eyelid crease
Lower eyelid: Placed just below the lash line or inside the lid (transconjunctival)
Pain: Minimal and manageable with medication
Aftercare:
Lubricating eye drops and ointment
Antibiotic + Steroid eye ointment
Rest, icing and sleeping with an elevated head of bed
Sunglasses recommended for 1 week outdoors
Massaging is started at 7 days
Downtime:
Bruising and swelling for ~1 week (up to 2 to 3 weeks depending on patients and type of work)
Typically no visible signs of surgery after 3 weeks
Follow-Up Appointments
Day 7: Suture removal
6 weeks: Second check-up for monitoring, and referral for peels or lasers
3 Months: Final assessment
Temporal Brow Lift Overview
Incision: Horizontal, hidden in the hairline (temporal region)
Goal: Gently lifts the outer third of the brow using deep tissue anchoring
for longer-lasting results
Sensation: Mild tugging or tightness; minimal pain
(some patients might feel a tension headache for the first week to 10 days,
this is usually temporary and responds well to over-the-counter pain relief)
Recovery:
Swelling and bruising for 1-2 weeks
Staples removed after 7 days
Second follow-up: At 3 months, to assess for symmetry and the need for botulinum toxin (great for maintenance of result)
Frequently asked questions in my practice
-
Upper blepharoplasty addresses excess skin and, when necessary, muscle or fat in the upper eyelid that can create heaviness or visual obstruction.
Lower blepharoplasty focuses on under-eye bags, fat protrusion, and skin laxity. In selected cases, fat is repositioned rather than removed to avoid a hollow appearance.
Each eyelid requires a different strategy.
They are related anatomically, but not treated the same way. -
It shouldn’t.
Modern blepharoplasty prioritizes preservation and redistribution of fat rather than aggressive removal. The goal is to restore a smooth lid–cheek transition while maintaining natural volume.
Hollowness is usually the result of over-resection, or over-indication.
Conservative structural balance is key. -
Most visible swelling and bruising improve within 10–14 days. Subtle edema can persist for several weeks, particularly in the lower eyelid.
Final refinement is gradual. The eyelids are delicate structures, and tissue settles over time rather than immediately.
Early results are encouraging. Final definition requires patience.
-
Blepharoplasty removes excess skin; it does not correct a weak levator muscle (the one that lifts the eyelid).
If the eyelid margin itself sits low (true ptosis), levator advancement or a posterior approach may be indicated. Addressing ptosis at the time of surgery ensures that skin removal does not mask an underlying functional issue.
Skin and muscle are separate problems.
They should be evaluated separately. -
Blepharoplasty removes or repositions tissue; it does not restore volume loss that occurs with aging.
In patients with tear trough hollowing, midface deflation, or a sharp lid–cheek junction, conservative fat grafting may be used to re-establish structural continuity. The objective is softening the boundary between the lower eyelid and cheek.
Volume should be measured and anatomical.