It's all in the eyes: The rejuvenating impact of blepharoplasty

They say that the eyes are the window to the soul. However, what if the window dressing looks tired and worn out? Many of us want the area surrounding our eyes to look as vibrant and youthful as we feel.

Don't despair! There are ways to rejuvenate your eyes and the surrounding area, especially if you have sagging eyelid skin or bags under your eyes. Blepharoplasty, or eyelid surgery, can help revamp the area around your eyes, giving them the sparkle in the spotlight they deserve.

What is blepharoplasty?

Blepharoplasty is a surgical procedure that has grown in popularity since the end of the pandemic. ASPS statistics from 2022 show a 13 percent increase in blepharoplasty surgeries from 2019 to 2022. The average surgeon fee for the procedure was $3,339 in 2022.

ASPS Member Surgeon Sara Dickie, MD, says that blepharoplasty is a broad term, and there are generally two types of blepharoplasty surgery – upper and lower blepharoplasty. These procedures can be performed separately or together.

"Typically, people who want to get an upper eyelid blepharoplasty are complaining of things like excess skin on their upper lids," said Dickie.

The excess skin can drape down over the eyelashes and give the appearance of droopy or baggy eyes. As we age, Dickie said some people can develop senile ptosis, where the muscle around the eye that lifts the eye gets stretched, leaving the margin of the eyelid low. This extra skin can make the eye area appear "tired." Genetics can also play a role in sagging or excess skin.

ASPS Member Surgeon Heather Furnas, MD, FACS, says that this excess skin can also impact a person's peripheral vision, and an upper blepharoplasty is not always a purely cosmetic procedure but necessary to improve someone's field of vision.

Lower blepharoplasty is a procedure that addresses loose skin and bags under the eyes. The "bags" that can appear under a person's eyes are large and bulging forward. Furnas explains that there are pockets of fat in the lower lid area. A physician can smooth out the look of the lower eye area by reducing the fat in those pockets.

"In patients who are older, we'll take a little bit of extra skin as well," said Furnas.

Why consider blepharoplasty?

Upper and lower blepharoplasty procedures can rejuvenate the eye area and take years off your appearance. Most blepharoplasty procedures aim to smooth the appearance of the eye area and remove excess skin that may be contributing to the dropping, tired or baggy appearance of the eye area.

If you are considering eyelid surgery to enhance the appearance of your eyes and make applying cosmetics easier, communication with your physician is vital. You need to be able to explain your expectations.

"One thing I've seen people talk more about on Instagram is the fact that eyelids are not standalone aspects of the face," said Dickie. "They really interact with the other parts of the face. You can't talk about the upper eyelid without talking about the brow, where the eyebrows sit. People need to be aware that just because they have a little skin hanging onto their eyelashes, they may be offered a different surgery than they anticipate because it may be more that their brow is pushing everything down."

The advice? Be clear about what result you want to achieve. Always consult a board-certified plastic surgeon who is an ASPS Member Surgeon for the best outcome. The face is a complicated anatomical structure with interconnected skin, muscle and tendons. The unique structure of your face and the result you want can influence which type of surgery is right for you.

What to expect from the recovery process

You may expect surgery involving the delicate area around the eyes to result in a painful recovery process. Both Dickie and Furnas said that isn't the case. Most people do fine with ice and over-the-counter pain relievers.

Expect some bruising and discoloration around the eyes for anywhere from five days to two to three weeks. Dickie explains some patients prone to dry eyes may also need eye lubricants during recovery.

You may already be thinking… a relatively pain-free procedure that can take years off my eyes, where do I sign up? Furnas has a word of caution. Always follow your doctor's postsurgical orders. In the absence of pain, some people push themselves further than they should.

"Don't bend over and sleep on a wedge of pillows or in a recliner so your head is elevated about 30 to 45 degrees," said Furnas.

The eye area has an excellent blood supply, and bending over can raise the blood pressure and force the clots near the surgical site to break, leading to bleeding. Although you may feel fine, trust your doctor and don't vacuum, do the laundry or engage in strenuous activities until you get all clear.

To find a qualified plastic surgeon for any cosmetic or reconstructive procedure, consult a member of the American Society of Plastic Surgeons. All ASPS members are board certified by the American Board of Plastic Surgery, have completed an accredited plastic surgery training program, practice in accredited facilities and follow strict standards of safety and ethics. Find an ASPS member in your area.