As we age, the delicate skin around our eyes often shows the first signs of fatigue, wrinkles, and sagging. Eyelid surgery, or blepharoplasty, is a popular cosmetic procedure designed to rejuvenate the eye area by removing excess skin, fat, and muscle. However, not all eyelid surgeries are the same, upper and lower blepharoplasty address different concerns and require distinct techniques.
If you’re considering eyelid surgery, understanding the differences between upper and lower procedures is crucial in making an informed decision. This guide breaks down the key distinctions, benefits, recovery expectations, and potential risks of each.
What Is Eyelid Surgery (Blepharoplasty)?
Blepharoplasty is a surgical procedure that corrects drooping eyelids, under-eye bags, and puffiness to create a more youthful, refreshed appearance. Depending on your concerns, you may opt for:
- Upper eyelid surgery: Focuses on removing sagging skin and fat that can impair vision or create a tired look.
- Lower eyelid surgery: Targets under-eye bags, wrinkles, and dark circles for a smoother, brighter contour.
Some patients choose to combine both procedures for a complete eye rejuvenation.
Upper Eyelid Surgery: What to Expect
Who Needs It?
- Upper blepharoplasty is ideal for individuals with:
- Hooded eyelids
- Fat deposits causing puffiness
- Impaired vision due to sagging eyelids
- Aging or hereditary heaviness in the upper lids
- The Procedure
- Incision: The surgeon makes a discreet cut along the natural crease of the upper eyelid.
- Tissue removal: Excess skin, fat, and sometimes muscle are trimmed or repositioned.
- Closure: Fine sutures are used to minimize visible scarring.
Recovery & Results
- Swelling & bruising: Subsides within 7–10 days.
- Final results: Visible in 4–6 weeks, with a more alert, youthful appearance.
- Longevity: Results last 10+ years, though aging continues naturally.
Lower Eyelid Surgery: What to Expect
Who Needs It?
Lower blepharoplasty helps those with:
- Under-eye bags (herniated fat pockets)
- Loose, wrinkled skin beneath the eyes
- Dark circles caused by shadowing from bulging fat
- A hollow or sunken appearance (may require fat grafting)
The Procedure
There are two primary techniques:
- Transcutaneous (External) Approach – An incision is made just below the lash line to remove or redistribute fat and tighten skin.
- Transconjunctival (Internal) Approach – A hidden incision inside the lower lid removes fat without visible scars (best for patients with good skin elasticity).
Recovery & Results
- Initial healing: 7–14 days for swelling and bruising to fade.
- Final results: Apparent after 6–8 weeks, with smoother, brighter under-eyes.
- Longevity: 10+ years, though lifestyle factors (sleep, sun exposure) play a role.
Key Differences Between Upper & Lower Eyelid Surgery
| Factor | Upper Blepharoplasty | Lower Blepharoplasty |
| Primary Concern | Hooded eyelids, drooping | Under-eye bags, wrinkles |
| Incision Location | Eyelid crease | Below lashes or inside lid |
| Scar Visibility | Well-hidden in natural fold | Minimal (external) or none (internal) |
| Recovery Time | 7–10 days | 10–14 days |
| Anesthesia | Local with sedation (usually) | Local or general (case-dependent) |
Combining Upper & Lower Blepharoplasty
Many patients opt for a “double blepharoplasty” to achieve balanced, harmonious results. Benefits include:
- Single recovery period
- Cost savings
- A fully rejuvenated eye area
However, combining procedures may extend swelling and downtime slightly.
Which One Is Right for You?
Still unsure? Ask yourself:
- Do my upper lids sag, affecting my vision or appearance?
→ Upper blepharoplasty. - Are under-eye bags my main concern?
→ Lower blepharoplasty. - Do I want a full eye rejuvenation?
→ Consider both.
A consultation with a qualified surgeon will help tailor the best approach for your anatomy and goals.
Final Thoughts
Whether you choose upper, lower, or combined eyelid surgery, blepharoplasty can dramatically refresh your look by restoring a youthful, rested appearance.
Ready to explore your options? Book your consultation today.