Facial Cosmetic Eyelid Surgery – FAQs

Read below commonly asked questions about facial cosmetic eyelid surgery (Blepharoplasty).

Eyelid Surgery (Blepharoplasty)

Why do eyelids sag?

Everyone experiences changes in the eyelids over time. Every time you blink – and you blink billions of times over the course of your lifetime – the skin and muscles of your upper eyelids stretch a bit. Elastic fibers in the skin draw them back to their natural position. Imagine what happens to a rubber band when you stretch it out and snap it back repeatedly, and you can easily see what happens in your eyelid – over time, the skin and muscles of the upper eyelid get longer.

The eyes are surrounded by a protective layer of fatty tissue encased in a membrane that holds it tightly in place. Over time, the membrane can weaken allowing the fatty tissue to slip downward. Skin and muscle are stretched by the protruding tissue, producing puffy bulges that are impossible to hide with cosmetics.

The problem often is worst in the morning, because fluid collects in the fatty tissue while you are lying down. Gravity may draw the fluid away after you get up in the morning, but if you have a great deal of excess fatty tissue, it may take a long time to clear up.

Blepharoplasty removes excess skin in the upper lids and reduces the amount of fatty tissue under the eyelid with both upper and lower eyelid surgery. Surgery may be done on the upper or the lower lids or both, depending on the specific problem.

Patients may undergo laser resurfacing of the lower eyelids a few months after surgery to remove wrinkles of the lower eyelids.

How is cosmetic eyelid surgery done?


Eyelid surgery is done with a local anesthetic in combination with intravenous sedation. You are in a state of what we call “twilight sleep” throughout the procedure. This eliminates the risks and side effects of a general anesthetic


cosmetic eyelid surgeryIncisions in the upper lids are made in the crease above each eye. Excess muscle, fat and loose skin are removed and fine sutures are used to close the incisions. The resulting scar normally fades to a fine line that virtually disappears into the eyelid crease.

To remove excess fatty tissue below the eye, Dr Bartlett makes incisions just inside the lower eyelid, on the pink part that you see when you pull your eyelid downward. This eliminates an external scar and is called a transconjunctival approach. The incisions may be closed with tiny sutures that dissolve within a few days or they may not be sutured at all. If excess skin or muscle needs to be removed, the incision may be made in a natural smile crease below the lashline or may be treated with laser resurfacing after the surgery.

What should I expect after cosmetic eyelid surgery?

You may experience some mild swelling or bruising of your eyelids after surgery, but this usually subsides quickly. We recommend using cold compresses and keeping your head elevated when you lie down to help reduce swelling and speed healing. If you have any discomfort after surgery, it can be controlled with mild pain medications.

Antibiotic drops, lubricants and artificial tears are used after lower eyelid surgery for a period of up to one week.

Most people feel fine to go out the day after surgery usually wearing sunglasses to hide swelling and may do limited work within days.

When can I return to work?

Most people wait up to one week to return to full work and social activities to allow for the swelling or bruising to subside.