Dr. Griffiths is a well credentialed and an excellent physician. Her staff are pleasant and professional. The office runs like a well-oiled machine. Kudos to them for providing such excellent care.
Holly Horn
Eyelid Surgery (Blepharoplasty)
How the Procedure Works
Blepharoplasty can be performed on the upper lids, the lower lids, or both during the same session. The approach depends on your anatomy, your goals, and whether the concern is skin, fat, or a combination of both.
The incision is placed inside the natural crease of the upper lid, where any resulting scar is hidden when the eye is open. Through this opening, your surgeon removes a carefully measured strip of excess skin and, when needed, a small amount of underlying muscle. Fat pockets near the inner corner can be trimmed or gently repositioned. Fine sutures close the incision and are typically removed within about a week.
Lower lid surgery uses one of two main approaches, and your anatomy guides the choice. When the primary concern is puffiness from fat, a transconjunctival incision placed inside the lower lid avoids any visible external scar. When loose skin also needs to be addressed, a subciliary incision placed just below the lash line allows the surgeon to work on both skin and fat.
- Transconjunctival approach: hidden inside the lid, best when fat is the main issue
- Subciliary approach: just below the lashes, used when skin removal is needed
- Fat repositioning to soften a hollow area beneath the lower lid
Blepharoplasty is almost always performed as an outpatient procedure, meaning you go home the same day. Most patients receive local anesthesia combined with light sedation so they feel relaxed and comfortable without being fully unconscious. General anesthesia may be used when blepharoplasty is combined with additional facial procedures or when a patient prefers to be fully asleep.
Depending on whether one or both lids are treated, surgery typically takes one to three hours. You will need a responsible adult to drive you home and stay with you for at least the first 24 to 48 hours.
Preparing for Your Surgery
Good preparation before your procedure helps your surgery go smoothly and supports a faster, more comfortable recovery. Your eye doctor will walk you through every step well in advance of your scheduled date.
Your doctor will review your full health history, all current medications, and any prior eye or facial surgeries. Blood thinners and anti-inflammatory medications are often paused for a set window before surgery, but only with guidance from the doctor who prescribed them. Herbal supplements including vitamin E, fish oil, and ginkgo biloba can also affect bleeding and may need to be stopped ahead of time.
- Hold aspirin and blood thinners only as directed by your prescribing doctor
- Stop nicotine for at least two weeks before your procedure
- Bring a complete list of all supplements and over-the-counter products to your consultation
For functional cases, your doctor will document visual field test results, eyelid measurements, and standardized photographs. For cosmetic cases, photographs alone are often sufficient. Dry eye testing may also be included because blepharoplasty can temporarily worsen dryness in the months following surgery.
During your consultation, ask to see before-and-after photographs of patients with anatomy similar to yours. Reviewing these images helps align your expectations with realistic outcomes.
Arrange a ride home and plan to have someone available to help you for at least the first day or two. Before your surgery date, stock your home with cool compresses, lubricating eye drops, and extra pillows to keep your head elevated while you rest. Loose button-up clothing is easier to manage than pullover tops during early recovery.
Recovery and What to Expect
Recovery from blepharoplasty is gradual, and healing continues for several months after surgery. Understanding what is normal at each stage makes the process much easier to navigate.
Bruising and swelling are most noticeable during the first 48 to 72 hours and gradually improve from there. Cool compresses applied in short intervals and keeping your head elevated help reduce both. Your eyelids may feel tight, slightly numb, or heavy during the first few days, which is a normal part of healing.
- Apply cool compresses in short sessions for the first 48 hours
- Sleep with your head elevated on two pillows for the first week
- Use antibiotic ointment on incisions as directed
- Apply lubricating eye drops frequently throughout the day
Sutures are typically removed between days five and seven for upper lid incisions. Most patients feel comfortable returning to social activities within 10 to 14 days, once the most visible bruising has faded. Light activity can usually resume around two weeks after surgery, with more strenuous exercise waited until closer to four weeks.
The final shape of the lids and full scar maturation take several months to settle. Your results will continue to improve gradually long after you have returned to your daily routine.
Upper blepharoplasty results are long-lasting, often remaining visible for seven to ten years or more. Lower blepharoplasty rarely requires revision. While the skin removed during surgery does not return, natural aging continues in the surrounding areas over time.
Wearing UV-protective sunglasses and applying daily sunscreen around the eyes are two of the most effective habits for preserving your results as long as possible.
Risks and What to Watch For
Blepharoplasty is a commonly performed and generally safe procedure, but like all surgery it carries some risk. Knowing what to expect, and what to report, helps you stay safe throughout recovery.
Most patients experience bruising, swelling, tightness, and some dryness in the weeks following surgery. Dry eye symptoms are especially common after upper blepharoplasty and usually respond well to consistent use of lubricating eye drops. Blurry vision caused by ointment or dryness is temporary and clears within hours to a few days.
Following your drop and ointment schedule closely during the first several weeks makes a significant difference in comfort and healing.
Though uncommon, certain complications can occur after blepharoplasty. A hematoma, which is a collection of blood under the skin, may need to be drained. Lagophthalmos, the inability to close the eye fully, can occur if too much skin is removed. Ptosis, or drooping of the upper lid, may develop if the internal lifting mechanism is disturbed during surgery. Minor asymmetry between the two sides sometimes requires a small revision procedure.
- Hematoma that may require drainage
- Lagophthalmos or difficulty fully closing the eyelid
- New or worsened eyelid drooping (ptosis)
- Asymmetry between the two sides
- Rarely, orbital compartment syndrome caused by bleeding behind the eye
Some symptoms are not part of normal recovery and should be treated as urgent. Severe pain that is getting worse rather than better, sudden changes in vision, or rapid swelling with a feeling of firmness or pressure behind the eye all require immediate attention. Contact your surgeon right away and go to the nearest emergency department if needed.
Bleeding behind the eye is rare, but early treatment is critical to preserving vision.
Insurance, Cost, and Choosing Your Surgeon
Understanding what your insurance covers and what you should ask during a consultation helps you plan confidently and compare your options clearly.
Medicare and most commercial insurance plans cover blepharoplasty only when it is deemed medically necessary due to vision impairment. Documentation typically includes visual field test results, standardized photographs, and a physician letter explaining the functional impact. Cosmetic blepharoplasty is not covered by insurance and is paid out of pocket. Coverage rules vary by plan, so verifying your benefits before scheduling is important.
For cosmetic cases, total costs include the surgeon's fee, the facility or operating room fee, and the anesthesia fee. Combined upper and lower surgery will cost more than treating a single lid. Your consultation will include a written quote so you understand exactly what is included before making any decisions.
- Surgeon's fee
- Facility or operating room fee
- Anesthesia fee
- Post-operative visits and suture removal
Ask whether follow-up visits and suture removal are included in your quoted price so you can compare quotes from different practices on equal terms.
An oculoplastic surgeon is an ophthalmologist who has completed additional fellowship training specifically in eyelid, orbit, and lacrimal surgery. This specialized background is especially relevant for procedures near the eye. Plastic surgeons and facial plastic surgeons also perform blepharoplasty, and experience matters regardless of specialty.
Ask how many blepharoplasty procedures your surgeon performs each year, request before-and-after photographs of patients with anatomy similar to yours, and make sure your consultation feels thorough and unhurried. Writing your questions down beforehand helps you get the most out of the visit.
Frequently Asked Questions
These answers address questions that come up often and are not fully covered elsewhere on this page.
Most surgeons recommend waiting approximately two weeks before returning to contact lens wear. During that window, the eyelids are still healing and handling contacts can irritate the incisions or introduce bacteria to vulnerable tissue. Plan to wear glasses during recovery and get clearance from your doctor at a follow-up visit before putting lenses back in.
Upper blepharoplasty is designed to open the appearance of the eye without altering its underlying shape. Lower blepharoplasty should preserve the natural almond contour of the lid margin. However, over-aggressive skin removal from the lower lid can pull the lid downward and create an unintended rounded or fatigued appearance. Choosing a surgeon with specific experience in eyelid anatomy helps prevent this outcome, and sharing photographs of how your eyes looked in earlier years gives your surgeon a useful reference point.
It depends on what is causing the darkness. If the dark appearance comes from a shadow cast by an under-eye fat bulge, removing or repositioning that fat during lower blepharoplasty can visibly improve it. If the darkness comes from skin pigmentation or thin skin that makes underlying blood vessels visible, surgery will not change the color. Your eye doctor can help you identify the cause during your exam and let you know whether surgery is likely to help.
Yes, and many patients choose to do this. Brow lift, facelift, and laser skin resurfacing are all commonly performed alongside blepharoplasty. Combining procedures means a single anesthesia session and one recovery period, which is convenient. The trade-off is a longer surgery and more initial swelling. Your surgeon will help you weigh whether a combined approach or a staged plan better fits your health, goals, and schedule.
Short domestic flights are generally manageable after about a week, though your doctor will advise you based on your individual healing. Longer flights are better delayed until two to three weeks after surgery, since cabin pressure and prolonged sitting can worsen swelling and slightly elevate the risk of blood clots. If early travel is unavoidable, staying well hydrated, moving your legs regularly, and keeping your head slightly elevated during the flight all help reduce risk.
The tissue removed during blepharoplasty does not grow back, so results are long lasting. Upper lid surgery typically holds well for seven to ten years or more. Lower lid surgery rarely needs to be repeated. That said, natural aging continues in the surrounding areas, and factors like sun exposure, sleep quality, and skin care habits all influence how long your results look their best. Protective sunglasses and daily sunscreen are two of the most effective ways to extend the life of your outcome.
Schedule a Blepharoplasty Consultation at NewView Eye Center
If drooping eyelids are affecting your vision, your appearance, or both, our team is here to help you find the right path forward. NewView Eye Center brings decades of ophthalmology expertise and a genuine commitment to personalized care to every patient we see. We invite you to schedule a consultation at either of our Northern Virginia offices and take the first step toward clearer, more comfortable vision and a look that reflects how you truly feel.
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