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Authored by: Dr. Sam Sukkar, MD on January 5th, 2026
Blepharoplasty surgery is a surgical procedure that removes or repositions excess skin, fat, and sometimes muscle from the eyelids to improve vision or appearance. In medical practice, it’s used to treat sagging skin, puffy bags, and drooping lids that can block peripheral vision or make someone look constantly tired. The core idea is simple: carefully reshape the upper and lower eyelids to create a more open, youthful appearance while protecting eye function.
Blepharoplasty or eyelid surgery is one of the most commonly performed plastic surgery procedures, with solid data on safety and outcomes. Expertise routinely help patients return to normal activities in about a week to about two weeks, with swelling and bruising steadily fading.
Good candidates for eyelid surgery are healthy adults with realistic expectations, stable eye health, and no uncontrolled conditions like severe dry eye, major heart disease, or bleeding disorders.
Blepharoplasty surgery is an eyelid surgery procedure that removes or repositions excess skin, excess fat, and sometimes certain muscles from the upper and lower eyelids.
Cosmetic eyelid surgery focuses on appearance. It targets sagging eyelid skin, puffy bags under the eyes, and fine wrinkles that create tired or aged expressions. Many patients want a more youthful appearance or simply a rested appearance that matches how they actually feel.
Cosmetic upper blepharoplasty usually reshapes the upper lids by removing extra skin and protruding fat and defining the natural crease. Lower blepharoplasty focuses more on bags under the eyes, eye bags, and skin discoloration or dark circles. These cosmetic procedure goals are about refinement, not changing someone’s basic facial identity.
Functional blepharoplasty is different. Here, the main goal is to improve vision, especially peripheral vision blocked by drooping skin or heavy upper lids. In these cases, excess skin can literally hang over the lashes, acting like a curtain.
The best candidates for blepharoplasty surgery are healthy adults with bothersome eyelid changes and realistic expectations about what surgery can and cannot achieve.
Medical history is reviewed in detail. The evaluation includes thyroid problems, circulatory disorders, bleeding disorders, and prior eye conditions such as glaucoma or a detached retina. Tear production and existing dryness are important considerations, since treatment can temporarily worsen dry eye symptoms.
Lifestyle matters too. Smoking, vaping, and certain herbal supplements can impair healing and increase the risk of circulatory disorders or poor scars. Blood thinners such as aspirin, warfarin, or some newer agents raise bleeding risk during and after surgery procedures.
Blepharoplasty is not right for everyone.
People with uncontrolled high blood pressure, serious heart disease, or major bleeding disorders may face higher risks than benefits. Those with untreated thyroid problems or severe dry eyes may also need to avoid or delay surgery.
Active eye infections, recent other surgeries near the eyes, or a history of poor wound healing are red flags. Some patients with unrealistic expectations, body dysmorphic disorder, or pressure from others to “fix” their face are also poor candidates.
In these cases, other treatment options may be suggested, like skin resurfacing for fine wrinkles, or medical treatment for dryness first. The goal is always safety, comfort, and emotionally healthy reasons for surgery.
Different blepharoplasty procedure types focus on the upper eyelid, lower eyelids, or both, and may be combined with other surgeries for balanced results.
Upper eyelid surgery, or upper blepharoplasty, targets excess skin and fat on the upper lids. An incision is placed in the natural crease, where it hides well once healed. Through this opening, they can remove excess skin, remove excess fat, and sometimes trim certain muscles.
This surgical procedure is usually straightforward and often performed as an outpatient procedure. For functional cases, extra skin that blocks peripheral vision may be removed. Sometimes they also repair eyelid droop, known as ptosis repair, at the same time.
Lower eyelid surgery is more complex and must be tailored carefully. There are two main incision choices. A skin incision just below the lash line, or a transconjunctival incision hidden inside the lower lids, leaving no external scar.
When eye bags are mainly from protruding fat, a transconjunctival approach is preferred and reposition fat instead of just removing it. This can smooth puffy bags and reduce hollowing at the same time. If there is extra skin or drooping skin, they may combine this with a conservative skin pinch under the lashes.
Lower blepharoplasty can also address fine wrinkles and mild skin discoloration. In some cases, gentle skin resurfacing, such as laser treatment or a chemical peel, is added to tighten remaining eyelid skin. Careful technique is critical, since overly aggressive lower eyelid surgery can pull the lid down.
Double eyelid surgery creates or defines a natural crease in patients who lack a visible upper lid fold. This is more common in East Asian eyelids. The goal is not to Westernize the eye, but to enhance the patient’s own anatomy.
Suture techniques or small incisions can be used to attach the eyelid skin to deeper structures. This creates a new or more defined crease while maintaining a natural appearance. Fat removal is typically conservative to avoid a hollowed look.
Blepharoplasty surgery is often combined with other surgeries for more complete rejuvenation. A brow lift can raise a drooping forehead that pushes the upper lids down. Without lifting the brows, removing too much eyelid skin might look unnatural.
Some patients pair eyelid lift surgery with facelift, neck lift, or nonsurgical skin resurfacing to treat fine wrinkles and sun damage. Combining procedures can mean a single anesthesia event and one recovery period.
Understanding each step of the blepharoplasty procedure helps patients feel calmer on surgery day and know what is normal.
Incision lines are marked along natural creases and just beneath the lower lashes. Precise cuts are made through the skin and, in some cases, a thin strip of muscle. In the upper eyelids, excess skin and protruding fat pockets are removed or reshaped to restore a smoother contour.
In the lower eyelids, a transconjunctival incision may be used to reposition fat over the bony rim. This technique reduces puffy bags while preserving a smooth, natural transition. When extra skin is present, a fine strip may be carefully trimmed beneath the lashes.
Bleeding is controlled using delicate cautery. Skin incisions are closed with very fine sutures, and ointment is applied to keep the eyelids and eyes well lubricated. In some cases, small paper tapes are placed to provide temporary support to the lower eyelids during early healing.
Most standalone blepharoplasty surgeries take one to two hours. Combined operations may be longer. Patients rarely feel pain during the procedure, only pressure or tugging. After surgery, there may be slight discomfort, tightness, and blurred vision from ointment. Staff review instructions on cold compresses, eye drops, and how to reduce swelling. Patients leave the center the same day once fully awake.
They are advised to wear dark sunglasses on the way home to protect from light and wind. Written instructions cover when to use cold compresses, how to clean the eyelids, and what signs of trouble require a call.
Recovery after eyelid surgery is usually smooth, but it follows a predictable arc with normal side effects and rare complications.
In the first 24 to 48 hours, swelling and bruising peak. Cold compresses and keeping the head elevated are the main tools to reduce swelling. Vision may be a little blurry from ointment or mild dryness.
By about a week, most patients feel comfortable outside with dark sunglasses. Stitches, if not dissolvable, are often removed around this time. Bruising shifts from deep purple to yellow‑green.
Over the first few weeks, eyelids gradually settle. Tightness, mild asymmetry, and small bumps along the incision usually fade. Final results are closer at four to six weeks, while subtle refinement continues for several months.
Common short‑term issues after blepharoplasty surgery include swelling and bruising, mild pain, dry eyes, tearing, and sensitivity to light. Cold compresses in the first two days, then occasional warm compresses later, can ease discomfort.
Artificial tears support tear production and comfort. Is recommended that patients sleep with their head elevated and avoid rubbing their eyes. They may instruct them to wear dark sunglasses outdoors for a few weeks.
Blepharoplasty offers long‑lasting improvement, but it does not stop the natural aging process around the eyes.
Incisions for upper eyelid surgery hide in the natural crease, while lower eyelid scars sit under the lashes or inside the lid. In most patients, scars fade to thin, pale lines over several months. Good surgical technique and healthy healing are key.
The results of upper and lower eyelid surgery typically last many years. Extra skin and puffy bags removed or reshaped rarely return quickly. Still, gravity, sun exposure, and genetics continue to influence eyelid skin and deeper tissues.
Some people may later notice new fine wrinkles or mild sagging as they age. These changes are usually milder than before surgery. Non‑surgical treatments or, much later, a touch‑up procedure may be options.
Protecting the delicate eyelid skin helps preserve results. Daily sunscreen around the eyes, wearing dark sunglasses outdoors, and avoiding tanning beds all slow photoaging. Sun damage is a major driver of wrinkles and skin discoloration.
Avoiding smoking and managing overall health also matters. Stable thyroid function, controlled blood pressure, and regular eye exams support long‑term eyelid health. Gentle skin care and occasional skin resurfacing can help maintain texture without additional surgery. Patients who follow their long‑term care advice tend to enjoy a refreshed appearance and rested appearance for many years after their blepharoplasty procedure.
Blepharoplasty surgery is an eyelid procedure that removes or repositions excess skin, fat, and sometimes muscle from the lids. It can improve sagging eyelid skin, puffy under‑eye bags, hooded eyes, and in functional cases, can restore blocked peripheral vision.
Good candidates are generally healthy adults, usually in their 40s or older, who have sagging eyelid skin, excess fat, or puffy bags that bother them functionally or cosmetically. They should have stable vision, controlled medical conditions, realistic expectations, and be willing to stop smoking and adjust blood‑thinning medications before surgery.
Most people return to normal daily activities about one to two weeks after eyelid blepharoplasty. Swelling and bruising peak in the first 48 hours, then steadily fade. Stitches are often removed around a week, and lids continue to soften and settle over four to six weeks, with subtle refinements over several months.
Common short‑term effects include swelling, bruising, mild pain, dry eyes, tearing, and light sensitivity. Rare but serious risks include heavy bleeding, infection, trouble closing the eyes, and sudden vision changes. Rapidly increasing swelling, persistent bright‑red bleeding, severe pain, or vision loss require urgent contact with your post-opt care team.
There is no single “best” age for blepharoplasty surgery. Many patients seek treatment in their 40s to 60s when sagging skin and bags become more noticeable, but some younger people with hereditary eye bags are candidates. Timing depends on anatomy, symptoms, health, and personal goals rather than a strict age cutoff.
Non-surgical options can help mild concerns but cannot duplicate blepharoplasty results. Laser or chemical peels can improve fine wrinkles and texture, and injectable fillers may soften hollows or tear troughs. Topical creams and energy devices offer modest tightening. When extra skin or significant bags are present, surgery is usually the most effective solution.
Blepharoplasty surgery is a well-established procedure that can improve both appearance and function of the eyelids. By carefully removing or repositioning excess skin and fat, eyelid surgery helps reduce a tired or heavy look. When planned thoughtfully, results look natural rather than overdone.
The best outcomes come from proper candidate selection, detailed medical evaluation, and a clear understanding of what blepharoplasty can and cannot achieve. Recovery is usually straightforward, with most swelling and bruising resolving within one to two weeks, and long-term results that last for many years. While aging continues, eyelids typically age more gracefully after surgery.
For individuals bothered by sagging eyelid skin, puffy bags, or functional vision issues, blepharoplasty remains one of the most reliable facial procedures available. When approached with realistic expectations, and careful aftercare, it can deliver a refreshed, rested appearance while preserving eye comfort and safety.
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Board-Certified Plastic Surgeon Dr. Sam Sukkar, MD, FACS, and the The Clinic for Plastic Surgery Team provide advanced eyelid surgery solutions to refresh and restore the appearance of the eyes.
If you are dealing with drooping eyelids, under-eye bags, puffiness, or tired-looking eyes, we offer comprehensive eyelid surgery options, including:
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Dr. Sam Sukkar, MD, FACS is a highly respected Board-Certified Plastic Surgeon in Houston, Texas, known for his expertise in advanced cosmetic and reconstructive procedures. As the founder of The Clinic for Plastic Surgery, Dr. Sukkar has set a new standard for excellence, performing over 20,000 procedures with a focus on delivering natural, refined results.
Dr. Sukkar earned his Doctor of Medicine (M.D.) degree from Louisiana State University School of Medicine in 1992 after graduating summa cum laude with a Bachelor of Science in Microbiology. He then completed an intensive General Surgery Residency at the University of Texas Hermann Hospital before being selected for a highly competitive Plastic Surgery Fellowship at Northwestern University in Chicago, one of the most prestigious training programs in the country.
With more than 20 years of experience, Dr. Sukkar is a Diplomate of the American Board of Plastic Surgery and a Fellow of the American College of Surgeons (FACS). He is also an active member of the American Society of Plastic Surgeons (ASPS) and the Houston Society of Plastic Surgery (HSPS). His dedication to innovation and continuing education has solidified his reputation as a leading expert in aesthetic surgery, specializing in breast surgery, body contouring, facial procedures, and non-invasive treatments.
Dr. Sukkar’s expertise has been recognized by Houston Magazine, naming him one of Houston’s “Top Docs for Women,” and he has been featured among RealSelf’s America’s Top Doctors. Committed to his patients, he prioritizes personalized care, ensuring every individual feels informed, comfortable, and confident in their aesthetic journey.
Contact Dr. Sukkar today to schedule a consultation, visit DrSukkar.com to learn more, or call us directly at (281) 940-1535.
Cover Image Illustration by: Dr. Sam Sukkar, MD, The Clinic for Plastic Surgery.
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