Blepharoplasty: Upper or Lower? Should You Get Both?

close up of young woman's blue eyes


Blepharoplasty, or eyelid surgery, is the ultimate solution for droopy eyelids. The procedure can be completed for either the upper or lower eyelids, and for some patients, if needed – both. The blepharoplasty procedure typically involves the removal of excess skin, fat, and muscle surrounding the eye area.

Why Undergo Blepharoplasty?

As people grow older, their eyelids begin to stretch and the muscles that support them, begin to weaken. The eyelids can no longer hold the fat, which then gathers above and sometimes below. As a result, you will see that your eyebrows are saggy while your upper eyelids begin to droop.

At the same time, the bags under your eyes become more pronounced. When you look in the mirror, you may not recognize your reflection. You may see a person who looks older than you feel. 

Droopy eyelids are not just an aesthetic issue, sometimes they can affect your peripheral or side vision. If this is the case, the blepharoplasty procedure provides a solution since the surgery can eliminate, or at least reduce, vision issues. 

In addition, you gain the advantage of having eyes that make you look younger and feel more beautiful!

Before and After the Procedure

Before scheduling an appointment, it is important to set realistic expectations for the surgery, as results can vary from one person to another. Dr. Michael Boggess has 19 years of experience in facial cosmetic procedures, including thousands of successful eyelid surgeries. He is highly qualified to perform and provide you with information about eyelid surgery.

Preparation is crucial before any surgery or procedure. At Youthful Reflections, we take time to make sure that you are informed and that we have answered any questions or concerns you have, including any potential risks of the procedure. You will receive preoperative and postoperative directions, which you should follow carefully. These detailed instructions will help you ensure that everything goes smoothly before and after the procedure, in order to achieve the best results!

To ensure your full safety, you may also have to stop taking certain medications, including but not limited to: 

• Warfarin

• Aspirin

• Ibuprofen

• Naproxen

The medications listed above are known to increase bleeding. You should consult Dr. Michael Boggess, or any of the experts at Youthful Reflections, to find out if, and when, you need to stop taking the medicine. It is also not advised to smoke for several weeks before the procedure as it can reduce your natural ability to heal.

Finally, be sure that you have someone who will drive you home after the eyelid surgery. It is possible to experience watery eyes, blurry vision, and even light sensitivity after the procedure.

Upper vs. Lower Eyelid Surgery

As previously mentioned, blepharoplasty can be performed on the upper and lower eyelids. Here are the differences between the two:

Upper eyelid surgery: This procedure is performed to stop drooping of the upper eyelids. The lids tend to sag because of the excess skin, fat, and muscles in the area. It may also be due to wrinkles on the upper lids. Drooping eyelids can make some people look angry or sleepy. In this procedure, the excess skin will be removed on the upper lids and the natural-looking results will give you a more youthful appearance.

Lower eyelid surgery: When the skin loses its elasticity or has collected herniated fat, the under-eye area can appear dark and puffy.

Lower eyelid surgery, also known as the eye bag treatment, reduces the prominence of the bags under your eyes. This way, you do not look tired or sleepless. 

These two procedures are quite different. For the upper lids, the surgery involves making an incision on the skin of the upper eyelids. Typically, the incision is placed in the natural crease of the lids. Dr. Boggess will remove the excess skin and then stitch the area closed. After the treatment, you will see that your eyelids are tighter and smoother.

For the lower eyelid, or eye bag surgery, an incision may be made just below the lash line of the lower lids (transcutaneous) or on the inside of the lower lids (transconjunctival) and excess fat is removed. With the transcutaneous approach, excess skin and muscle are removed along the incision line, as needed.  There are also procedures where laser resurfacing may be helpful in tightening the loose skin of the lower eyelids. Dr. Boggess is happy to discuss this treatment option with you if you are interested.

Is It Safe to Undergo Both Surgeries at the Same Time?
Some patients will only require one of these two procedures, while others may require both. The reason many patients choose to go through upper and lower eyelid surgeries in one session is to reduce the time required for recovery. Contrary to popular belief, having the two surgeries together will not add more risk to the patient. Though it is generally up to the patient to decide if they want to have both procedures, Dr. Boggess is here to help you determine which option is best for you.  Contact Youthful Reflections today to set up your complimentary consultation and to begin your journey to feeling and looking more refreshed!

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