Upper Eyelid? Lower Eyelid? Which Type of Surgery is Right for You?

Posted November 29, 2021
Eyelid surgery types

The side effects of aging skin aren’t only found on your forehead and neckline. It can show up as sagging and loose skin around your eyes and lids, possibly impacting your eyesight and making you look tired all the time.

Luckily, two types of eyelid surgeries can help address these issues, but which eyelid surgery is the best type for you? An upper eye lift that helps with the drooping skin above the lash line, or a lower eyelid surgery that removes the bags underneath the eyes? 

We’ll explain what’s involved with the two different eyelid procedures and if it’s possible to have both types of surgery done at once. But first, what’s causing all these changes around the eyelids? 

Which Type of Eyelid Issues Do You Have?

As we age, the elasticity of our skin decreases, and the collagen we produce isn’t as fortified to maintain the skin’s structure. This can result in thin and saggy skin around the upper eyelid and lashes. And the normal fat around the eyes begins to drop as we get older, shifting beneath the eyes, creating “bags.” Here are some visible signs of how our eyelids change over time.  

Changes to the eyelids:

  • Loose or sagging skin that hangs over the lash line, possibly impairing sight
  • Excess skin around the upper eyelid, creating multiple folds and creases
  • Fatty deposits around the inner corner of the eyes
  • Puffiness under the eyes, making “bags” beneath the eyes look
  • Lower eyelids drooping revealing white below the iris
  • Fine wrinkles and sagging skin around the lower eyelid

People facing these eyelid issues run the risk of looking a lot older than their actual age or always looking tired. An eyelid lift or eyelid surgery is a permanent solution to restore the youthful appearance of your eyes, and helping you look more awake and alert.

Let’s take a deeper look into the two different eyelid surgeries that can help address these signs of aging. 

The Different Types of Cosmetic Eyelid Surgery  

There are two main types of eyelid surgery, upper eyelid blepharoplasty, and lower eyelid blepharoplasty. 

Upper Eyelid Blepharoplasty 

An upper blepharoplasty starts with an incision along the natural crease of the upper lid, removing the extra skin that hangs over. The incision also removes any fat deposits that have collected around the corners of the upper lid. The surgeon carefully sutures the incisions close to avoid any scarring or marks post-surgery. 

Lower Eyelid Blepharoplasty

A lower blepharoplasty addresses the loose skin, muscle, or both, below the eye. With lower eyelid surgery, the goal is to reposition the fat beneath the eyes to a better position. The surgeon makes an incision 1-mm or 2-mm below the lower eyelash line and proceeds to the point of the crow’s foot, then raises the flap of the tissue. The surgeon then carefully goes underneath the tissue, identifies the lower lid’s fat compartments, and adjusts accordingly. The incisions are closed with sutures or skin glue. 

Can I Have Both Types of Eyelid Surgery Done at Once?  

You can have both an upper and lower eyelid surgery performed simultaneously if your board-certified surgeon believes it would be necessary for both procedures. Determining if you need both types of eyelid surgery will depend on the condition of the skin and the amount of puffiness at the top and bottom of the eyelids.  

What to Expect After an Upper or Lower Eyelid Surgery 

The recovery from an upper or lower blepharoplasty will vary from patient to patient. However, the initial downtime is typically 2-3 days, and to help control the swelling and bruising; patients are required to wear a cold compress around the eyes. 

Any sutures made during the procedure are removed 5-7 days post-surgery. The bruising and swelling around the eyes can take up to two weeks to subside. But once the skin begins to heal and normalize, you notice a smoother and tightened surface around the eyes. The full results of an eyelid surgery typically appear 2-3 months post-procedure. 

What’s Next? 

If you are considering getting eyelid surgery to reclaim the look of your age (or possibly younger), make sure to consult with a board-certified plastic surgeon. They will guide you on which type of eyelid surgery is ideal for helping you look awake and have the more youthful appearance you deserve.

Do you have a question about a cosmetic procedure? Try our helpful “ask a doctor” feature. Leave a question for one of our board-certified doctors to answer or find the answer to your question asked by our Cosmetic Town community.

- VM


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