Eyelid Lift - Blepharoplasty, Upper & Lower Lid Surgery

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Benefits

Refreshed Appearance

Eliminate the tired, aged look caused by heavy upper lids or under-eye bags. People will notice you look more rested and alert without knowing why.

Improved Vision

For patients with significant upper lid hooding, blepharoplasty can restore peripheral vision blocked by drooping skin, often qualifying for insurance coverage.

Natural Results

Modern blepharoplasty preserves or restores youthful volume rather than simply removing tissue. The goal is refreshed eyes, not an obviously surgical appearance.

Long-Lasting Improvement

Unlike temporary treatments, blepharoplasty provides lasting correction. While aging continues, most patients enjoy their results for many years.

Expected Results

Blepharoplasty creates a more refreshed, alert appearance while maintaining the natural character of your eyes. The goal is never to change how you look fundamentally, but to restore the youthful, rested version of yourself. Results are visible immediately once initial swelling resolves, with final results apparent over several weeks.

Upper Lid Rejuvenation

Removal of excess skin eliminates the heavy, hooded appearance while conservative techniques prevent the hollow, aged look that can result from over-resection. Volume restoration with fat grafting to the upper lid area can further enhance results by recreating youthful fullness.

Lower Lid Improvement

Under-eye bags are addressed by repositioning or removing fat that has herniated forward. Combined with fat grafting to the tear trough, this creates a smooth transition from the lower lid to the cheek, eliminating the tired, aged appearance of sunken eyes and prominent bags.

Overall Facial Harmony

Refreshed eyes improve the entire face. When eyes look rested and alert, the whole face appears more vibrant and youthful, often without any additional procedures.

Real Patient Results

Browse our extensive gallery to see the natural, symmetrical results Dr. Neavin achieves.

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Patient Stories

5-Star Experiences

“

For years people asked if I was tired or upset. My heavy lids just made me look that way. After surgery, I look like myself again, just more awake. Nobody can tell I had anything done.

— Upper Blepharoplasty Patient

Types of Blepharoplasty Surgery

Upper Blepharoplasty

Upper eyelid surgery addresses excess skin, muscle, and sometimes fat that creates a heavy, hooded appearance. The procedure requires careful planning to avoid removing too much tissue, which creates a hollow, aged look that can be very difficult to correct.
The incision is placed within the natural crease of the upper eyelid. Excess skin is carefully measured and marked before surgery, often with the patient sitting upright to assess natural lid position. The amount removed must account for how much skin is needed for proper eye closure and natural appearance.

In some patients, the issue isn’t just excess skin but volume loss in the upper lid area. The hollow that develops beneath the eyebrow contributes significantly to an aged appearance. Dr. Neavin may recommend fat grafting to this area, either alone or in combination with skin excision, to restore youthful fullness.

For men, upper blepharoplasty requires particular care. Male eyebrows sit lower than female eyebrows, and the upper lid aesthetic differs between genders. Aggressive skin removal in men can create a feminized appearance that is immediately recognizable as surgical. This is one of the most common mistakes in male facial plastic surgery.

Lower Blepharoplasty

Lower eyelid surgery addresses bags, puffiness, excess skin, and hollowing. The anatomy is more complex than the upper lid, and the procedure carries more potential complications, requiring careful patient selection and surgical technique.

Three fat compartments exist in the lower eyelid: nasal (near the nose), central, and lateral (toward the temple). Bulging in any or all of these compartments creates the appearance of bags. Modern technique emphasizes repositioning this fat over the orbital rim rather than simply removing it, which can create a hollow, skeletal appearance.

Transconjunctival Approach: The incision is made inside the lower eyelid, leaving no visible scar. This approach is ideal for patients who primarily need fat repositioning or removal without significant skin excess. The fat is accessed through this internal incision and either removed or repositioned to fill the tear trough hollow.

Transcutaneous (External) Approach: When significant skin excess exists, an incision is made just below the lash line. This allows access to the fat compartments while also permitting skin removal. The scar typically heals very well and becomes nearly invisible.
Fat grafting to the tear trough and midface often accompanies lower blepharoplasty. This creates a smooth lid-cheek junction, eliminating the harsh transition that can make lower lids look aged even after bag removal.

The Role of Volume

Traditional blepharoplasty focused almost exclusively on removal: removing skin, removing fat, removing anything that seemed excessive. This approach often created patients who looked hollow and older, not younger.

Modern understanding recognizes that facial aging involves both descent and deflation. Fat migrates and sags, creating bags and hollows. Simply removing the prominent fat without addressing the hollows creates an unnatural appearance.

Fat grafting has revolutionized eyelid rejuvenation. By harvesting fat from elsewhere on the body and injecting it into the upper lid sulcus, tear trough, and midface, Dr. Neavin can restore the volume that characterizes youthful eyes. In some patients, fat grafting alone (without any tissue removal) provides the desired rejuvenation.

The combination of conservative tissue removal with strategic volume restoration creates results that look natural and refreshed rather than surgical and hollow.

Related Procedures and Alternatives

Brow Lift: If the eyebrows have descended, they push excess skin onto the upper eyelids. In these cases, upper blepharoplasty alone won’t solve the problem because the real issue is brow position. Dr. Neavin carefully evaluates brow position during consultation and will recommend a brow lift if needed, either alone or combined with blepharoplasty.

Fillers: For patients with hollowing (particularly in the tear trough) but no significant fat bulging or skin excess, injectable fillers like Juvederm or Restylane can provide improvement without surgery. Results are temporary (typically lasting 6-12 months) but require no downtime. Fillers can also be used to camouflage mild bags by filling the surrounding hollows.

CO2 Laser Resurfacing: Often combined with lower blepharoplasty, laser resurfacing tightens skin and improves texture. This can enhance results when skin laxity is present but not severe enough to warrant excision.

Facelift/Necklift: Patients with comprehensive facial aging often combine blepharoplasty with other facial procedures. Addressing the eyes, midface, and neck together creates harmonious rejuvenation.

Patient Profile

Candidates

Ideal Candidates

Excess skin on upper eyelids creating a heavy or hooded appearance
Puffiness or bags beneath the eyes that persist regardless of rest
Hollowing in the upper eye area that creates a tired look
Good overall health and realistic expectations
Non-smokers or willing to quit before and after surgery
Desire a more refreshed, alert appearance

Not Ideal Candidates

Uncontrolled high blood pressure (critical for lower lid surgery)
Dry eye syndrome or other ocular conditions (requires evaluation)
Brow ptosis as the primary cause of upper lid heaviness (may need brow lift instead)
Unrealistic expectations about eliminating all signs of aging
Medical conditions that impair healing

Estimated Investment

$6,000 – $15,000

The cost of blepharoplasty varies depending on whether upper lids, lower lids, or both are addressed, whether fat grafting is included, and whether the procedure is performed under local or general anesthesia. Upper blepharoplasty alone under local anesthesia in the office represents the lower end of this range. Comprehensive upper and lower blepharoplasty with fat grafting under general anesthesia represents the higher end. In some cases, upper blepharoplasty may be covered by insurance if excess skin demonstrably obstructs vision. Documentation requirements include visual field testing and photographs. Our office can help determine if your situation might qualify for coverage. Your quote includes the surgeon's fee, anesthesia, facility fees (if applicable), and all standard follow-up appointments.

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Special Considerations for Men

Male blepharoplasty requires a fundamentally different approach than female blepharoplasty.

The aesthetic ideals differ significantly, and failure to account for these differences creates obvious, feminized results that are immediately recognizable as surgical.

Male eyebrows naturally sit lower on the brow bone, closer to the eye. This means less skin can be safely removed from the upper lid before creating difficulty with eye closure. More importantly, the ideal male upper lid shows less crease than the female lid. Aggressive skin removal that might look refreshed on a woman can make a man look startled or feminine.

If you observe male celebrities who appear to have had obvious plastic surgery, upper blepharoplasty is frequently the culprit. The eyes are the center of the face, and overly aggressive surgery here is impossible to hide.

Dr. Neavin approaches male blepharoplasty with extreme conservatism. The goal is subtle improvement that restores a rested appearance without feminizing the face or creating an operated look. In many men, volume restoration (fat grafting) plays a more important role than skin removal.

Surgery Day Journey

Arrival & Preparation

You'll arrive at the surgical facility and be greeted by our team. Pre-operative photographs are taken. You'll change into a surgical gown and meet with Dr. Neavin to review the surgical plan. Markings are made with you sitting upright to ensure accurate assessment of skin excess and ideal crease position. You'll have the opportunity to ask any final questions.

Anesthesia

Upper blepharoplasty alone can be performed comfortably under local anesthesia in the office. Lower blepharoplasty typically requires sedation or general anesthesia for patient comfort. If combining with other procedures, general anesthesia is used. The anesthesia team ensures your complete comfort and safety throughout the procedure.

The Procedure

For upper blepharoplasty, excess skin and sometimes fat is removed through an incision hidden in the natural crease. Fat grafting may be performed to restore volume. For lower blepharoplasty, fat is repositioned or removed through either an internal or external incision. Fat grafting addresses hollow areas. CO2 laser may be used for additional skin tightening. Total surgical time ranges from 45 minutes for upper lids alone to 2 hours for comprehensive upper/lower surgery with fat grafting.

The Artisan Promise

Comprehensive
Aftercare Support

Protecting Your Eyes

Keep your head elevated at all times for the first several days, including during sleep. Apply cold compresses as directed to minimize swelling and bruising. Use all prescribed eye drops and ointments to keep your eyes lubricated. Avoid rubbing your eyes. Wear sunglasses when going outside to protect from sun and wind. Do not wear contact lenses until cleared by Dr. Neavin.

Activity Restrictions

Avoid bending over, straining, heavy lifting, or any activity that increases blood pressure or pressure behind the eyes for at least two weeks. This is especially important after lower blepharoplasty. Light walking is encouraged, but avoid strenuous exercise. Avoid swimming and hot tubs until fully healed. Do not wear eye makeup until incisions have healed completely (typically 10-14 days).

When to Call

Contact our office immediately if you experience severe pain not controlled by medication, sudden increase in swelling, significant decrease in vision, excessive bleeding, or any concerns about your recovery. Blood pressure control is critical, especially after lower blepharoplasty. Some swelling, bruising, and mild discomfort are normal, but any severe or worsening symptoms should be evaluated promptly.

Healing Timeline

Every patient heals differently, but this timeline offers a general guide for your return to daily life.

Days 1-3: Initial Healing

Expect swelling and bruising around the eyes, typically peaking at day 2-3. Keep your head elevated, apply cold compresses as directed, and use prescribed eye drops and ointments. Avoid bending over, straining, or any activity that increases pressure. Pain is usually mild and well-controlled with oral medication. Sleep with your head elevated.

Days 4-7: Turning the Corner

Swelling and bruising begin to improve significantly. If external sutures were placed, they may be removed around day 5-7. You may feel comfortable going out in public with sunglasses. Continue gentle activity only. Most patients can work from home during this period if their work doesn't require strenuous activity.

Weeks 2-4: Returning to Normal

Most visible bruising and swelling have resolved. Many patients feel comfortable returning to work and social activities, though some residual swelling remains. You can gradually resume exercise, starting with light activity and progressing as tolerated. Avoid swimming and activities that risk eye trauma. Scars may appear pink but will fade.

Months 2+: Final Results

Residual swelling completely resolves, revealing final results. Scars continue to mature and fade, becoming nearly invisible in most patients. Any temporary tightness or numbness should be fully resolved. If fat grafting was performed, the final volume becomes apparent once all swelling subsides.

Safety &
Potential Risks

Blepharoplasty is generally safe when performed by an experienced surgeon with proper patient selection. Lower blepharoplasty carries more potential complications than upper blepharoplasty and requires careful attention to blood pressure control before, during, and after surgery.

Important Considerations

Hematoma (blood collection): More common in lower lid surgery. Uncontrolled high blood pressure significantly increases this risk. In rare cases, a hematoma can compromise vision if not addressed promptly.
Dry eyes: Temporary dryness is common. Permanent dry eye syndrome is rare but possible. Patients with pre-existing dry eye conditions require careful evaluation.
Difficulty closing eyes: If too much upper lid skin is removed, patients may have difficulty fully closing their eyes, particularly during sleep. This is why conservative skin excision is essential.
Asymmetry: Some degree of natural asymmetry exists in all faces. While Dr. Neavin strives for symmetry, perfect symmetry is not always achievable.
Lower lid malposition (ectropion/retraction): The lower lid can pull down or turn outward after surgery. Risk is higher in patients with loose lower lids or those who have had previous surgery. Various techniques minimize this risk.
Hollowing: Removing too much fat creates a hollow, aged appearance. This is why conservative fat removal and strategic fat grafting are emphasized.
Scarring: Upper lid scars are typically hidden within the crease and heal extremely well. Lower lid external scars are placed just below the lash line and usually become nearly invisible.
Need for revision: Some patients may require additional surgery to achieve optimal results or address asymmetries.

Frequently Asked Questions

What is the difference between upper and lower blepharoplasty?

Upper blepharoplasty addresses excess skin, muscle, and fat on the upper eyelids that create a heavy or hooded appearance. The incision is hidden in the natural crease. Lower blepharoplasty addresses bags, puffiness, and excess skin beneath the eyes. The incision may be inside the eyelid (invisible) or just below the lash line. Different patients need one or both procedures depending on their anatomy and concerns.

Will blepharoplasty eliminate my dark circles?

It depends on the cause. If dark circles result from shadows cast by prominent bags or deep tear trough hollows, blepharoplasty with fat grafting can significantly improve them. If dark circles are caused by thin skin showing underlying blood vessels or hyperpigmentation, surgery will not address them. Dr. Neavin will evaluate your specific situation during consultation.

How long do results last?

Results are long-lasting but not permanent. Aging continues after surgery, and over many years (typically 10-15+), some skin laxity may return. However, you will always look better than if you had never had the procedure. Some patients choose revision surgery many years later, but most enjoy their results for a very long time.

Can blepharoplasty be done under local anesthesia?

Upper blepharoplasty can be performed comfortably under local anesthesia in the office, often in under an hour. Lower blepharoplasty typically requires sedation or general anesthesia because the surgery is more involved and patient movement could compromise safety and results.

What about fillers instead of surgery?

Fillers can be an excellent option for patients whose primary concern is hollowing (tear trough) rather than bulging fat. Fillers can camouflage mild bags and restore volume. However, fillers are temporary (requiring repeat treatment) and cannot remove excess skin or address significant fat herniation. Dr. Neavin will discuss whether fillers, surgery, or a combination is best for your situation.

Dr. Tim Neavin

The Artisan

Artistry Meets
Surgical Precision

Eyelid surgery requires understanding what actually makes eyes look aged or tired. It’s rarely just excess skin. Dr. Neavin evaluates the complex anatomy of the eyelids, including skin laxity, fat distribution, muscle position, and brow relationship. He recognizes that aggressive skin removal, once the standard approach, often creates a hollow, operated appearance that actually ages the face. His philosophy emphasizes conservative skin excision combined with volume restoration where needed, preserving or enhancing the natural fullness that characterizes youthful eyes.

Precision Eye Rejuvenation

Board-certified plastic surgeon with extensive facial surgery experience
Understands gender-specific aesthetic ideals (particularly critical for male blepharoplasty)
Combines fat grafting with traditional blepharoplasty for comprehensive rejuvenation
Performs upper and lower blepharoplasty using multiple techniques tailored to each patient
Honest evaluation of whether surgery or non-surgical options will best address your concerns

Diplomate American Board of
Plastic Surgery

Philosophy "Surgery with
Symmetry"

Beverly Hills & Santa Barbara

Start Your Transformation

Schedule your private consultation with Dr. Neavin today.

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