Upper Blepharoplasty vs Lower Blepharoplasty

Our eyelids contain some of the thinnest skin in our bodies, intended to protect the vulnerable eyeball delicately. This thin skin is especially prone to changes as we grow older and lose collagen, often being the first area to show significant signs of aging. Blepharoplasties are an excellent surgical option for eyelid rejuvenation — the procedure eliminates excess skin and wrinkles while improving puffiness and dark circles. As we spend more and more time looking closely at our faces, blepharoplasties have grown in popularity, becoming the second most requested plastic surgery in America, with people of all ages looking into the procedure. Since everyone’s eyes are different and respond to aging uniquely, blepharoplasties are highly customizable. The most significant difference is whether the surgery focuses on the upper or lower eyelid or combines both. Barrett Plastic Surgery performs comprehensive Los Angeles upper and lower blepharoplasties that holistically address each patient's needs. Keep reading to learn more about the difference between upper and lower blepharoplasties. 

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Who makes a good candidate for a blepharoplasty?

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Ideal patients for eyelid rejuvenation experience excessive sagging, puffiness, or wrinkling around their eyes. Candidates for eyelid surgery should be in good health with no underlying medical or vision issues that could impair healing. The effects of aging are not the only reason to look into blepharoplasty; some people are genetically prone to puffy under eyes and dark circles and may look to eyelid surgery to improve their appearance. Blepharoplasties are also easily performed in tandem with other procedures like eyebrow and facelifts. Eyelid surgery could also be medically necessary for those who experience problems with their peripheral vision due to drooping. However, individuals experiencing eyelid ptosis, which is a diagnosable medical condition that causes the eyelid to droop over the eye significantly, require a different procedure and are not good candidates for blepharoplasties. Barrett Plastic Surgery performs meticulous Beverly Hills blepharoplasties, using precise suturing techniques to close incisions that minimize tension and discomfort. 

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What is the difference between an upper and lower blepharoplasty?

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Depending on the patient’s unique needs, solely operating on either the top or bottom eyelid may be ideal. For example, a patient genetically prone to dark undereye circles and bags but doesn’t have significant sagging or wrinkling may only need a lower blepharoplasty. Patients work closely with their doctor during the initial consultation to determine what’s best for them. 

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Here is the difference between an upper and lower blepharoplasty:

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Upper blepharoplasties focus on removing drooping skin of the top eyelid as well as repairing the muscle that opens the eye. After a lifetime of opening and closing our eyes, sometimes the fibers that make up our eye muscles become loose or disconnected, causing more drooping. This condition is called blepharoptosis and can be corrected through an upper blepharoplasty.

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Lower blepharoplasties focus on removing the built-up fluid and tissue that create what we refer to as undereye bags. The surgeon may reposition or completely excise this fat during a lower blepharoplasty for a youthful, rested appearance.  

Blepharoplasties generally take around an hour under general anesthesia. Before the surgery, patients attend a consultation to work with the doctor and get a sense of realistic results. An eye exam is required to test tear production, measure the patient’s eye dimensions, and test for blind spots in the peripheral vision. The doctor provides pre- and post-op instructions, and patients should find a caregiver to assist after the surgery. 

How will the surgeon perform an upper blepharoplasty?

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For an upper blepharoplasty, the surgeon makes incisions within the natural crease to remove excess skin and tissue and tighten the underlying muscles. To close the incisions, your surgeon will use a unique layered suturing technique that minimizes tension to minimize scarring. 

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How will the surgeon perform a lower blepharoplasty?

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During a lower blepharoplasty, the surgeon makes an incision directly below the lashes or inside the lower lid. Then, the surgeon removes or redistributes fat to smooth wrinkles and eliminate bags and puffiness. There's no visible scarring for lower eyelid surgery since the surgeon makes the incision inside the eyelid.

Are there risks to blepharoplasties?

Like all surgeries, there is the risk of blood clots, infection, and scarring. Finding a qualified, board-certified surgeon with a reputation for successful procedures significantly reduces the risk of complications. Other risks include:

• Skin discoloration
• Difficulty closing the eyes
• Dry eyes
• Eye muscle injury
• Temporary blurred vision
• Visual impairment

Are there non-invasive options?

For those interested in rejuvenating their eyes without surgery, there are non-invasive options to treat minimal drooping and sagging. Barrett Plastic Surgery offers alternatives like non-surgical brow lifts and other injectable treatments. Non-surgical options are an excellent fit for patients looking to correct minor concerns around the eyes, but blepharoplasties offer the most effective and long-lasting results. 

I’m interested in starting my eye rejuvenation journey — what are the next steps?

If you’re interested in a blepharoplasty in Beverly Hills, Dr. Barrett Plastic Surgery offers consultations to determine if the procedure is correct for you. To learn more about Barrett Plastic Surgery, subscribe to our blog and follow us on social media at TikTok, Instagram, Realself, and YouTube for updates. Call us at (310) 398-2648 or fill out this virtual consultation form, and we will contact you as soon as possible. We’re excited for you to take this next step!  

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