What Is Upper Blepharoplasty (Eyelid Surgery)?
The eyes are the focal point of the face — they reflect how rested, expressive, and vibrant we appear. But with age, the upper eyelids begin to sag, hiding the crease, shrinking the eyes, and conveying fatigue we don't feel. Upper blepharoplasty is a refined surgical technique that restores this openness — gently removing excess skin and contouring the lid to recapture a more awake, natural expression.
Though often described as an “eyelid lift,” upper blepharoplasty is more than a cosmetic tweak. When sagging skin begins to obstruct vision or cause headaches, the procedure restores not just appearance, but comfort and function as well. It’s one of the most popular facial surgeries worldwide, and for good reason — even subtle improvements to the eyes can dramatically enhance a person’s expression, presence, and ease.
Why Do Eyelids Sag?
The upper eyelid skin is the thinnest on the body — under 1 mm thick — and undergoes thousands of micro-movements each day. Over time, this leads to stretching of the skin and weakening of the underlying support structures.
With aging, several changes occur:
- Skin becomes lax and forms folds (dermatochalasis)
- Fat pads may bulge forward as the orbital septum weakens
- Muscles such as the levator may stretch, making the lid appear droopy
- The eyebrows may descend, worsening the heaviness
All of this contributes not only to a tired look, but also to vision obstruction in the upper or peripheral fields. Many patients unconsciously raise their brows to compensate, causing deep forehead lines and tension.
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Modern vs. Traditional Techniques
Older techniques focused on removing as much skin and fat as possible — often resulting in hollow, overcorrected eyes. Today, modern upper blepharoplasty is guided by the principle of conservation over subtraction.
Contemporary surgeons focus on:
- Preserving or repositioning fat pads rather than removing them
- Maintaining or restoring the natural eyelid volume
- Respecting anatomical differences (ethnicity, age, bone structure)
- Customizing the excision design to correct lateral hooding without flattening the contour
This shift has led to more natural, balanced, and long-lasting results.
Who Is a Good Candidate?
You may be a good candidate for upper blepharoplasty if you:
- Have excess skin folding over the upper eyelid crease
- Appear tired, sad, or angry even when you’re not
- Struggle to apply makeup due to lid folds
- Experience tension headaches or eye fatigue
- Have visual field obstruction
- Are in good general health and a non-smoker
Sometimes, what appears to be eyelid sagging is actually a brow droop (brow ptosis). A proper evaluation is essential to determine whether a blepharoplasty, brow lift, or both are needed for the best result.
Who Should Avoid This Surgery?
Upper blepharoplasty is generally safe, but it may not be suitable for everyone. Your surgeon may advise against this procedure if you:
- Suffer from severe dry eye syndrome that could worsen after surgery
- Have uncontrolled medical conditions, such as high blood pressure, diabetes, or thyroid disorders (e.g. Graves’ disease)
- Take blood thinners and cannot stop them safely
- Have a history of poor wound healing or problematic scarring
- Show signs of muscle-related ptosis that requires a different surgical approach
- Have unrealistic expectations about the result
- Cannot stop smoking or vaping, which significantly affects healing
A thorough consultation, including eye exam and medical history, is essential to determine if blepharoplasty is right for you.
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How the Procedure Works
Upper blepharoplasty is a short outpatient procedure, typically performed under local anesthesia with or without sedation. Most patients go home the same day.
Surgical Process:
- The surgeon carefully marks the natural eyelid crease while the patient is upright
- A precise incision is made within this fold
- Excess skin is removed, and if necessary, a small amount of muscle or fat is adjusted
- The incision is closed with fine sutures, usually removed within 5–7 days
Because the scar lies in the natural fold, it becomes nearly invisible once healed.
- Duration: 45–60 minutes
- Setting: Outpatient
- Anesthesia: Local ± sedation
Aesthetic and Functional Benefits
Upper blepharoplasty delivers both cosmetic and medical improvements.
Aesthetic benefits:
- Eyes look larger, brighter, and more open
- The natural lid crease is restored
- Makeup applies more cleanly and evenly
- The overall face appears refreshed and more expressive
Functional benefits:
- Enlarged peripheral visual field
- Reduced muscle strain and forehead overuse
- Relief from eye fatigue and headaches
- Improved contrast sensitivity and vision clarity.
Patients often report feeling “lighter” in the eyes and forehead after surgery.
Perceived Age and Social Impressions
In a controlled study, observers rated post-surgery patients as looking 9 years younger on average, and significantly more attractive, healthy, and successful.
These changes weren’t limited to appearance — patients were perceived as more vibrant and engaged in social interactions, reinforcing the strong link between eyelid appearance and overall impression.
Feel like yourself again — just more vibrant
A subtle change to the eyes can shift how others see you — and how you see yourself.
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Upper Blepharoplasty vs. Brow Lift
Many patients mistakenly believe they need an eyelid lift, when the real issue lies in the descending eyebrow.
If the outer brow has dropped — which is common with age — it may push excess tissue into the upper eyelid space. Removing eyelid skin alone can worsen this imbalance or make the brow look even heavier.
An upper blepharoplasty removes skin directly from the eyelid, ideal when the brow position is stable. A brow lift raises the position of the brow and forehead, correcting the source of heaviness in cases of brow ptosis. In many cases, both procedures are performed together for a natural, harmonious result.
Recovery Timeline
Recovery is generally fast, with most people returning to social life in 1–2 weeks.
Typical timeline:
- Days 1–3: Bruising and swelling peak. Use cold compresses and sleep with head elevated.
- Days 4–7: Stitches removed. Bruising shifts downward.
- Week 2: Makeup can be resumed. Many return to work or daily life.
- Weeks 3–4: Eyelids soften, scars fade.
- 3 months: Final result visible.
Your surgeon may prescribe lubricating eye drops, and you’ll be advised to avoid contact lenses and heavy lifting during early healing.
Longevity of Results
Upper blepharoplasty results often last 10–15 years, and in many cases, the procedure never needs to be repeated. While your face will continue to age naturally, the improved eyelid contour and visual ease are long-lasting.
The durability of results depends on skin quality, genetics, lifestyle, and sun protection.
Risks and Complications
Upper blepharoplasty is considered a low-risk procedure when performed by a qualified specialist, but like any surgery, it does carry the possibility of complications. Most side effects are temporary and mild — such as swelling, bruising, or a feeling of tightness around the eyes during the first week. Some patients experience dryness, light sensitivity, or mild asymmetry during healing, which typically improves on its own or with minor adjustments.
More serious complications are uncommon, but they can occur. These may include difficulty fully closing the eyes if too much skin is removed, visible scarring, or prolonged irritation. In rare cases, bleeding, infection, or longer-term changes in eyelid position may require further treatment or revision surgery.
The best way to minimize risk is to choose an experienced, board-certified plastic surgeon or oculoplastic specialist who understands eyelid anatomy in depth and prioritizes conservative, tailored techniques. During your consultation, your surgeon will assess your medical history, eye surface health, and expectations to ensure the procedure is both safe and appropriate for you.
When performed with precision and care, upper blepharoplasty tends to heal quickly and predictably — with high satisfaction and very few complications.
Pricing in Belgium
- Typical range: €1,200 to €2,500
- Mutuelle coverage: If sagging skin obstructs your visual field, partial or full reimbursement may be possible through Belgian health insurance. Your surgeon can provide documentation for the request.
Pricing varies by clinic, surgeon experience, and anesthesia method. Ask whether the cost includes pre-op consultation and follow-up care.
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