An eyelift, known medically as blepharoplasty, is a surgical procedure that removes excess skin, fat, and sometimes muscle from the upper eyelids, lower eyelids, or both. It’s one of the most common facial cosmetic procedures, performed both for appearance and for practical reasons like restoring blocked peripheral vision. The surgery is typically outpatient, meaning you go home the same day.
Upper vs. Lower Eyelid Surgery
Upper and lower eyelifts address different problems and use different techniques, though some people have both done at the same time.
An upper eyelift targets sagging skin that droops over the eyelid crease, making you look tired or, in more severe cases, partially blocking your side vision. The surgeon cuts along the natural fold of the eyelid, removes excess skin and possibly some fat, then closes the incision. Because it sits in the crease, the scar is nearly invisible once healed. If the eyelid itself has dropped low enough to approach the pupil, a separate technique called ptosis repair may be combined with the eyelift to physically raise the lid’s position.
A lower eyelift targets puffiness and bags beneath the eyes. The surgeon makes a cut just below the lash line or on the inside of the lower lid (leaving no visible external scar). From there, excess fat is removed or repositioned, and loose skin is tightened. Repositioning fat rather than simply removing it has become increasingly common because it smooths the transition between the lower lid and cheek, avoiding a hollow look.
What Recovery Looks Like
Most people are surprised by how manageable the recovery is compared to other facial surgeries, though the first few days aren’t pretty. Expect noticeable swelling and bruising around both eyes, even if only one set of lids was treated. Cold compresses and keeping your head elevated while sleeping help considerably during this stretch.
Stitches typically come out around day five to seven. Bruising fades over the first two weeks, and by weeks three to four, most of the swelling has subsided enough that you look presentable without sunglasses. Low-impact exercise like walking is usually fine at that point. Full physical activity, including heavy lifting and intense workouts, is generally cleared after about six weeks.
During the first week or two, your surgeon will likely ask you to avoid contact lenses, screens for extended periods, and anything that dries out your eyes. Temporary blurry vision and light sensitivity are common in the first few days but resolve quickly.
Risks and Complications
Blepharoplasty has a strong safety profile compared to many cosmetic procedures, but no surgery is risk-free. The most commonly reported issue is temporary dry eye, which affects a meaningful number of patients. In large studies, up to about 25% of people reported some dry eye symptoms after surgery, with the rate climbing higher when upper and lower lids were done together. The reassuring part: symptoms resolved with basic eye drops and conservative care in over 95% of cases. Only about 0.5% of patients needed any follow-up procedure for persistent dryness.
Hematoma (a pocket of collected blood under the skin) is the main surgical complication to be aware of, occurring in roughly 0% to 2.2% of cases depending on the technique used. Serious complications like an inability to fully close the eyelids are exceedingly rare in published research.
How Long Results Last
Upper eyelid results typically last about five to seven years before aging and gravity cause the skin to gradually sag again. Some people opt for a second procedure at that point, which tends to be quicker than the first because less tissue needs to be addressed. Lower eyelid results are essentially permanent. The fat pads and skin beneath the eyes don’t tend to re-accumulate in the same way once they’ve been corrected.
Cost and Insurance Coverage
The average surgeon’s fee is $3,359 for an upper blepharoplasty and $3,876 for a lower blepharoplasty, according to the American Society of Plastic Surgeons. Those figures cover only the surgeon’s time. When you add anesthesia, the surgical facility fee, medications, and pre-operative testing, the total typically runs noticeably higher.
Insurance does not cover cosmetic eyelifts, but it often covers upper eyelid surgery when drooping skin measurably impairs your vision. To qualify, you’ll need an automated visual field test showing that excess eyelid tissue blocks at least 12 degrees of your upper field of vision. The test is then repeated with the lid taped up, and the results must show at least a 30% improvement in the number of points you can see. Your eye doctor or surgeon handles this testing, and the results go to your insurer for pre-authorization. Lower eyelid surgery is almost never covered by insurance because it doesn’t affect vision.
Non-Surgical Alternatives
If you’re not ready for surgery or your concerns are mild, several non-surgical options can improve the eye area, though none delivers results as dramatic or long-lasting as blepharoplasty.
- Botox: Relaxes the muscles around the eyes to soften crow’s feet and create a subtle brow lift, which opens up the eye area. Results last three to four months.
- Dermal fillers: Plump the hollow troughs beneath the eyes that create a shadowed, tired look. The procedure takes minutes with no downtime, but results are temporary and need refreshing.
- Laser resurfacing: Removes the outermost layers of skin so that smoother, tighter skin grows back. This has the longest recovery time of the non-surgical options but produces more visible skin-tightening results.
- Ultrasound therapy (Ultherapy): Uses focused energy to stimulate collagen production beneath the skin, gradually firming the area over several months.
The central tradeoff is permanence. Non-surgical treatments require repeat sessions to maintain results, while a surgical eyelift provides years of correction from a single procedure. Many people start with injectables and move to surgery later when they want a more definitive fix.
Who Is a Good Candidate
The best candidates for an eyelift are people with visible excess skin on the upper lids, persistent under-eye bags that don’t improve with sleep or lifestyle changes, or functional vision problems caused by drooping tissue. Good overall health and realistic expectations matter more than age, though most patients are in their 40s or older simply because that’s when eyelid skin loses enough elasticity to become bothersome.
People with certain eye conditions, uncontrolled thyroid disease, or chronic dry eye may need those issues managed before surgery is considered. If your main concern is a drooping brow rather than excess eyelid skin, a brow lift may address the root cause more effectively than an eyelift alone. A consultation with a board-certified plastic surgeon or oculoplastic surgeon (a specialist who focuses exclusively on the eye area) is the clearest way to determine which approach fits your situation.