An eye lift, 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 surgeries, performed both for appearance and, in some cases, to restore blocked vision caused by severely drooping upper lids. The average surgeon’s fee runs about $3,359 for upper eyelids and $3,876 for lower eyelids, not counting anesthesia or facility costs.
Upper vs. Lower Eyelid Surgery
Upper and lower blepharoplasty are distinct procedures that address different concerns, and they can be done separately or together in one session.
For an upper eyelid lift, the surgeon makes an incision along the natural fold of the eyelid, roughly 6 to 8 millimeters above the lash crease. Through this opening, they remove a strip of excess skin and a thin layer of muscle tissue, and in many cases, trim or reposition fat pads that cause puffiness. The incision heals within the fold, making the scar nearly invisible once it matures. People seek upper blepharoplasty to correct hooded lids that make their eyes look heavy or tired, or because sagging skin has started interfering with their peripheral vision.
Lower eyelid surgery targets under-eye bags, puffiness, and loose skin beneath the lashes. The surgeon can approach it one of two ways: an external incision placed just below the lower lash line, or an internal incision made on the inside surface of the eyelid (called a transconjunctival approach). The external route allows the surgeon to remove both excess skin and bulging fat while smoothing the transition between the lower lid and cheek. The internal approach is better suited when the main problem is fat pockets rather than loose skin, since it avoids a visible scar entirely. If skin tightening is needed with the internal approach, a laser can be used on the surface instead of a second incision.
When It’s Cosmetic vs. Medically Necessary
Most eye lifts are elective cosmetic procedures, but insurance may cover an upper blepharoplasty when drooping skin measurably obstructs your vision. To qualify under Medicare guidelines, a visual field test must show at least a 12-degree difference between your normal resting field and the field measured when the drooping lid is manually lifted out of the way. Alternatively, if redundant tissue clearly blocks your line of sight when looking to the side, that can also meet the threshold.
If the eyelid itself droops (not just the skin over it), the underlying muscle may be weak. This condition, called ptosis, requires a separate repair that’s often combined with the blepharoplasty. Your surgeon would lift the lid’s structural support in addition to removing extra skin.
What Recovery Looks Like
The first three to five days are the worst, with noticeable swelling and bruising around the eyes. Most people look like they’ve been in a minor scuffle. By the end of the first week, bruising starts lightening and shifting from purple to yellow, and any external stitches are typically removed. You can usually wear eye makeup again around 7 to 10 days out, once the incisions have sealed.
The improvement feels gradual. Bruising and visible swelling largely resolve within 7 to 10 days, which is when most people feel comfortable going out in public again. But the eyelids continue refining over the following weeks. Fine swelling and incision lines keep maturing for two to three months, which is when results start looking truly natural. By six months, the eyelids appear fully settled, and the improvement looks completely integrated with your face.
Risks and Side Effects
Dry eye is the most talked-about complication, and its frequency varies widely depending on the procedure. Studies report dry eye rates of about 13% after upper blepharoplasty alone and around 21% after lower blepharoplasty alone. When both are done together, the rate climbs to roughly 31%. For most patients, dry eye symptoms are temporary and manageable with lubricating drops, but the risk is worth discussing beforehand, especially if you already deal with dry eyes.
Other possible complications include chemosis (swelling of the clear membrane over the white of the eye), which is common but typically resolves on its own. More concerning is ectropion, where the lower lid pulls downward and away from the eyeball after too much skin is removed. This is why surgeons tend to be conservative with skin removal on the lower lid, since scarring during healing can tighten the area further. A supporting stitch at the outer corner of the eye can be placed during surgery to reduce this risk.
Temporary blurred vision, sensitivity to light, and minor asymmetry during healing are also normal. Serious complications like vision loss are extremely rare.
How Much It Costs
According to the American Society of Plastic Surgeons, the average surgeon’s fee is $3,359 for upper blepharoplasty and $3,876 for lower blepharoplasty. These figures cover only the surgeon’s time. The total bill also includes anesthesia, the operating facility, and pre-surgical testing, which can push the all-in cost significantly higher. Geographic location matters too: surgeons in major metropolitan areas generally charge more than those in smaller markets. If the procedure qualifies as medically necessary, your insurance may cover part or all of the cost after documentation of visual field loss.
Non-Surgical Alternatives
If your concerns are mild, or you’re not ready for surgery, a few non-invasive treatments can produce visible improvements without incisions or significant downtime. Laser resurfacing targets fine lines, crepey texture, and discoloration around the eyes by stimulating your skin’s collagen production, gradually tightening and smoothing the area. Radiofrequency devices deliver heat to deeper skin layers, encouraging the tissue to remodel and firm up over time. These approaches work best for people with early or mild skin laxity.
The trade-off is straightforward: non-surgical options offer a subtle refresh with minimal recovery, but they can’t match the dramatic, long-lasting improvement of surgery. If you have heavy upper lids, significant under-eye bags, or pronounced sagging, blepharoplasty remains the more effective choice. Non-surgical treatments are better thought of as maintenance tools or a bridge for people who aren’t yet candidates for, or interested in, a surgical approach.