An eye lift, known medically as blepharoplasty, is a surgical procedure that removes excess skin, muscle, and fat from the upper eyelids, lower eyelids, or both. It’s one of the most common facial cosmetic procedures in the United States, performed both to restore a more youthful appearance and to correct drooping eyelids that interfere with vision. The average surgeon’s fee runs about $3,359 for upper eyelids and $3,876 for lower eyelids, though total costs are higher once you factor in anesthesia and facility fees.
Upper vs. Lower Eyelid Surgery
Upper and lower eyelid procedures address different problems and use different techniques. For an upper eyelid lift, the surgeon cuts along the natural crease of your eyelid, then removes some combination of excess skin, muscle, and fat. Because the incision sits in the fold, the scar is nearly invisible once healed. This is the version most people picture when they think of an eye lift, and it’s the one that can improve both appearance and blocked upper vision.
Lower eyelid surgery targets puffiness and bags beneath the eyes. Surgeons use one of two main approaches. The first places the incision just below the lash line on the outside of the skin, giving broad access to the area but carrying a higher risk of the lower lid pulling downward after surgery. The second places the incision on the inside of the eyelid, leaving no visible scar at all. This internal approach has the lowest overall complication rate of the two, though it provides more limited access to the surrounding structures.
When It’s Medical, Not Just Cosmetic
Some eye lifts are medically necessary. Two conditions commonly drive this: ptosis, where the eyelid margin itself droops due to weakened muscles or nerve problems, and dermatochalasis, where an excess of skin and tissue weighs the lid down. Both can block your upper field of vision enough to interfere with driving, reading, or daily tasks.
Insurance typically covers the procedure when it’s deemed medically necessary, but the bar is specific. You’ll need automated visual field testing showing at least 12 degrees of lost upper vision. Then the test is repeated with your eyelid taped up, and it must show a 30% or greater improvement in the number of points you can see. Photographs documenting the drooping eyelid are also required. If your eyelids sag but don’t measurably obstruct your vision, the procedure is classified as cosmetic and you’ll pay out of pocket.
What the Procedure Involves
Blepharoplasty is usually performed as an outpatient procedure, meaning you go home the same day. It can be done under local anesthesia with sedation or under general anesthesia, depending on how extensive the work is and your surgeon’s preference. The surgery itself typically takes one to two hours for both upper and lower lids combined, less if only one set is being treated.
For cosmetic cases, the surgeon’s fee is only part of the bill. The total cost also includes anesthesia fees, surgical facility costs, prescriptions for post-operative medication, and any required medical tests beforehand. These additional expenses can add significantly to the base price.
Recovery Week by Week
Swelling peaks around 48 hours after surgery, then gradually improves. If your surgeon used non-dissolvable stitches, you’ll return to the office around days five to seven for removal. Some surgeons use dissolvable stitches that skip this step entirely.
Most people return to work and normal activities within 7 to 10 days. The initial bruising and swelling largely resolve within two weeks, but subtle changes continue beneath the surface as deeper tissues heal. Full results take three to six months to settle in. During the early recovery period, expect your eyes to feel sensitive and look noticeably swollen. Cold compresses, keeping your head elevated, and avoiding strenuous activity all help speed things along.
How Long Results Last
Upper eyelid results typically last 5 to 7 years, though some people find they never need a repeat procedure. The skin around the eyes is thin and ages relatively quickly, so genetics, sun exposure, and lifestyle all play a role in how long you’ll maintain the improvement. Lower eyelid surgery tends to be more durable, with results that can last a lifetime. Fat pads that are removed or repositioned beneath the eyes generally don’t return in the same way that upper lid skin continues to loosen over time.
Risks and Possible Complications
The most common side effects are temporary: bruising, swelling, dry or watery eyes, and light sensitivity. These resolve on their own during the first few weeks.
Less common but more serious complications include ectropion, where the lower eyelid pulls away from the eye and exposes the white below the iris. This is more likely with the external (below-the-lash-line) approach to lower lid surgery. Lagophthalmos, the inability to fully close your eyelids, is another known complication. When eyelids don’t close properly, you can develop chronic dry eye, a gritty or burning sensation, blurred vision, and in severe cases, a sore on the surface of the eye. These complications are uncommon but are worth understanding before you decide on surgery, especially when choosing between surgical approaches for the lower lids.
Choosing an oculoplastic surgeon, someone trained in both ophthalmology and plastic surgery of the eye area, can reduce the likelihood of these issues. The eyelids are delicate structures, and the margin for error is small.
Non-Surgical Alternatives
If your concern is mild skin laxity rather than significant drooping, non-surgical options exist. Radiofrequency treatments use energy to penetrate the deeper layers of skin in a targeted dot pattern, triggering the body’s healing response and stimulating new collagen production. The surrounding untreated skin, which contains stem cells, helps drive that regeneration. These treatments tighten the skin gradually over several sessions and involve little to no downtime.
Non-surgical options work best for early signs of aging around the eyes. They can’t remove excess skin or reposition fat pads the way surgery can, so they’re not a substitute for blepharoplasty when there’s significant sagging or vision obstruction. Think of them as maintenance tools rather than replacements for a procedure that fundamentally reshapes the eyelid.