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Blepharoplasty: The Eyelid Lifting Procedure Is on the Rise — But Is it Safe?

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In general, “an upper eyelid surgery is an easy thing to go through,” assures New York City-based double-board certified plastic surgeon Melissa Doft, MD. “It’s not so painful, and a lot of skin tightens by week four or five.” New York City board-certified plastic surgeon Lara Devgan, MD, always tells her blepharoplasty patients that they’re “going to look a little worse than they feel” and to have loads of ice ready to help with swelling. Because the eye area is so delicate and vision may be blurred, both Drs. Devgan and Rosenberg like to send patients home with a private nurse for the first night. “The surgery is very anxiety-producing for patients, and I just think it makes for a smoother recovery,” says Dr. Rosenberg.

Dr. Chang cautions that a lower eyelid procedure “can take a little longer to resolve, just because the swelling can be a little bit more significant in those cases.” Dr. Rosenberg adds that for the upper eyelids, you’ll see “a magnificent result within three weeks,” and for the lower lids, he estimates six weeks max until your eyes look as back to normal. During the three to six months post-op, your eyelids will look “crisper and crisper and crisper,” says Dr. Chang, as the skin will tighten even more as the healing continues.

What risks are associated with blepharoplasties?

Both upper and lower blepharoplasties are widely considered to be one of the safer cosmetic procedures when performed by an experienced board-certified plastic surgeon. Physical complications, like dry eye or visual acuity, are usually temporary but can be permanent in the rare patient. An overly taut sensation, as if the lid was pulled too tight, “isn’t uncommon” according to Dr. Chang, and will correct itself in a very short period of time.

The more serious risk, according to Dr. Rosenberg, is improper patient selection, which can lead to unnecessarily invasive treatment. “Sometimes the doctor suggests a blepharoplasty when the patient really needs a brow lift,” he says, and sometimes even both to achieve their desired result. “It’s important to remember that it’s not just the eyelid skin, but often the brow as well, that has changed over time.”

Cheek and undereye fillers can also be stubborn foes and can thwart a patient consultation, especially to an untrained eye. “I always ask my patients if they’ve had filler in the past, and even if it was eight years ago, I’m going to use a melting agent to dissolve that old filler,” says Dr. Rosenberg, who notes that sometimes, it’s the only procedure a patient needs. “I’m customizing what I’m seeing and treating them based on one: is it fat bags from aging or is it filler that was placed a long time ago that doesn’t look right?” he explains, “and two, is it the brow or the upper eyelid skin? This is not cookie-cutter care.”

How much does a blepharoplasty cost?

Just like any surgical procedure, cost depends on location and surgeon skill, but a New York City patient can expect to drop at least $8,000 for an upper eyelid procedure and $9,000 for a lower one, according to Dr. Devgan. “Some patients require fat grafting, and others require internal tightening and so forth,” she says. “[Cost] really just reflects the complexity of the surgery, as well as different little maneuvers that can be done to customize results.”

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