When you look in the mirror, do you notice sagging upper eyelids that make you look tired or even interfere with your vision? Or maybe it’s the puffiness, hollowness, or dark circles under your eyes that draw unwanted attention and make you appear older than you feel? These age-related changes around the eyes can affect not only your appearance but also your confidence in personal and professional settings.
At Bellevue Plastic Surgeons, board-certified plastic surgeon Dr. George Marosan specializes in advanced eyelid surgery, also known as blepharoplasty. With decades of experience in facial rejuvenation surgeries, he helps patients explore their options and achieve results that conform to their unique anatomy and goals. In this article, you’ll learn the differences between upper and lower eyelid surgery, so you can better understand which option may be right for you.
Primary goals
Upper blepharoplasty
The primary goal of upper eyelid surgery is to address drooping, sagging skin that hangs over the lash line. As you age, the delicate skin of your upper eyelids loses elasticity, leading to folds that can make you look older, constantly tired, or even angry. In advanced cases, excess skin can even obstruct your peripheral vision. An upper blepharoplasty removes extra skin and, when necessary, tightens underlying muscle for a lifted, refreshed appearance.
Lower blepharoplasty
Lower eyelid surgery focuses on correcting puffiness, under-eye bags, and dark circles. Over time, fat beneath the eyes can shift forward, while skin becomes thinner. This creates shadows and bags that makeup can’t conceal. The goal of a lower blepharoplasty is to smooth the lower eyelid area by removing or repositioning fat, trimming away excess skin, and restoring natural volume. The result is a smoother, brighter under-eye area that blends with your cheeks.
Incision placement and scarring
Upper blepharoplasty
During upper eyelid surgery, the incision is hidden in the natural crease of the eyelid. Once healed, the scar is virtually invisible and blends with the surrounding skin. Due to this placement, patients achieve natural-looking results with minimal visible signs of surgery.
Lower blepharoplasty
For lower eyelid surgery, incisions are made just beneath the lash line or inside the eyelid (transconjunctival). Both minimize visible scarring. The lash line incision allows for skin tightening in addition to fat removal, while the internal incision leaves no external marks.
Functional benefits vs. cosmetic benefits
Upper blepharoplasty
Upper eyelid surgery often provides both functional and cosmetic improvements. By lifting drooping eyelids, the procedure can expand your visual field, making everyday tasks like reading, driving, or using a computer easier and more comfortable. At the same time, the procedure refreshes your appearance, helping you look alert and youthful.
Lower blepharoplasty
The benefits of lower eyelid surgery are primarily cosmetic. By reducing puffiness and dark circles, the procedure helps you look more rested. While lower blepharoplasty doesn’t improve vision, it has a significant impact on overall facial balance and perceived age. Patients often find that their under-eye area no longer makes them look fatigued.
Recovery process and downtime
Upper blepharoplasty
Recovery from an upper blepharoplasty is simple. Most patients experience mild swelling and bruising for one to two weeks. Sutures are typically removed within the first week, and most people can return to work or social activities within 10 to 14 days. The final results become visible as the swelling subsides, with eyes appearing brighter and more youthful.
Lower blepharoplasty
Lower eyelid surgery tends to involve slightly more swelling and bruising than upper eyelid surgery, particularly if fat repositioning or transfer is performed. Recovery typically takes 10 to 14 days, but subtle swelling may persist for longer. Makeup can help camouflage early bruising, and results become increasingly noticeable as the healing process continues.
Longevity of results
Upper blepharoplasty
The results of an upper blepharoplasty are long-lasting, often enduring for a decade or more. While the natural aging process continues, most patients never experience the same degree of drooping again. In some cases, patients experience permanent improvements, especially when functional concerns such as impaired vision are corrected.
Lower blepharoplasty
Lower blepharoplasty results are also long-lasting, though the under-eye area can continue to change with age, genetics, and lifestyle. Most patients enjoy a refreshed appearance for many years, with fat repositioning and skin tightening offering lasting improvements. Maintenance with non-surgical treatments, such as fillers or skin resurfacing, can help extend results.
Which blepharoplasty is right for you?
There are multiple factors that can help you to decide which blepharoplasty is right. If droopy upper lids make you look tired or interfere with your vision, an upper eyelid procedure may be the best choice. If under-eye bags, puffiness, or dark circles are your primary frustration, a lower blepharoplasty may be more appropriate.
For many people, both the upper and lower eyelids exhibit signs of aging simultaneously. In these cases, combining procedures can deliver the most comprehensive and harmonious results while allowing you to go through a single recovery period.
At Bellevue Plastic Surgeons, Dr. George Marosan provides personalized recommendations tailored to your needs and goals. With his advanced training and artistic eye, he ensures that your results look natural, refreshed, and in harmony with your overall facial features. Please schedule a consultation to explore your blepharoplasty options in Bellevue, WA.
