ph: 512.642.5050
fax: 512.642.8186

Upper Blepharoplasty (Upper Eyelid Skin & Fat)


Droopy EyelidsOur eyes are the first and most important tool we use every day to express ourselves. However, due to aging and/or heredity, our eyes can sometimes deceive those around us. Eyebags, extra eyelid skin and puffiness around the eyes can lead others to believe we are sad, angry or tired, when in fact we feel quite the opposite. Eyelid surgery can do wonders for restoring the youthful, rested look to your entire face.

One of our most frequently performed surgical procedures at Austin Oculofacial Plastics, the upper eyelid blepharoplasty, is used to remove the fat deposits, loose and drooping skin that may form around the upper eyelids with age. Heredity, smoking, edema from allergies and sun damage can accelerate these changes. Younger people also elect to have this procedure done to eliminate puffiness of the eyes from congenital excess fatty tissue.

Upper lid blepharoplasty can improve two common problem areas:

  1. Excess skin on the upper eyelid itself, often called “hooding of the upper lid, and
  2. Puffiness in the inner corner and middle of the upper eyelid caused by herniation (pushing forward) of fat.

This procedure is frequently done at the same time as other procedures, such as a lower eyelid blepharoplasty, facelift or forehead lift, and can be combined with Botox or cosmetic injectables to smooth skin wrinkles. When drooping of the upper lids interferes with your vision, the procedure may sometimes be partially or fully covered by insurance.

Upper Lid Blepharoplasty Before & After


Most patients who get eyelid surgery are over 30 years old, however adults of any age can have the procedure. Eyelid surgeries are a popular choice for individuals looking to reduce signs of aging, particularly droopy eyelids or under eye bags. Although most candidates choose eyelid surgery for cosmetic reasons, it is also a functional surgery performed to remove sagging upper eyelid skin that interferes with vision and may sometimes be covered by insurance.

You might be a good candidate if you are:

  • Healthy with no medical issues
  • Have excessive drooping or sagging skin around the eyes.
  • Non-smoker

You may NOT be a good candidate if you:

  • Have serious eye or medical conditions (glaucoma, diabetes,etc), as these can increase the risks of complications.
  • Have unrealistic expectations.


During your initial consultation, Dr. Paul will discuss your concerns about your eyes. He will also carefully evaluate your medical history, noting any prior history of eyelid surgery, dry eyes, or the use of blood thinners. He will also pay special attention to the surrounding anatomic structures such as the upper eyelids, cheeks, as well as the strength of the lower eyelid muscles.


Typically, the anesthesia used will be tailored to the patient’s comfort level and the type of procedure(s) being performed. If only blepharoplasty is being performed, local anesthesia with oral sedation can be an excellent option in our office, however if combined with other procedures – or if the patient prefers – general anesthesia can be used at one of our outpatient surgical centers around the greater Austin area. Eyelid surgery takes about 1-2 hours on average when performed as a standalone procedure for both eyes.

Upper blepharoplasty usually involves the conservative removal of skin and occasionally muscle and fat of the upper eyelid and is performed through small incisions in the upper eyelid crease.

Upper Lid Blepharoplasty Procedure Steps

Scarring is minimal for both techniques, as the incisions are small and hidden within the eyelids and eyelashes. Major complications with blepharoplasty surgery are rare, and the procedure is considered very safe. Dr. Paul is always meticulous with his approach, avoiding the removal of too much skin and fat for a very natural appearance and beautiful results.


In most cases, eyelid surgery is performed on an outpatient basis. Once the anesthesia wears off, you will be able to return home, although you will need someone to drive you, because your eyesight will be blurry and the eyes may need to be covered.

Following your eyelid surgery, the eyelids will be supported with paper tape to ensure that the tissue heals with the correct contours. Gauze may also be worn over the eyes for up to three days following blepharoplasty. It is very important to leave these post-surgery coverings in place, as directed by the doctor, to ensure a fast eyelid surgery recovery and optimum results. If you have had transconjunctival blepharoplasty, in which the tissues are accessed through an incision behind the lower eyelid, your eyes may not need to be covered following surgery. Typically, the sutures used during the eyelid surgery procedure need to be taken out by Dr. Paul a couple of weeks after the procedure.

Although every surgical procedure comes with the possibility of scars, visible scars following eyelid surgery are minimized due to the placement of incisions. Because incisions are placed in natural skin folds, or sometimes behind the eyelid, they should not result in obvious scarring. Over time, any scars you see will fade into the surrounding skin. If desired, Dr. Paul can also recommend topical treatments or serums which could further reduce scarring in the treatment areas.

During the eyelid surgery recovery period, use eye drops or ointments as directed by your surgeon. It’s also important to avoid disturbing the eyelid tissues as they heal; this requires keeping the head elevated while sleeping. Any discomfort you feel can be managed with pain medication and cold compresses.


Other treatment may also need to be considered. If the upper eyelid condition is accompanied by sagging of the eyebrows, then a forehead lift may be recommended. Smoothing of the crow’s feet may be accomplished with Botox, Dysport, or chemical peel resurfacing procedures. For dark circles under the eyes, alternatives to surgery include filler. Juvederm and Restylane are two great options we use at Austin Oculofacial Plastics to improve the appearance of sunken eyes or dark circles as well as hollowing of the cheeks. Dr. Paul and his knowledgeable team would be happy to provide further information if you have an interest in any of these additional procedures.

If you’re considering upper eyelid blepharoplasty, and want more detailed information, feel free to call Dr. Paul’s office at 512-642-5050 to set up a consultation.