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Eyes Guide

Eye Surgery: Which Procedure Is Right for You?

Eye surgery is divided into double eyelid surgery and ptosis correction, upper blepharoplasty, lower blepharoplasty, sub-brow lift, and canthoplasty, depending on whether the problem lies in eyelid sagging, eye-opening strength, or how much of the eye is exposed.

Eye surgeries may sound alike, but each addresses a different problem. The same concern, "my eyes look small," may call for a different operation depending on whether the cause is sagging eyelid skin, the strength of the muscle that opens the eye, or the range of the eye that is exposed. This page is a guide to which surgery fits, organized along those three axes.

If sagging is the problem, surgery that removes the loose skin comes first: upper blepharoplasty, lower blepharoplasty, or a sub-brow lift. If opening strength is weak, ptosis correction adjusts the power of the muscle. If the exposed range is narrow, double eyelid surgery or canthoplasty adjusts the width and height of the visible eye. Many people have two or more of these issues at once, so we plan the combination of procedures that is needed.

At Atelier Plastic Surgery, the director personally handles everything from consultation through surgery and follow-up. Upper-eyelid and under-eye sagging that come with age affect both vision and appearance, so we decide on surgery by looking not only at the shape of the eye but also at how much the field of vision is obstructed, the position of the eyebrows, and the thickness of the skin.

Based on what the concern is

My upper eyelids sag, my eyes feel heavy, and my vision is obstructedWith age, the upper-eyelid skin stretches and comes to cover the lashes, or you develop the habit of tensing your forehead to open your eyes. The site of excision depends on how much skin is loose and on the distance between the eyebrow and the eye.

Upper blepharoplastyWhen the loose skin is concentrated near the double eyelid line and there is enough distance between the eyebrow and the eye Sub-brow liftWhen the brow-to-eye distance is short or outer sagging is pronounced, or when you want to keep your existing double eyelid line as it is

My eyes open weakly and look sleepy or tiredThis is not skin sagging but weakness of the muscle that opens the eye (the levator), which leaves much of the iris covered by the eyelid. Double eyelid surgery alone may bring limited improvement, so ptosis correction, which adjusts the strength of the muscle, is needed.

Double eyelid surgery · Ptosis correctionWhen the iris is covered by the eyelid and the eyes look sleepy, or when opening strength differs between the two eyes Upper blepharoplastyWhen skin sagging and weakened opening strength occur together after middle age (combined with ptosis correction)

I have no double eyelid, or the line is faint and my eyes look heavyWe choose among the non-incisional, partial-incision, and incision methods based on eyelid skin thickness, fat volume, and opening strength. On thin eyelids a line may hold with the non-incisional method; thick eyelids or those with a lot of fat may require an incision.

Double eyelid surgery · Ptosis correctionWhen creating a new double eyelid line or re-establishing a line that has faded Canthoplasty (upper canthoplasty)When there is a double eyelid but the vertical opening is narrow, making the eyes look small

My eyes are narrow horizontally, or the epicanthal fold covers the inner cornerWhen the epicanthal fold at the inner corner covers the front of the eye, the eyes look far apart and small. Epicanthoplasty adjusts this skin to widen the horizontal opening, and it is often planned together with double eyelid surgery.

Canthoplasty (epicanthoplasty)When the epicanthal fold is prominent and the eyes look widely spaced Double eyelid surgery · Ptosis correctionWhen adjusting the line and opening strength together with the horizontal width

My under-eye area bulges or looks shadowed and tiredUnder-eye concerns fall broadly into two groups: cases with skin sagging and wrinkles together, and cases where the skin still has elasticity but bulging fat and hollowing create shadows. The surgery differs depending on whether skin needs to be removed.

Lower blepharoplastyAfter middle age, when the under-eye skin has loosened and fine wrinkles are pronounced Lower-eyelid fat repositioningWhen the skin still has elasticity and dark circles come from bulging fat and the hollowing beneath it

At a glance

Surgery · Treatment	Main concern	Incision · Approach	Anesthesia	Recovery
Double eyelid surgery · Ptosis correction	Line · opening strength	Non-incisional · partial incision · incision	Local (with sedation if needed)	About 1–2 weeks
Upper blepharoplasty	Upper-eyelid sagging · vision	Along the double eyelid line	Local (with sedation if needed)	About 1–2 weeks
Lower blepharoplasty	Under-eye sagging · wrinkles	Below the lashes	Local (with sedation)	About 1–2 weeks
Lower-eyelid fat repositioning	Under-eye fat bulging · hollowing	Conjunctival (no skin incision) or below the lashes	Local (with sedation)	About 1 week
Sub-brow lift	Upper-eyelid sagging · brow-to-eye distance	Along the lower brow border	Local (with sedation if needed)	About 1–2 weeks
Canthoplasty	Horizontal width · vertical height	Small incisions at the inner corner · inner upper eyelid	Local (with sedation if needed)	About 1 week

Recovery periods are typical ranges and vary by individual.

Procedures

Eye Surgery

Double eyelid surgery · Ptosis correction

The extent of incision, whether non-incisional, partial, or full, is chosen by eyelid thickness and opening strength.

Upper blepharoplasty

Removes only as much loose upper-eyelid skin as needed to improve both vision and appearance.

Lower blepharoplasty

Tidies loose under-eye skin and bulging fat and reinforces the supporting structure.

Lower-eyelid fat repositioning

Moves bulging fat into the hollow groove to soften under-eye shadows and contours.

Sub-brow lift

Removes skin just below the brow to lift sagging while keeping the double eyelid line.

Canthoplasty

Epicanthoplasty widens the horizontal opening and upper canthoplasty the vertical, adjusting how much of the eye is exposed.

After surgery

After surgery and recovery care

Most eye surgery is performed under local anesthesia or sedation, and you go home the same day. Swelling and bruising peak during the first 2–3 days, and stitches are generally removed at about 5–7 days. Return to daily life takes about 1–2 weeks, and a natural shape settles over about 1–3 months. Recovery speed varies with the extent of surgery and the individual. The timing for washing your face, wearing makeup, and using contact lenses differs by procedure, so please refer to the recovery section of each page. Anesthesia management, infection prevention, and the post-operative care system are described on the Safety Care System page.

Safety Care System · Aftercare schedule

Related treatments in other categories

Safety Care System

See the anesthesiologist on the team, the recovery room, and the post-operative care schedule.

Before & After Cases

For eye surgery, comparing before-and-after photos by procedure helps you choose.

Personal Consulting

Before deciding which surgery fits, we review your skin, daily routine and recovery environment together.

Related research

Dr. Juyoung Go's academic activity in this field

ConferencePoster

Asian Upper Lid Blepharoplasty Surgery

2nd Oculoplastic Aesthetic Forum · 2018.07 · Shenyang, China

Poster presentation summarizing surgical approaches to Asian upper-eyelid blepharoplasty

Each treatment page lists the items relevant to it; the full list is on the Academic Activities page. View all academic activities

FAQ

Q1How do double eyelid surgery and ptosis correction differ?

Double eyelid surgery creates a fold line in the eyelid, while ptosis correction adjusts the strength of the muscle that opens the eye. The surgery you need depends on whether your eyes look heavy because there is no line or because opening strength is weak, and many people need both.

Q2My eyelids have sagged with age. Which is right for me, upper blepharoplasty or a sub-brow lift?

If the loose skin is gathered near the double eyelid line and there is enough distance between the eyebrow and the eye, we consider upper blepharoplasty. If the brow has dropped, the brow-to-eye distance is short, or outer sagging is pronounced, we consider a sub-brow lift. A sub-brow lift may also suit you if you want to keep your existing double eyelid line as it is. The two are sometimes divided and performed together.

Q3People often tell me my eyes look sleepy. Is double eyelid surgery enough?

If the sleepy look comes from weak eye-opening strength, creating a double eyelid line alone may bring limited improvement. We check how much of the iris is covered by the eyelid to decide whether ptosis correction is needed. After middle age, skin sagging is often present as well, so we sometimes plan upper blepharoplasty and ptosis correction together.

Q4How do I choose between lower blepharoplasty and lower-eyelid fat repositioning?

The elasticity of the under-eye skin is the criterion. If the skin still has elasticity and the main problem is bulging fat with hollowing beneath it, we recommend lower-eyelid fat repositioning, which moves the fat through the conjunctiva without a skin incision. If the skin has loosened and fine wrinkles are pronounced, we recommend lower blepharoplasty, which also tidies the skin and reinforces the supporting structure.

Q5Is eye surgery done under general anesthesia?

Most eye surgery is performed under local anesthesia, with sedation added when you are very anxious or the extent of surgery is larger. We work together with a board-certified anesthesiologist, and you go home the same day.

Q6How long does recovery take? When can I return to work?

Swelling and bruising are generally at their peak around days 2–3, and stitches are removed at about 5–7 days. Return to work is often around 1–2 weeks depending on the extent of surgery, and a natural shape settles over about 1–3 months. This varies from person to person.

Q7Can I have several procedures at once?

Yes. Combinations such as upper and lower blepharoplasty, or double eyelid surgery and canthoplasty, are often performed together, with the advantage of a single recovery period. However, a larger extent of surgery can prolong swelling, so depending on your health and recovery environment we sometimes stage the procedures.

Q8I had double eyelid surgery before, and my eyelids have sagged with age. Can I have surgery again?

Yes. We consider upper blepharoplasty, which keeps the previous line and removes only the sagging skin, or a sub-brow lift, which lifts from below the brow without touching the line. Tissue may have adhered from the previous surgery, so we assess the condition at consultation.

Q9What will the scars be like?

It depends on the incision site. For double eyelid surgery and upper blepharoplasty the incision sits within the line, for lower blepharoplasty just below the lashes, and for a sub-brow lift along the lower brow border, and these fade over time. Epicanthoplasty leaves an incision line on the skin at the inner corner of the eye, while lower-eyelid fat repositioning through a conjunctival incision leaves no incision line on the skin. Results vary with your tendency to scar.

Q10What is checked at the consultation?

We check the thickness and laxity of the eyelid skin, eye-opening strength, brow position and brow-to-eye distance, under-eye skin elasticity and fat bulging, and differences between the two sides. We examine you both sitting and lying down, listen to the look you want and your daily circumstances, and then decide on surgery. The director conducts the consultation personally.