Upper blepharoplasty removes upper-eyelid skin that has loosened with age to correct sagging that obstructs vision.
With age, the upper-eyelid skin stretches and drapes over the lashes, and the double eyelid line becomes hidden or turns into multiple folds. At first this only makes the face look heavy, but as it progresses the upper and outer field of vision is obstructed, and tensing the forehead to open the eyes can lead to forehead wrinkles and eye fatigue. Upper blepharoplasty corrects this sagging by removing the loose skin and, where needed, some muscle and fat.
The key is not how much is removed but how precisely the right amount is removed. Removing too much skin keeps the eyes from closing well, causing dry eye and corneal irritation, and pulls the brows down, making the face look heavier instead. Removing too little leaves sagging behind. We set the amount to remove by considering brow position, the amount of skin that must remain, and eye-opening strength together.
Eyelid sagging after middle age often involves not only loose skin but also weakened strength of the muscle that opens the eye and a lowered brow. At Atelier Plastic Surgery we assess these three separately, and where needed we combine ptosis correction or suggest a sub-brow lift as an alternative. Consultation, surgery, and follow-up are handled personally by the director.
Loose skin is removed along the existing double eyelid line or a newly set line, and where needed some orbicularis muscle and protruding fat are tidied before closure. The incision sits within the line and is hidden when the eyes are open.
Along with skin removal, the levator aponeurosis is tightened to strengthen eye opening. This is combined when removing skin alone would leave the iris still covered and the eyes looking sleepy.
If fat inside the eyelid protrudes and looks puffy, some is removed; conversely, if fat has been lost and the eyes look hollow, fat is preserved or grafting is considered. After middle age, it is important not to remove too much fat.
When the brow-to-eye distance is short or the brow has dropped, removing skin at the double eyelid line can pull the brow down further. In such cases a sub-brow lift, which removes skin just below the brow, may be more suitable, so we compare the two at consultation.
These may vary depending on your condition; we will give you precise details at your consultation.
Upper blepharoplasty is a matter of vision before it is a matter of shape. At consultation we check how far the eyelid covers the lashes and pupil, whether you use your forehead to open your eyes, and how tired your eyes feel, and we set the extent of correction on that basis.
Rather than how much to cut away, we first calculate how much must remain for the eyes to close comfortably. To avoid incomplete eye closure and dry eye from over-removal, we remove only the amount needed.
If only eyelid skin is removed while the brow has already dropped, the brow can drop further and the face can look heavier. We check brow height and the brow-to-eye distance to judge whether upper blepharoplasty is suitable or a sub-brow lift would be better.
Sagging after middle age often combines loose skin with reduced levator function. Removing skin alone can leave the eyes looking sleepy, so we plan ptosis correction alongside when needed.
Begin cold compresses and rest with your head elevated. You go home the same day; take the prescribed medication and keep water away from the incision sites.
Swelling and bruising are at their peak. Continue cold compresses and avoid strenuous activity and bending your head down.
Stitches are removed. You can wash your face after stitch removal, and switching to warm compresses from this point helps the swelling resolve.
Major swelling subsides and most daily activities are possible. Light makeup is possible, and this is when you begin to notice that your vision feels lighter.
Fine swelling resolves and the line becomes natural. The incision line may look red at first but gradually fades, and scar care is added if needed.
The final shape settles. Recovery speed and results vary from person to person.
Bleeding and hematoma, infection, swelling, and bruising may occur. Removing too much skin can cause incomplete eye closure, leading to dry eye, corneal irritation, and a foreign-body sensation, while removing too little can leave sagging behind. Asymmetry in line height or eye size, incision-line scarring, and depression along the inside of the line may occur, and brow position may change or forehead wrinkles may temporarily differ. When ptosis correction is combined, overcorrection or undercorrection may occur, and there may be temporary reduced sensation and eyelid stiffness. Revision surgery may be needed depending on the result, and outcomes vary from person to person. We explain the risks and limitations fully at consultation.
The content on this page is general medical information provided in accordance with the Medical Service Act. The results of surgery and treatments and the recovery period may vary by individual. All surgeries and treatments carry a risk of side effects, so please decide after a thorough consultation with a specialist.
A sub-brow lift that removes skin below the brow to lift sagging while keeping the double eyelid line
Learn more Related Lower BlepharoplastyLower blepharoplasty that tidies loose skin and bulging fat and reinforces the supporting structure
Learn more Related Double Eyelid · Ptosis CorrectionDouble eyelid surgery and ptosis correction, with the extent of incision chosen by eyelid thickness and opening strength
Learn more Related Eye Surgery GuideA guide to choosing eye surgery by sagging, opening strength, and eye exposure
Learn moreConsultations are conducted by the Director herself. Schedule one by phone or KakaoTalk, or leave an online consultation request.
