Your Complete Blepharoplasty Procedure Walkthrough

Blepharoplasty, commonly known as eyelid surgery, is one of the most sought-after facial procedures for people seeking a refreshed, more alert appearance, especially for patients suffering from the effects of thyroid eye disease (TED).

For some, it’s about turning back the clock and reducing the signs of aging. For others, it’s a medical necessity following TED inflammation, correcting drooping eyelids that interfere with their field of vision. Whether your goals are cosmetic, functional, or a bit of both, understanding how blepharoplasty works can help you feel confident about the process and your potential results.

This comprehensive guide walks you through every phase of blepharoplasty, from deciding if you’re a candidate to what recovery really looks like.

What Is Blepharoplasty and Who Needs It?

Blepharoplasty is a surgical procedure that removes or repositions excess skin, fat, and sometimes muscle from the upper and lower eyelids. On the upper lids, this helps reduce heaviness or sagging that can create a tired look or obstruct your vision. On the lower lids, it typically addresses puffiness or under-eye bags that don’t respond to skincare alone.

Most people who consider blepharoplasty fall into one of two groups.

1. Cosmetic candidates are typically bothered by the appearance of hooded upper lids, puffy under-eyes, or a general look of fatigue. The goal is often rejuvenation to restore a more youthful, rested appearance.
2. Functional candidates may have vision that’s partially blocked by drooping upper eyelid skin, particularly in the outer corners. In some cases, insurance may cover the procedure if it’s deemed medically necessary.

Candidates should generally be in good health, non-smokers, and have realistic expectations about the results. While blepharoplasty can create dramatic improvements, it won’t fundamentally change the shape of your eyes or eliminate every wrinkle.

Preparing for Upper and Lower Eyelid Surgery

Preparation starts with a detailed consultation. Your surgeon will examine your eye area, discuss your concerns, and determine whether you need upper blepharoplasty, lower blepharoplasty, or both. You may be asked to see your ophthalmologist or primary care provider beforehand, especially if you have underlying conditions like dry eye, glaucoma, or hypertension.

Pre-surgery instructions typically include:

• Stopping blood-thinning medications or supplements (like aspirin, ibuprofen, or vitamin E) about one to two weeks prior.
• Arranging for someone to drive you home and stay with you for the first 24 hours.
• Avoiding alcohol and smoking, both of which can interfere with healing.

Your surgeon may also take pre-operative photos to document your baseline appearance (after TED inflammation has passed) and use them to help guide the procedure.

What Happens During the Procedure

• Blepharoplasty is typically performed as an outpatient procedure, meaning you’ll go home the same day.
• The surgery usually takes 1 to 2 hours, depending on whether you’re having upper eyelids, lower eyelids, or both treated.
• Local anesthesia with sedation is commonly used, but general anesthesia may be recommended in some cases.
• For upper eyelid surgery, the surgeon makes an incision along the natural crease of the eyelid.
• Excess skin, muscle, and fat are removed or repositioned to create a more lifted and open appearance.
• For lower eyelid surgery, the incision is either just below the lash line or inside the lower lid (transconjunctival approach), depending on the technique and your anatomy.
• Fat pockets may be removed or redistributed to smooth out under-eye bags and reduce puffiness.
• If needed, the surgeon may also tighten the skin or use laser treatments to improve tone and texture.
• Incisions are closed with fine sutures that are either dissolvable or removed within a few days.
• Once complete, you’ll be monitored briefly in recovery before being discharged with post-op instructions.

Recovery Timeline and Following Healing Instructions from Your Surgeon

Most people are surprised by how manageable the recovery from blepharoplasty can be. The first two days tend to be the most uncomfortable, with swelling, mild bruising, and maybe a little blurry vision from the ointments or residual puffiness. During this period, keeping your head elevated—even while you sleep—and applying cold compresses as instructed can go a long way in reducing swelling and helping you feel more comfortable.

By the end of the first week, the majority of bruising begins to fade, and any external stitches are typically removed. While your eyes may still feel a little tender or tight, many people are up and about, running light errands or working from home by this point. Some wear sunglasses outside to cover up any lingering discoloration, and that’s perfectly fine. If you wear contact lenses, you’ll need to hold off on those until your surgeon gives the all-clear, usually after about two weeks.

It’s important to avoid rubbing your eyes, wearing eye makeup too soon, or doing anything that strains the healing tissue. Most patients return to normal routines gradually, starting with light activity in the second week and resuming more intense exercise after three to four weeks. Complete healing takes time, but the discomfort generally eases up after the first several days.

What matters most during recovery is being patient and following your surgeon’s instructions. You’ll likely notice positive changes fairly quickly, but it can take several weeks for swelling to fully settle and for your results to take their final shape.

Expected Results and Longevity of Outcomes

Blepharoplasty helps you look like yourself, only more rested and refreshed. It doesn’t change the shape of your eyes, but it reduces puffiness, sagging, and heaviness that can make you look tired. Most people say they appear brighter, more alert, and less weighed down.

For upper eyelid surgery, results typically last about 10 to 15 years. Lower eyelid procedures often have even longer-lasting outcomes, especially when fat is removed or repositioned. While the aging process continues, the improvements from surgery tend to hold up very well.

You’ll still experience changes in your skin and facial structure over time, but chances are your eyes will continue to look younger than they would have otherwise. Some people eventually choose to have a second procedure if TED inflammation returns, but many don’t find it necessary.

How long your results last also depends on your lifestyle. If you avoid smoking, protect your skin from the sun, and take good care of your health, your results will last longer. Simple habits like staying hydrated, using a quality eye cream, and getting enough sleep can also help maintain a refreshed appearance, despite your battle with thyroid eye disease.