Derms and plastic surgeons will tell you the universal cosmetic woe is: “I just look tired.” This can be due to drooping eyelids, when the skin on the upper lid hangs down a little lower than it used to or just lower than one would like. Typically, the treatment recommended is blepharoplasty, AKA an “eyelid lift” (not to be confused with the “lip lift”).
Eyelid surgery is one of the most common cosmetic surgeries in the country and refers to both upper and lower eyelid surgery. Lid lifts have grown in popularity as part of the “Zoom boom” of treatments that saw a marked uptick over the past two years and have become more well-known thanks to social media. Beauty business brain Alli Webb, who is the president of Canopy humidifiers and the founder of Drybar, posted very openly about her blepharoplasty to her 234k Instagram followers earlier this year.
“I have heavy lids and brows naturally, so my eyes are already very small,” says Webb. “I had been going to my surgeon for Botox and as we started talking about my eyes, the idea of a lid lift came up. When she used double-sided lid tape to show me what it could look like and I looked so refreshed — immediately, I was like, ‘Let’s do it.’”
While there are non-surgical options (more on that below), blepharoplasty is one of the simplest, most accessible, and consistent types of plastic surgery. “What else can you do in the office, under local anesthesia in under an hour, with pretty straightforward recovery?” says Dr. Flora Levin, an oculofacial plastic surgeon in Westport, Connecticut, whose practice is almost exclusively eyelid surgeries. “It also has a huge impact as far as looking less tired and setting yourself back many years. So I think it's unique in that regard.” And, as far as cosmetic surgery is concerned, it’s on the more affordable side.
Below, find answers to common questions about upper lid lifts from some of the top surgeons who do this treatment regularly.
What Is An “Eyelid Lift” Exactly?
“It's an outpatient procedure that requires a very fine and small incision in the natural crease of their upper eyelid, where we remove a crescent of skin,” says Dr. Sachin Shridharani, a plastic surgeon in New York City. “Sometimes [we also remove] a slight amount of muscle and fat.” The results reveal more eyelid, make the eyes look more well rested, and help improve eyesight if excess skin was blocking the field of vision. For some patients, it’s also about the seemingly small things like enjoying makeup.
“Even though I've always had slightly hooded eyes, I was always able to wear eyeliner,” says Suzanne Scott, a 38-year-old London-based beauty journalist who had upper blepharoplasty over the Christmas holiday. “But over the last couple of years, it just felt pointless because you couldn't see it anymore.”
Who Is A Good Candidate For An Eyelid Lift?
“The ideal candidate has extra eyelid skin,” says Dr. Sarmela Sunder, a plastic surgeon in Beverly Hills. “Oftentimes people think they need an eyelid lift but really need a brow lift. As we age, our brow starts to descend and pushes on the eyelid skin. Sometimes people confuse the two.” There’s also eyelid ptosis, which occurs when one of the muscles that opens the eyelid is naturally weaker or weakened through injury — this requires a different surgery as well. A qualified doctor will be able to spot these differences and will also encourage you to take other consultations so that you feel confident you’re getting an accurate assessment.
“There’s a big genetic component, so I’ve had patients in their 20s and 30s, but most have lid lifts done in mid- to late 40s or early 50s,” says Dr. Shridharani (this is the typical age range reported by the American Academy of Plastic Surgeons as well). “I find that people who wait until their late 50s or 60s say they wish they’d done it sooner.”
Does Eyelid Lift Surgery Vary By Eye Shape?
Yes. Scott, for example, had additional heaviness on her outer corners, so her doctor tailored the incision “almost like a winged eyeliner” to help pick up those outer corners. But it’s also critical that your doctor is able to speak to and respect your features as related to your ethnicity. “Unfortunately, doctors are really taught about Northern European faces in school, but that can’t be applied to every anatomy,” says Dr. Sunder, who is South Asian and Pacific Islander. “I've got naturally hooded lids myself. If [a surgeon] got rid of that entirely, it would totally freak me out. You want to look like a more youthful version of you.”
What Should I Expect At My First Appointment?
First, make sure it’s been more than three months since you last received a neurotoxin injection in your forehead as that can affect assessment. You should also gather images of yourself from 10, 20, and 30 years ago as well as images of your biological parents to help in conversation about ideal results.
“We talk extensively about ocular history such as dry eye symptoms, history of eye trauma, vision, contact lenses, or allergies,” says Dr. Shridharani. “For example, if a patient has seasonal allergies and it’s spring, we do not want to have them rubbing their eyes during healing.”
You should also get into detail about desired aesthetics. Ask to see the surgeon’s before and afters, including photos that are more than a year after surgery. And one big important note: Make sure you are never pressured to book your surgery.
How Much Does An Eyelid Lift Cost?
According to 2020 statistics from the American Society of Plastic Surgeons, the average cost of cosmetic eyelid surgery in the US is $4,120 (not including anesthesia and operating room fees). But prices really range based on location and the experience or prestige of the doctor. The surgeons interviewed for this story estimate between $5,000 and $10,000 in metropolitan areas.
This is also one of very few cosmetic procedures that could be covered under insurance. “You usually have to have something called a visual field test to see if your vision is occluded from the drooping,” explains Dr. Shridharani.
What Happens In An Eyelid Lift Surgery?
In the days leading up, you’ll avoid alcohol, supplements, green tea, and other things that can thin blood. You’ll also arrange for someone to drive you or at least pick you up — you will be under sedatives and your eyes will be swollen so you cannot drive yourself home.
Once there, you’ll prep for surgery, sign final paperwork, and the doctor will put markings on your skin where they plan to cut. You might be given a Xanax if you’re feeling nervous. All surgeons do eyelid surgery under local anesthetic, but a lot of patients request twilight anesthesia, too.
Doctors use a scalpel, scissors, cutting laser, or heat devices to cut the thin skin — each doctor is a little different. The most painful part is the injection of the local anesthesia, otherwise the main sensation (if you’re not under twilight medication) is tugging of the skin as it’s being cut and sewn. Dr. Levin says she talks conscious patients through her steps to help calm them. The surgery usually takes between 45 and 60 minutes.
What Is The Aftercare For Eyelid Lift Surgery?
You will have some bruising and swelling post-surgery. “Keep the head of your bed elevated, use ice packs almost around the clock for the first 48 hours, and avoid extra salty foods, alcohol, and exercise,” says Dr. Shridharani. The sutures are usually removed between four to six days later.
Webb actually had to give her first company meeting at Canopy just a few days after her surgery. She decided to just own it. “I didn’t realize how sore I was going to be, so I just did that first meeting with sunglasses on and said ‘Listen, I’m not a diva! I’m just swollen’,” says Webb. “I just want to be very unapologetic about who I am. Plus, I was already public about the surgery on Instagram.”
As far as scar prevention, most doctors recommend keeping the incision covered in some kind of ointment like Aquaphor. Some faint scaring is fairly unavoidable, but is well-disguised in the crease of the eyelid.
What Are The Risks Of Eyelid Lift Surgery?
The biggest risks are mostly cosmetic. For example, asymmetry or removal of too much tissue which can leave the eye socket looking hollowed out (or like a “deer in headlights,” says Dr. Shridharani). These two issues can be somewhat corrected with a fat transfer, though it's far better to avoid it all together. There’s also a risk of not seeing much change if a doctor does a blepharoplasty when a brow lift was needed. And if the surgery was too extreme, there’s a risk of being unable to close the lids all the way, which is very difficult to correct (this is rare). Finally, there is always a very small risk of infection or blindness, which prompts us to encourage you to seek out board-certified and well-respected doctors!
How Long Until You See The Final Results?
“In five days, my patients look pretty good to be social,” says Dr. Sunder. The six-week mark is when you should see the real results. If you’re prepping for a big event, give yourself at least six weeks just for the healing process, but ideally 12 weeks.
“If done appropriately, it's one of those things where no one else can pinpoint you had an eyelid lift,” says Dr. Sunder. “The comment that I get the most from patients is, ‘People keep telling me that my eyes are so bright,’ or, ‘I get compliments on my lashes,’ when it's not that.” Webb says her friends keep saying she looks like she’s slept for a week.
How Long Will An Eyelid Lift Last?
Because it is more of a reset, the length of the results is more a question of how quickly your skin will “re-age” to the point where you’d want to redo this surgery again. That tends to be 10 to 15 years, but if you continue to treat with skin care and lasers you can go for longer.
Is Plastic Surgery The Only Option?
If surgery isn’t something you’re comfortable with for any reason, don’t do it. There are other options. But, depending on the amount of laxity, the alternatives only offer partial results.
- Laser: Tightening is possible with a CO2 laser on the eyelids, but this is only an option for lighter skin tones and the results likely won’t match a lid lift unless the drooping is slight. Doctors use a protective lens under the eyelid during the process.
- Prescription eye drops: If you simply want your eyes to look more open, you may be a candidate for an eye drop called Upneeq, which tightens the Muller’s muscle behind the upper lid — the one responsible for true ptosis. “If loose skin and hooding really are the issue, Upneeq will not address that,” explains Levin.
- Tape: Double-sided tape for the eyelid crease isn’t a daily option for every eyelid (and some find the tape irritating), but it can be a great idea for a last minute event or photoshoot.
- Skin Care: Both doctors and patients are lackluster about topical solutions. While good for hydrating and post-healing skin care, eye creams can do little to prevent sagging. Dr. Levin did offer one exception specifically for the lower eyelids: The viral Peter Thomas Roght Instant FIRMx Eye Temporary Eye Tightener creates a “shrink wrap” to temporarily tighten skin as it dries. “It does work,” she says. “But you can't put makeup over it.”