When it comes to cosmetic surgery, a blepharoplasty or "eye lift" is one of the simplest, safest, and most effective procedures you could undergo.
"You really cannot get more bang for your buck," says Michael Olding, MD, chief of plastic and reconstructive surgery at George Washington University. "I have people come in all the time who say they want a face lift, and they can't believe it when I tell them they only need an eye lift."
Olding points out that, when you're speaking with someone, you usually look at their eyes—not their nose, mouth, or other areas often targeted for cosmetic surgery. "If your upper eyelids look saggy, that can make you look tired, old, and not engaging," he says. "So getting rid of that redundant skin on the upper lids can make a dramatic difference." (Lose up to 25 pounds in 2 months—and look more radiant than ever—with the new Younger In 8 Weeks plan!)
Here, he explains everything you need to know about the procedure—including the cost, specifics of the surgery, and recovery times.
There are actually several types of eye lifts.
When you hear the term "eye lift," that usually refers to a surgery of the upper eyelid. "It involves removing excess skin, and maybe a little muscle or fat," Olding says.
The second, less-common type of eye lift involves the lower lid or the area below your eye. "If you have big bags under your eyes, they can be easily removed without a visible incision by going inside between the eyeball and eye lid and moving or manipulating fat," Olding explains. He adds: "We used to just take out every bit of that fat. But then people—as they got older—would have a hollow look below their eyes. So now it's more about redistributing that fat." (Lash lifts are now a thing, too. Should you try them?)
All of these are outpatient procedures.
For an upper eyelid lift, Olding says the surgery involves local anesthetic either with or without some local sedation—but never with general anesthesia.
Your doctor will mark the portion of your eyelid she intends to remove. And then, using a scalpel or other surgical cutting devices, she'll snip away that skin and close the incision with stitches. Thanks to the natural folds of your eyelid, any scarring is basically hidden, Olding says. If you're having under-eye bags removed, there may not even involve a visible incision. "But if you have surgery performed on your lower lids, that's a more complex procedure and requires sedation," he adds.
All these procedures may also include lasering your lids to improve the quality of the scar, and to remove signs of sun damage and aging, Olding says. For under-eye bags, your doctor may also inject fillers to smooth the areas, according to the American Society for Aesthetic Plastic Surgery.
Recovery is (usually) quick.
For an upper eyelid lift, the bruising and swelling tend to be minimal. "Most people could drive themselves home after the surgery, though we never recommend that," Olding says.
Some people experience more swelling and bruising than others, but that typically goes down after a couple days, he says. "The sutures come out after 3 to 5 days, and by day six you can apply makeup and not tell anything was done."
During that first 24 hours, you'll likely have to ice your eyes regularly to keep the swelling down. You may also have to apply drops or topical lubricants for a few days, or take antibiotics to prevent infection.
Having skin removed from the lower lid tends to involve longer recovery times. "Gravity is working to pull skin down away from the eye, so that makes it more complex," Olding says.
But if you're having bags removed, you could be "back to normal" the day after surgery. "Since there may be no incision at all, it's really all about how much you bruise," Olding adds. (Not ready for surgery? Try these makeup tips to lift droopy eyes.)
There could be complications.
The major risks of any of these surgeries are excessive bleeding or bruising, and "asymmetry," Olding says. "A doctor could take out too much skin, or not enough." While removing too little simply requires a follow-up procedure, taking out too much can leave a patient without adequate skin to cover her eye when blinking or sleeping. "But that's extremely uncommon," Olding says. He's quick to point out that eye lifts are never to blame for the "deer in headlights" look mocked in tabloids and celebrity mags. "That's from an improperly done forehead lift, so no need to worry about that here."
"Aging and sun damage combine to make the skin of your eyelid less elastic," Olding says. For some people, that causes the skin of their lids to sag so much that it begins to obstruct their vision.
If your doctor suspects your vision is compromised, he may suggest a "visual field examination," Olding says. "You sit in front of screen, and press a button when you see lights appear." You'll repeat this once with your eyelids "taped up," and again without assistance. Depending on your results, you may need an eye lift in order to see properly.
Insurance may cover it.
If your vision is obstructed, some insurers will pick up the tab for a lid lift. We know what you're thinking: Bring on the test! But Olding says it's difficult to "game" the visual field exam. "The test is done in a way that makes it very hard to cheat," he says. (Here are 6 more surprising things insurance may cover.)
Even if you can get insurance to foot the bill, Olding says you may have to pay extra if you want your doctor to go beyond what's necessary for proper vision. "A lift for aesthetic purposes may involve removing more skin in different places," he says.
If you're paying for the whole operation out of pocket, expect to pony up between $1,500 and $5,000, he says.
The surgery won't last forever.
After you've had an eye lift, the passage of time and the sun's rays will continue to damage your eyelids' looks and the skin's elasticity, Olding says. (These simple face exercises can help fight wrinkles.) You likely wouldn't need a duplicate procedure for many years, and the vast majority of patients never need a repeat eye lift. But if you undergo the surgery during your 50s or 60s, understand that you may not enjoy the same level of eyelid rejuvenation for your lifetime.