Will a blepharoplasty help my eyes look less tired?

Q: I’ve been feeling like I look tired. Someone said I should have a blepharoplasty. Can you tell me what is actually done in a blepharoplasty?

A: This is a very common question I hear in my practice, and it’s a good one. Looking tired doesn’t always mean you are tired. Very often, it reflects natural changes around the eyes that happen over time.

A blepharoplasty is a surgical procedure designed to refresh the appearance of the eyes by addressing excess skin and fat that can make someone look fatigued or older than they feel. The procedure can involve the upper eyelids, the lower eyelids, or both, depending on what is causing the tired appearance.

For the upper eyelids, the surgery primarily involves removing excess skin. In some patients, a small amount of fat in the central portion of the eyelid is also removed if it is contributing to heaviness or fullness. The incision is placed in the natural eyelid crease so that, once healed, it is usually very difficult to see.

For the lower eyelids, the main issue is typically protruding fat that creates under-eye bags. In some cases, a small amount of skin may also be removed if there is looseness. Lower eyelid surgery can be done in two ways. One approach uses an external incision just beneath the lashes, called a subciliary incision. The other approach is done from the inside of the eyelid, known as a transconjunctival approach. In plain terms, this means the surgery is performed through the inside of the eye, with no external incision and no stitches on the skin.

Recovery from blepharoplasty is usually about a week for most patients. If you have an important event or social engagement, it is best to allow about a month. Healing continues gradually, and the eyes often keep improving for up to a full year.

When done properly, a blepharoplasty should not make you look different. The goal is to help you look rested, refreshed, and more like yourself again.

Dr. Carlos Wolf is a partner in Miami Plastic Surgery and is board certified. Email questions to him at Cwolf@miamiplasticsurgery.com