Upper vs. Lower Blepharoplasty: Which Is Right for You?

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The eyes are often considered the windows to the soul, and they play a significant role in facial aesthetics. As we age, the delicate skin around the eyes can start to show signs of aging, such as sagging eyelids, puffiness, and wrinkles. Upper and lower blepharoplasty are popular cosmetic surgical procedures designed to rejuvenate the eye area and restore a more youthful appearance. In this blog, we will explore the differences between upper and lower blepharoplasty and how to decide which one is right for you.

Understanding Upper Blepharoplasty

Upper blepharoplasty, also known as an upper eyelid lift, is a surgical procedure aimed at addressing issues with the upper eyelids. Common concerns that can be addressed with this procedure include:

  • Excess skin: Over time, the skin of the upper eyelids may lose elasticity and begin to droop or sag, which can make you appear tired or older than you are.
  • Puffy eyelids: Fat deposits can accumulate in the upper eyelids, creating a puffy or bulging appearance.
  • Impaired vision: In severe cases, excess upper eyelid skin can obstruct your field of vision.

The Procedure: 

During an upper blepharoplasty, a skilled plastic surgeon will make an incision along the natural crease of the upper eyelid to remove excess skin and fat. This results in a more youthful and rejuvenated upper eyelid contour.

Understanding Lower Blepharoplasty

Lower blepharoplasty, also referred to as lower eyelid surgery, focuses on the lower eye area. It addresses issues such as:

  • Under-eye bags: With age, the fat beneath the lower eyelids can become displaced, leading to noticeable bags under the eyes.
  • Excess skin and wrinkles: Wrinkles and loose skin around the lower eyelids can give a tired or aged appearance.
  • Dark circles: While not always solely related to aging, dark circles can be improved through lower blepharoplasty.

The Procedure: 

During lower blepharoplasty, the surgeon makes an incision either along the lower lash line or on the inside of the lower eyelid (transconjunctival approach). Excess fat, skin, or muscle is then removed or repositioned to create a smoother and more youthful lower eye contour.

Choosing the Right Procedure for You

The decision between upper and lower blepharoplasty should be based on your specific concerns and goals. Here are some factors to consider when making your choice:

Individual Concerns: 

Assess which area of your eyes bothers you the most. If it’s the upper eyelids, upper blepharoplasty may be the right choice, and if it’s the lower eyelids, opt for lower blepharoplasty. Some individuals may require both procedures to achieve their desired results.


Consult with a board-certified plastic surgeon who specializes in eyelid surgery. They will evaluate your unique anatomy, discuss your goals, and recommend the most suitable procedure or combination of procedures for you.

Realistic Expectations: 

Have realistic expectations about what each procedure can achieve. While both upper and lower blepharoplasty can significantly improve the appearance of the eye area, they won’t completely halt the aging process.

Recovery and Downtime: 

Consider the recovery time associated with each procedure. Upper blepharoplasty typically involves less downtime compared to lower blepharoplasty, which may require more healing time due to the sensitive nature of the lower eyelids.


Cost can vary between upper and lower blepharoplasty, so it’s essential to factor this into your decision-making process.


Upper and lower blepharoplasty are effective surgical procedures for rejuvenating the eye area and enhancing facial aesthetics. The right choice for you depends on your individual concerns, goals, and consultation with a qualified plastic surgeon. Whether you opt for upper, lower, or a combination of both procedures, the goal is to achieve a more youthful and refreshed appearance that boosts your confidence and overall well-being. Always prioritize safety and choose a reputable surgeon with extensive experience in eyelid surgery to ensure the best possible results.

Lee A. Kleiman a doctor at Anne Arundel ENT

Dr. Lee A. Kleiman is a double board certified ENT & plastic surgeon at Anne Arundel ENT in Annapolis, Maryland known for his superior clinical outcomes in all Surgical and Non-Surgical ENT, specializing in Sinus Care, Voice and Swallowing, Rhinoplasty and Revision Rhinoplasty, and Facelifts and Non-surgical Aesthetic. He also continues to attend conferences internationally and nationally to keep abreast of the latest treatments and technology.