Boston Blepharoplasty – or eyelid surgery – is one of the most effective, and inexpensive, routes to achieving a more refreshed and youthful appearance.

According to Plastic blepharoplasty was in the top three cosmetic surgeries performed in America in 2020 with over 325,000 patients electing to undergo the procedure. In fact, 95% of patients on say it’s worth it.

What is Boston Blepharoplasty?

We all know how important our eyes are. We make long-lasting connections through eye contact and they often provide the real clues to what someone else is truly feeling. There’s no hiding eyes that twinkle with laughter or fill with tears.

But according to the American Board of Cosmetic Surgery, they’re also very susceptible to the effects of getting older, “Our eyelids are the thinnest, most delicate skin on our bodies, so it’s no surprise that signs of aging will begin to appear around our eyes earlier than in most other areas.”

And that’s not good news for our self-confidence and willingness to let our eyes do the talking – both key tools in building relationships.

Luckily, there’s a very effective solution.

According to the Mayo Clinic, blepharoplasty, or Bleph for short, is a surgery that repairs droopy eyelids and often involves removing excess skin, muscle, and fat from around the eyes.

And because it is relatively easy to achieve at an affordable cost, it’s a popular solution for many.

It is predominantly the over 55s who are seeking to have the surgery to rejuvenate the eyelids and reduce signs of aging. Blepharoplasty is commonly performed for patients in this age category, alongside a Boston Facelift procedure. Since a facelift addresses the lower two-thirds of the face, combining it with eyelid surgery allows for concerns across the face to be addressed.

Conversely, the procedure is also favored by many thousands of under 30’s – including teenagers – who may want to create a different look, improve symmetry, or correct puffiness or shadows – conditions that may have been inherited.

Who is a good candidate for Blepharoplasty surgery?

Eyelid surgery is an effective procedure for correcting a wide variety of anxieties patients have about their eyes. 

It helps people who are:

  • Worried about looking older
  • Concerned their upper eyelids are too droopy
  • Finding they have excess skin on the lower lids
  • Experiencing reduced peripheral vision
  • Worried about puffiness under their eyes
  • Unhappy with wrinkles on their lower lids

What types of Eyelid Surgery are there and what do they achieve?

There are many different types of procedure that are available. The specific procedure a surgeon recommends will depend on the problem a patient is hoping to solve and their ethnic background.

Upper Eyelid Surgery

This process is used to correct drooping or hooded upper lids and uses incisions to allow for the removal of skin and fat. A thin stitch is then used to bring the skin together to allow for the creation of an eyelid crease.

If the upper eyelid droops close to the pupil, this is known as “ptosis” and as the American Academy of Ophthalmology reports, this can affect both adults and children, limiting or even blocking normal vision. Correction requires adjustments to the eye’s muscles so that they can more easily lift the eyelids.

Lower Eyelid Surgery

According to, a lower eyelid blepharoplasty is for patients who want to improve sagging and baggy skin or wrinkles of the under-eye area. It’s also for those who suffer from eye bags or puffiness below the eyes (caused by herniation of fat from the eyeball socket). Puffy eyes are often due to the aging process but can happen in young people because of their genetics.

Lower lid blepharoplasty can be performed in a number of ways:

The Transcutaneous method uses an incision made directly below the eyelashes, which gives the surgeon access to any muscles that may need tightening, excess skin for removal and fatty areas to be reduced or smoothed out.

By contrast, the Transconjunctival incision is favoured when there’s no excess skin to remove. The cut is made inside the lower lid allowing the surgeon to access excess fat to improve the appearance of eye bags. The benefit of this method is that it doesn’t leave any visible scars and patients can experience a faster recovery time than with the more traditional transcutaneous procedure.

Other alternatives include canthopexy (which means the tightening of the eye ligaments mostly using stitches) and canthoplasty (surgery that focuses on the corner of the eye) which are useful ways to restore the integrity of the lower lid.

African American Eyelid Surgery

Not all upper and lower eyelids are made the same – which means finding a surgeon with the right experience is essential.

According to, African Americans tend to have less fat in the orbital area compared to Caucasians and the maxilla (upper jaw bone) can be more level which can further exacerbate the appearance of dark circles. This makes them good candidates for lower bag surgery.

Asian Eyelid Surgery

Blepharoplasty is a popular procedure with those of Pacific Asian descent.

One study reports that approximately 50% of Asian people do not have an upper eyelid crease (desired by many) and so blepharoplasty has been the most common cosmetic surgical procedure of the face among this population. Double eyelid surgery is performed more often on women than in men and there are various techniques available depending on the patient’s presenting issue and desired outcomes.

Are Non-Surgical Eyelid procedures available?

Although blepharoplasty is largely regarded as one of the more simple and quick plastic surgery procedures in the hands of an experienced board-certified surgeon, there are definitely avenues to explore before deciding to go down the surgical route. Indeed, reports that non-surgical eyelifts are on the rise.

According to Dr. Hessler on, “A resurfacing laser can refresh and rejuvenate the eyes without a scalpel.”  It smoothes out fine lines and wrinkles and can make a dramatic impact.”

The American Society of Plastic Surgeons also reports that Botox around the eyes can soften crow’s feet and correct asymmetric eyelids or eyebrows. A Botox brow lift not only treats frown lines between the brows, but it can also elevate the height of the eyebrows and open up the eyes. Regular visits for top-ups are required.

Read our blog on Who Should Inject Your Botox.

Fillers are also an option to improve the eyes, both their elevation and the shadows beneath. In the Harpers Bazaar article, New York, Dermatologist, Paul Jarrod Frank MD says, “Fillers can make you look as though you’ve slept 12 hours. They also help build collagen, so dark circles are less visible.”

Is eyelid surgery the next step for you?

But while there are a variety of minimally invasive eyelifts on the market, many of these options require return visits to the treatment room, so for those looking for a more long-lasting solution, surgery can prove to be the preferred route.

From teenagers through to those in the older age brackets, blepharoplasty provides a cost-effective solution that can last many years for a wide variety of issues.

Young people on are interested in correcting genetic asymmetries, improving the look of tired eyes and dark circles, and treating wrinkles, creases, and puffiness (caused by fat around the eyes) they may have inherited.

For those who are over 20 and not yet feeling the impact of the aging process – it’s likely that baggy or droopy eyelids also run in the family and surgery will solve their anxieties.

And for patients in the 40+ brackets, surgery offers the best chance to correct issues and slow down the impact of the aging process at a relatively low cost.

How long do Boston Blepharoplasty results last?

The benefits of blepharoplasty can be seen and felt for many years – although this can depend on the age that the patient had the procedure done, how naturally they age – as well as their genetics.

According to the Mayo Clinic, “For some people, results of surgery may last a lifetime. For others, droopy eyelids may recur”. puts a more conservative range on the results, “Upper eyelid surgery can last at least five to seven years. Lower eyelid surgery rarely needs to be repeated.”

What are the risks of Blepharoplasty?

Blepharoplasty is one of the most commonly performed facial cosmetic procedures but as with any surgery, a patient should check the risks with their surgeon and balance these up with the potential benefits before going ahead.

Possible risks include:

  • Risks generally associated with surgery – reaction to anaesthesia and blood clots
  • Infection and bleeding
  • Swelling and bruising
  • Dry eyes
  • Difficulty closing the eyes or other eyelid problems
  • Scarring
  • Injury to eye muscles
  • Temporary or even permanent change in vision
  • Skin discolouration
  • The need for follow up surgery

For further reading about the risks involved, refer to the American Society of Plastic Surgeons’ website.

How much does a Boston Blepharoplasty cost?

The price tag that comes with a blepharoplasty depends on the extent of the procedure (whether both upper and lower lids are to be operated on), the location of the surgeon’s office, their expertise and credentials, and the type of anaesthesia used.

The national average surgeon’s fee is $3165 while patients on report that the average cost to them was $4675.

In many cases, eyelid surgery has to be self-funded, although there are some cases for which insurance policies will provide coverage. reports that, “Insurance carriers will only cover the cost of upper eyelid surgery if the patient has obstruction of their visual field. This must be documented during an examination with formal visual field testing and photographs.”

So, if vision has some impairment, it is always worth a check with the surgeon and the insurer to see if some of the costs may be covered. 

How long will it take to recover?

Because eyelid surgery is usually done in an outpatient setting, in under two hours and using local anaesthesia, patients are able to go home the same day to start recuperating.

Patients report to having typically one to two weeks of downtime with some swelling around the eyes and returning to work after a week with most bruising having disappeared after a couple of weeks.

In the longer term, The American Board of Cosmetic Surgery advises that eyes will look more tired than usual for the first few weeks, they will need to be protected from the sun and the wind, and that patients need to avoid lifting, straining, and bending for up to four weeks after surgery.


Eyelid surgery, for teenage patients up to retirees, can be a simple, quick and affordable method of solving issues patients have with droopy, saggy or puffy eyes.

But as with all surgery, it’s imperative that patients carry out thorough research and find a board-certified surgeon who has the right experience for them, and is able to answer all of the questions they may ask.

But at the end of the day, it is said that blepharoplasty is one of the easiest ways to create a naturally younger looking appearance. And feeling positive about the eyes can change self-esteem, confidence and a person’s body image. After all, isn’t it said that the eyes provide the windows to the soul?


Please note: All materials on the Site, such as text, treatments, outcomes, photographs and images and any other material provided on the Site are for information purposes only and are not a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding treatments. Never disregard professional medical advice or delay in seeking it because of something you have read on this Site.
Though the content of this blog has been carefully prepared, the author of this content is not a medical doctor and the content has not been reviewed by a Board-Certified Plastic Surgeon. 
Unless specifically stated, patients referred to in this blog have not received a Blepharoplasty Boston procedure by Dr Mark Markarian. This blog does not endorse the work of any doctors or surgeons mentioned. Stories relating to patients’ personal experiences of the Blepharoplasty procedure should be treated as anecdotal only.
Any application of the material provided is at the reader’s discretion and his, her or their responsibility