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Blepharoplasty is eyelid surgery that involves removing extra skin, muscle, and (sometimes) fat from the upper and lower eyelids. Collagen and elastin production and overall face orientation drops with aging, resulting in extra skin on both upper and lower eyes and bulging fat around the eyes.


Apart from making you appear older, excessively sagging skin around the eyes can hinder peripheral vision (side vision), particularly in the upper and front portions of your range of view. Blepharoplasty can help alleviate or remove these vision difficulties while making your eyes appear more youthful and alert.  Patients also comment on how much lighter their eyelids feel!


Let's dig into the entire detailed notion of this treatment to discover what you can expect and weigh the benefits and risks of blepharoplasty. Also, by the end of this read, you will be crystal clear if blepharoplasty is appropriate for you or not.


Who is an Ideal Candidate for Blepharoplasty?

Eyelid surgery is frequently requested by people who are seeking long-lasting anti-aging treatments.


Blepharoplasty could be an excellent solution if you have any of the following:

  • Upper eyelids that are baggy or droopy
  • Excess upper eyelid skin that obstructs peripheral vision
  • Bulging lower eyelids or Under-eye bags
  • Looking for an eyebrow lift (not really eyelids, but it’s all part of the same anatomy)


While sagging skin around the eyes is a natural aspect of aging, you may consider eyelid surgery if these aging indicators become unpleasant. Removing extra fat and tissues from your upper and lower eyelids helps you look younger and refreshed.


An important consideration when talking about eye appearance, especially upper eyelids is the eyebrows.  Repositioning eyebrows is not typically included in blepharoplasty. However, some candidates will benefit from a brow lift in conjunction with an upper blepharoplasty. Someone who may benefit from both generally has a flat eyebrow shape and the outside part of their eyelid has more extra skin, called “lateral hooding”


Additionally, the ideal age for blepharoplasty is 30 and above.  Occasionally it can be done on people who are younger, but those patients are less common and absolutely need a personalized consultation with an expert surgeon to see if they’ve got the right anatomy.


Preparation before Surgery

Preparing for an eyelid surgery is not complicated. To begin, you'll need to schedule the first appointment with Dr. Couvillion to discuss your eyelid concerns and desired objectives. Additionally, don’t forget to inquire about credentials and expertise performing this sort of operation.


We need to perform some tests to determine if you’re a good candidate for surgery. These tests include:

  • A physical examination to check your eye's functioning and measurements.
  • Other examinations to test your vision and tears could also be a step.

Moreover, Dr. Couvillion will ask you for certain things like;

Your medical background: Your surgeon will ask you about previous surgeries and past or current conditions such as glaucoma, watering, dry eyes, allergies, circulatory issues, thyroid issues, and diabetes. Your specialist would also inquire about the prescriptions, food, herbal supplements, alcohol, nicotine, and narcotics you use.


Your goals for the surgery: An open and honest discussion about your surgical goals and motivations can help you and your surgeon set better goals. If you’re 70, you’re not going to look like a 20 year old model after the surgery!  It wouldn’t be in harmony with the rest of your face and frankly would look strange.

Directions You'll be Asked to Follow

  • At least 4 weeks before your surgery, quit smoking. Smoking can make it more challenging to recover from surgery.  This includes ANY nicotine source (vapes, chewing tobacco, etc.)  The nicotine decreases blood flow and can jeopardize healing
  • Stop using drugs like aspirin, ibuprofen (Advil, Motrin IB, others), naproxen, and herbal supplements that may cause excessive bleeding. Only take drugs that Dr. Couvillion has prescribed you or that you’ve discussed.  Before you resume any of your meds that you stopped, please ask so we don’t accidentally have a problem.
  • If you're having outpatient surgery, you need someone to drive you to and from the procedure. Also, make sure to ask someone to remain with you for the first night after surgery.


Procedure- What You can Expect?


Before Procedure

Blepharoplasties are done as an outpatient procedure. That implies you'll be able to return home soon following the surgery. Only a few people require general anesthesia and these are generally patients who have high blood pressure or do not want the procedure done in the office.  Most patients take some medication by mouth to help relax prior to receiving numbing medicine.

Prior to the procedure, you get detailed instructions about what to expect afterwards.  You also get some prescriptions to make the process go smoothly.

During the Surgery

Markings are made with you sitting up to decide how much skin will be removed.

If you are going to have surgery on your upper and lower eyelids, we often begin with the upper lids. After the eyelid is numb, an incision is made on the eyelid, excess skin is removed, then muscle and fat may then be removed.  The skin is then closed with stitches.  A cooling jelly pack is then placed over your eyes.

On the lower lid there are different surgeries for different anatomy.  Most commonly, an incision is made just below the lashes.  Dr. Couvillion then may remove or redistribute excess fat, muscle, and sagging skin and close the incision.

After the Surgery

Post-surgery, you’re monitored until you’re ready to go home.

Following surgery, you may have the temporary symptoms listed below:

  • Sensitivity to light, usually due to swollen eyelids not closing all the way
  • Eyelids puffy and numb
  • Bruising and swelling comparable to black eyes
  • Discomfort or pain, though generally this is minimal and controlled by Tylenol or celebrex

These should all resolve within a few days.


Post-Surgery Care- Suggestions

  • Apply cold gel packs to your eyes until the pack warms up.  Place it back on ice as instructed until it cools off and then repeat.  You should keep placing the cooling packs on your eyes for the first 24 hours at least.
  • Avoid wearing makeup and contact lenses for approximately two weeks from surgery.
  • Sleep with your head elevated above your heart to relieve/prevent swelling
  • Put any recommended eye drops or ointments as directed.
  • Clean your eyelids gently with 50:50 mix of peroxide and water if there is any residual antibiotic ointment or crusting.
  • For four weeks, abstain from straining, heavy lifting, and strenuous exercise.
  • Abstain from smoking for 4 weeks
  • Refrain from rubbing your eyes.
  • Return to the doctor's office as directed to get your stitches out
  • Avoid aspirin, naproxen sodium (such as Aleve, etc.), ibuprofen (Advil, Motrin IB, and others), and naproxen (Naprosyn) for approximately a week. Acetaminophen (Tylenol, others) is a great alternative right after surgery.


Risks Associated with Blepharoplasty

All surgical procedures have a risk of bleeding, swelling, and infection. There’s also going to be a scar – you had surgery!

Additional dangers and problems include the following:

  • Asymmetry of the result
  • Extra skin or fat left behind
  • Bleeding around the eye
  • Change in position of the lower eyelid

It is essential to discuss these risks with Dr. Couvillion in advance. Moreover, inform him if you have had previous difficulties with any surgery or medications.

You are always able to contact our office if you have any concerns after surgery.



Recovery varies from person to person and often depends on how much they bruise.  It also depends on what they want to be recovered to do.  For example, you can sit at a desk and work very soon after surgery.  If you’re going to go rock climbing or sky diving, the recovery is a bit longer.


How Long Does Blepharoplasty Last?

 The results can persist for a long time.  In general, most people never return to the appearance that they had before the procedure.  That said, some patients may want another surgery at about 10 years, but overall this is relatively rare. Sometimes when patients return, a brow lift may be more beneficial than further eyelid surgery.


What is the Cost of Upper Lid Blepharoplasty?

The cost of upper eyelid surgery varies significantly from one patient to another. The average cost of the surgery in 2018 was $3,163, according to the American Society of Plastic Surgeons. Some operations, on the other hand, can cost as little as $2,000 and as much as $7,000 or more.  It really depends on how extensive the procedure is and if it’s going to require anesthesia in a hospital.


Is Insurance Cover Blepharoplasty?

The cost of upper eyelid surgery may be covered entirely or partially by your insurance plan in some instances. The procedure may be appropriate for patients with severe drooping of the upper lid, making it challenging to perform daily life tasks, especially driving. Make sure to consult with your insurance carrier in advance to better grasp what is and is not covered by your policy. These procedures are generally performed by an ophthalmologist, as they require things like visual field testing and insurance pre-approval.  Insurance does not cover lower eyelid surgery.


Final Thoughts

Eyelid surgery is often a one-time procedure. Patients are generally very pleased with their blepharoplasty final results, including a more rested and youthful appearance with increased self-esteem and confidence. Moreover, a blepharoplasty is often added to other facial rejuvenation procedures such as a facelift or necklift.

If you’re interested in talking to Dr. Couvillion about a blepharoplasty, give us a call today at 713.850.0240 x. 1146 or book here!



Meet Dr. Couvillion

Dr. Ryan Couvillion is an experienced Houston, TX plastic surgeon specializing in cosmetic and reconstructive procedures for the breasts, body, face, and skin. A native Houstonian, Dr. Couvillion has been recognized for his passion and dedication in achieving the best possible results for his patients and is proud to return to Houston and build his practice in his hometown. His drive to pursue training in the field of plastic and reconstructive surgery began at a young age, and he is honored to have been mentored by some of the nation’s most recognized surgeons. Read his full bio here.