Eyelid surgery types: Upper vs. lower blepharoplasty explained

Blepharoplasty, or eyelid surgery, is plastic surgery that improves both the appearance and function of the eyelids. 

It targets puffiness under the lower eyelids and removes excess skin from the upper eyelids. As we grow older, our skin loses its natural elasticity, and the constant pull of gravity leads to sagging and the buildup of loose skin in the eyelid area.

Blepharoplasty surgery is performed for both cosmetic and functional reasons:

Cosmetic reasons:

• To reduce sagging or drooping eyelids
• To eliminate puffiness or bags under the eyes
• To achieve a more youthful, refreshed appearance
• To correct asymmetry in the eyelids

Functional reasons:

• To improve peripheral vision obstructed by excess upper eyelid skin
• To remove overhanging skin that may cause discomfort or interfere with daily activities
• To relieve strain from constantly lifting the eyebrows to see better

Whether it’s for enhancing appearance or restoring clear vision, blepharoplasty offers both aesthetic and practical benefits.

Upper eyelid blepharoplasty is a surgical procedure that corrects sagging or droopy upper eyelids by removing excess skin, fat, and sometimes muscle. 

It is often performed to refresh a tired or aged appearance and, in some cases, to improve vision when the drooping eyelid obstructs the visual field.

Key benefits

• Restores a more youthful and refreshed appearance
• Improves visual field in cases of significant eyelid droop
• Reduces heaviness and hooding of the upper eyelid
• Enhances the natural eyelid crease and definition
• Lifts the upper eyelids for a brighter, more alert appearance

Ideal candidates

You may be a good candidate for upper lid blepharoplasty if you have:

• Loose, sagging skin on the upper eyelids
• Hooded lids that affect vision or aesthetics
• A desire for a fresher, less tired look

Procedure

Upper blepharoplasty is typically performed under local anaesthesia, sometimes combined with light sedation. 

The surgeon makes a fine incision along the natural crease of the upper eyelid, ensuring any scarring remains discreet. Through this incision, excess skin, muscle, and fat are carefully removed or repositioned.

The incision is carefully closed with fine sutures, allowing for minimal scarring and a natural appearance. 

The entire procedure typically takes about 45 minutes to 1 hour and is often done as an outpatient surgery.

Results

Following upper eyelid blepharoplasty, most patients see a noticeable enhancement in the appearance of their upper eyelids. The eyes look more open, lifted, and refreshed. 

In cases where the drooping skin affected vision, patients often experience enhanced sight and less strain during everyday activities like reading or driving.

Lower eyelid blepharoplasty is a cosmetic surgical procedure that addresses puffiness, under-eye bags, and loose or wrinkled skin beneath the eyes. 

It’s a popular choice for individuals looking to smooth and tighten the under-eye area, giving the face a well-rested, more youthful appearance.

Key benefits

• Reduces under-eye puffiness and bags
• Tightens and smoothens wrinkled or crepey skin
• Diminishes dark circles and shadowing
• Enhances facial symmetry and youthful appearance

Ideal candidates

Lower lid blepharoplasty is suitable for:

• Individuals with chronic puffiness or bulging under the eyes
• Those with loose or sagging lower eyelid skin
• People who want to reverse the tired or aged look caused by under-eye bags

Procedure

There are two common approaches to lower lid blepharoplasty:

• Transcutaneous approach – An incision is made just beneath the lash line to remove or reposition fat and tighten skin.
• Transconjunctival approach – An incision is made inside the eyelid, which is ideal for patients who only need fat removal or repositioning without skin excision.

The lower blepharoplasty surgery is usually done under local anaesthesia with sedation and may take 1–2 hours, depending on complexity. It can be combined with skin resurfacing or fillers for enhanced results.

Results

Post-surgery, patients typically notice a smoother, firmer, and more youthful under-eye contour. 

The puffiness and bulging are visibly reduced, giving the eyes a more rested and youthful appearance. Wrinkled or loose skin under the eyes becomes tighter and more toned. 

Long-term results can last many years, especially when paired with good skincare and sun protection habits.

Eyelid surgery can be performed on the upper or lower eyelids—or both—depending on the concerns being addressed. While both eyelid surgery types aim to rejuvenate the eyes, they target different problem areas and have unique surgical techniques and recovery timelines.

Double eyelid surgery, also known as Asian blepharoplasty, is a cosmetic procedure designed to create a visible crease in the upper eyelid. This transforms a “monolid” (an eyelid without a crease) into a “double eyelid” appearance. 

It is a popular choice among individuals of East Asian descent who naturally lack an upper eyelid fold and wish to enhance the definition and openness of their eyes.

Ideal candidates

You may be a good candidate for double eyelid surgery if you:

• Have monolids (no visible eyelid crease) and desire a defined upper lid fold
• Experience asymmetrical eyelids, where one eye has a crease, and the other doesn’t
• Have excess skin or puffiness in the upper eyelid area
• Want to make your eyes appear larger, more alert, or more open
• Desire a more defined eyelid for easier makeup application
• Are in good general health, both physically and emotionally

Key benefits

• Creates a defined upper eyelid crease for a more open-eyed appearance
• Enhances the balance and symmetry of your facial features
• Gives the illusion of larger, more expressive eyes
• Improves makeup application, especially for eyeliner and eyeshadow
• Offers both subtle and natural-looking results when performed by a skilled surgeon
• Boosts self-confidence and satisfaction with appearance

Recovery after eyelid surgery is typically smooth with proper care. Whether you’ve had upper blepharoplasty or lower blepharoplasty, following post-operative instructions is crucial for optimal healing.

In the first few days, expect swelling and bruising around the eyes. Apply cold compresses to reduce discomfort, and keep your head elevated while resting. Refrain from strenuous activities, heavy lifting, or bending over for at least a week.

For upper blepharoplasty recovery, it’s important to avoid any activities that may strain your eyes—like prolonged screen time, reading, or wearing contact lenses too soon. You may also be advised to avoid makeup and facial creams near the eyelids during early healing.

When it comes to lower blepharoplasty recovery, protecting the delicate under-eye skin is key. Avoid rubbing or applying pressure to the area. Your surgeon may recommend lubricating eye drops or ointments to prevent dryness and irritation.

Wearing sunglasses when outdoors protects your healing eyelids from dust, wind, and UV exposure. Refrain from strenuous activities or heavy lifting until your surgeon gives you clearance. 

Always follow post-op instructions carefully, and attend all follow-up appointments to ensure your recovery is progressing smoothly.

All surgery has risks, including reaction to anaesthesia and blood clots. Besides those, rare risks of blepharoplasty surgery include:

• Dry, irritated eyes
• Infection and bleeding
• Noticeable scarring
• Injury to eye muscles
• Difficulty closing the eyes or other eyelid problems
• Skin discoloration
• Temporarily blurred vision or, rarely, loss of eyesight
• The need for follow-up surgery

The upper blepharoplasty cost in Dubai begins at 30,000 AED, while the cost of lower lid blepharoplasty starts from 35,000 AED. If both upper and lower eyelid procedures are performed together, the combined upper and lower eyelid surgery starts at 45,000 AED (excluding VAT).

The final price for upper blepharoplasty or lower blepharoplasty surgery is determined during your consultation. 

Several factors influence the overall cost, including:

• Pre-operative tests required for eye surgery
• The extent of sagging skin and wrinkles to be addressed
• Whether additional surgical procedures, such as a brow lift or other complementary surgeries, are necessary for a complete aesthetic transformation

Each patient’s needs are unique, so a personalised assessment ensures accurate pricing based on your desired outcome.

Blepharoplasty, or eyelid surgery, offers transformative benefits—removing excess skin, reducing puffiness, and restoring a youthful, refreshed appearance to the eyes. Whether you’re seeking functional improvement or aesthetic enhancement, blepharoplasty can significantly boost your confidence and facial harmony.

Dr Adnan Tahir is a UK-trained and internationally recognised plastic surgeon with over 12 years of experience in aesthetic procedures. Renowned for his precision and natural-looking results, Dr Adnan takes a meticulous, patient-focused approach to every eyelid surgery—ensuring your concerns and goals are understood and met with care.

Whether it’s upper eyelid blepharoplasty, lower eyelid surgery, or a combination of both, Dr= Adnan customises each procedure for optimal outcomes tailored to your facial anatomy.

Book your consultation today.

How should I prepare for upper or lower blepharoplasty surgery?

Preparation may include discontinuing blood-thinning medications, avoiding smoking, and undergoing basic health evaluations. Your plastic surgeon will give a detailed list of do’s and don’ts before the procedure to ensure a safe and smooth experience.

What results to expect from upper blepharoplasty?

Upper blepharoplasty before and after images often show a more rested, youthful appearance. The procedure lifts droopy eyelids, making the eyes look more open and alert.

Is the procedure painful?

Most patients feel only mild discomfort during the recovery period. Local anaesthesia is typically used, and any post-operative soreness can be managed with prescribed medication.

Can blepharoplasty surgery be combined with other surgical procedures?

Yes, blepharoplasty surgery can be combined with other procedures, like brow lifts, facelifts, or skin resurfacing, to enhance overall results and maintain facial harmony.

How much does a lower blepharoplasty cost in Dubai?

The cost of lower blepharoplasty in Dubai typically starts from AED 35,000. However, the final cost depends on various factors, like the procedure’s complexity, the surgeon’s expertise, and whether it is combined with other surgeries.

What is the upper eyelid blepharoplasty cost?

The upper eyelid blepharoplasty cost may vary depending on the extent of skin removal required and any additional enhancements needed, like a brow lift.

Are there non-surgical alternatives to blepharoplasty?

While some non-invasive treatments like fillers, lasers, or radiofrequency can temporarily improve under-eye puffiness or fine lines, they can’t replace the long-lasting, structural improvements of upper lid blepharoplasty or lower lid blepharoplasty.

When can I resume daily activities or wear makeup?

Most patients can start light daily activities after a few days, though strenuous exercise and eye makeup should be avoided until your surgeon advises it is safe—usually after the initial healing phase.

Is blepharoplasty permanent?

While upper lid blepharoplasty and lower lid blepharoplasty offer long-lasting results, the natural ageing process will continue. Many patients enjoy their results for over 10 years, and some may never need a second procedure.