What Is Blepharoplasty?
Blepharoplasty is a surgical procedure that removes excess skin, fat, and sometimes muscle from the upper eyelids, lower eyelids, or both. It is one of the most commonly performed facial procedures and is done for both cosmetic and functional reasons. Cosmetically, blepharoplasty reduces puffiness, under-eye bags, and hooded upper lids to create a more youthful, refreshed appearance. Functionally, it removes sagging tissue that droops into the visual field and obstructs peripheral or upper vision.
At West Boca Eye Center in Boca Raton, blepharoplasty is performed by Dr. Brent Bellotte — a board-certified ophthalmologist with extensive experience in both functional and cosmetic eyelid surgery. Because Dr. Bellotte is an eye surgeon rather than a general cosmetic surgeon, his approach prioritizes both visual function and aesthetic results.
Cosmetic vs. Functional Blepharoplasty
Cosmetic Blepharoplasty
Cosmetic blepharoplasty is performed to improve the appearance of the eyelid area. As we age, the skin around the eyes loses elasticity, muscles weaken, and fat deposits that normally cushion the eye begin to bulge forward. This creates hooded upper lids, deep creases, under-eye bags, and a perpetually tired look. Blepharoplasty restores a firmer, more alert appearance while maintaining natural eyelid movement and expression.
Functional Blepharoplasty
Functional blepharoplasty is medically necessary when excess upper eyelid tissue droops far enough to obstruct the visual field. Patients with functional impairment often report difficulty reading, driving, or seeing objects above or to the side. A visual field test is typically performed to document the degree of obstruction. When significant visual field loss is confirmed, functional blepharoplasty may be covered by insurance.
Who Is a Candidate for Blepharoplasty?
You may be a candidate for blepharoplasty if you have:
- Excess or sagging skin on the upper eyelids that creates heavy folds or droops over the lash line
- Puffy upper eyelids caused by fat deposits
- Bags, puffiness, or loose skin beneath the lower eyelids
- Drooping upper lids that reduce your peripheral or upper visual field
- Tired-looking eyes that do not reflect how you actually feel
During your consultation, Dr. Bellotte will examine your eyelid anatomy, assess skin elasticity, evaluate tear production, and perform a visual field test if functional impairment is suspected. He will also discuss your goals to determine whether blepharoplasty alone is appropriate or whether an additional procedure — such as ptosis repair or a brow lift — would achieve a better result.
How Blepharoplasty Is Performed
Upper Blepharoplasty
An incision is made along the natural crease of the upper eyelid. Through this incision, excess skin, a small strip of orbicularis muscle (if needed), and protruding orbital fat are removed. The incision is closed with fine sutures that heal within the natural skin fold, making the scar virtually invisible once healed.
Lower Blepharoplasty
For the lower eyelids, one of two approaches is used depending on the patient's anatomy:
- Transcutaneous approach — an incision is made just below the lower lash line, allowing access to remove or reposition excess skin, muscle, and fat
- Transconjunctival approach — an incision is made on the inside surface of the lower eyelid, leaving no visible external scar; this technique is ideal for patients whose primary concern is fat bulging rather than excess skin
Combined Upper and Lower Blepharoplasty
Both upper and lower lids can be treated in the same session. The upper lids are typically addressed first. The entire procedure is performed as an outpatient surgery under local anesthesia with intravenous sedation — you will not feel pain during the procedure but will remain awake.
Recovery After Blepharoplasty
Most patients return home the same day. Here is a general recovery timeline:
- Days 1–3: Swelling and bruising are at their peak. Cold compresses help reduce swelling. Vision may be slightly blurry from ointment applied to protect the incision sites.
- Days 4–7: Bruising begins to yellow and fade. Most patients feel comfortable enough to resume light daily activities. Sutures that are not self-dissolving are removed around day 5 to 7.
- Weeks 2–4: Swelling continues to resolve. Most of the visible bruising is gone. Many patients return to work and social activities within 10 to 14 days.
- Months 2–6: Incision lines continue to mature and fade. Final results are fully visible by 4 to 6 months.
Upper blepharoplasty results typically last 5 to 7 years. Lower blepharoplasty results are long-lasting, often considered virtually permanent because under-eye fat pockets rarely re-accumulate after removal.
Risks and Possible Complications
Blepharoplasty is a safe procedure with a high satisfaction rate, but as with any surgery, risks exist. Possible complications include:
- Temporary dry eye or excessive tearing
- Swelling and bruising beyond the typical recovery period
- Infection (rare)
- Temporary or permanent changes in eyelid sensation
- Asymmetry between the two eyes
- Difficulty closing the eyes completely (lagophthalmos) — typically temporary
- Eyelid malposition requiring revision
Dr. Bellotte discusses all potential risks during the consultation and takes a conservative surgical approach that prioritizes eyelid function alongside cosmetic improvement.
Why Choose West Boca Eye Center for Blepharoplasty
Blepharoplasty is best performed by a surgeon who specializes in the anatomy and function of the eye. Dr. Brent Bellotte brings both ophthalmologic expertise and cosmetic precision to every procedure. West Boca Eye Center is an academic-grade facility equipped with advanced diagnostic and surgical technology, meaning every aspect of evaluation and treatment — from visual field testing to the procedure itself — is performed on-site in Boca Raton.
West Boca Eye Center is located at 9325 Glades Road, Suite 201, Boca Raton, FL 33434. Call (561) 488-1001 to schedule your blepharoplasty consultation.
Frequently Asked Questions About Blepharoplasty
How long does blepharoplasty surgery take?
Upper blepharoplasty typically takes 30 to 45 minutes. Lower blepharoplasty takes 45 to 60 minutes. When both upper and lower lids are treated in the same session, the total procedure time is usually 1 to 2 hours. The surgery is performed as an outpatient procedure under local anesthesia with sedation.
Is blepharoplasty covered by insurance?
Functional blepharoplasty — where excess eyelid skin obstructs the visual field — may be covered by insurance when a visual field test documents the degree of impairment. Cosmetic blepharoplasty performed solely to improve appearance is not covered. Dr. Bellotte's team can help determine whether your case qualifies for insurance coverage.
What is the difference between blepharoplasty and ptosis surgery?
Blepharoplasty removes excess skin, fat, and muscle from the eyelid. Ptosis surgery specifically tightens or repositions the levator muscle that lifts the upper eyelid. Some patients have both excess skin and a weak levator muscle, in which case both procedures may be performed together for the best functional and cosmetic result.
Will blepharoplasty scars be visible?
Upper blepharoplasty incisions are placed within the natural eyelid crease and become virtually invisible once healed. Transconjunctival lower blepharoplasty leaves no external scar at all. External lower lid incisions are placed just below the lash line and fade significantly over several months.
Can blepharoplasty be combined with other procedures?
Yes. Blepharoplasty is commonly combined with ptosis repair, brow lift, or skin resurfacing for a more comprehensive rejuvenation. During your consultation, Dr. Bellotte will assess whether additional procedures would improve your results and discuss the options with you.
