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THE SEATTLE FACIAL PLASTIC SURGERY CENTER
DR WILLIAM PORTUESE | 1101 MADISON ST #1280 SEATTLE, WASHINGTON 98104 | (206) 624-6200
The Seattle Facial Plastic Surgery Center - Dr William Portuese
Dr William Portuese - Board Certified Facial Plastic Surgeon in Seattle WA

Complete Guide To Blepharoplasty©

There are two kinds of blepharoplasties performed. There is the upper blepharoplasty for excess skin on the upper eyelids. The lower eyelid blepharoplasty is done with the primary goal of removing excess bags and sometimes trimming a little bit of skin at the lash line.

Many times, there are also preexisting asymmetries where one eyebrow and eyelid and orbital socket is lower than the opposite side. This is all taken into account when a blepharoplasty is performed. The goal of upper eyelid blepharoplasty is to reshape and sculpt the upper lids so that they look more well rested and the goal of lower eyelid blepharoplasty is to remove the excess bags on the lower lids to give a refreshed look.

The blepharoplasty operation is performed on people usually in their 40s or 50s when they eyelids start to sag or become puffy underneath. Other things that can cause puffiness on the lower lids are allergies, genetic predisposition, salt intake, fluid, and hormonal changes. Dark circles and lower eyelid pigmentation are not changed with lower eyelid surgery. The shadows that are created from the lower eyelid fat bags are improved when the preexisting fat is removed from the lower lids. A conservative pinch of lower lid skin taken at the eyelash line can also help with lower eyelid skin laxity.

Eyelid Surgery Cost and Recovery

The most common questions about eyelid surgery (blepharoplasty) is how much does it cost and what is the recovery like. This video explains what is involved in the cost.

    Upper and Lower Lid Blepharoplasty:

  • $6,050 (Surgeon & Operating Room) + $643 (Anesthesia)
    Upper or Lower Lid Blepharoplasty:

  • $3,850 (Surgeon & Operating Room) + $500 (Anesthesia)

The cost of eyelid surgery really depends on several factors. It costs more to do both upper and lower eyelids than it does just the uppers or just the lowers.

The real cost of any type of cosmetic surgery including eyelid surgery is dependent upon the amount of time it takes to perform the procedure in a formal operating room. Time monitored under general anesthesia by a physician anesthesiologist, and then the surgeon’s fees for performing the surgical procedure known as a blepharoplasty. Surgeon experience and geography does tend to play into the cost of any type of cosmetic surgery including eyelids. The recovery for eyelid surgery usually involves placing the patient under general anesthesia for approximately an hour and then the recovery time is usually another hour just kind of waking up from the anesthesia and then the patients go home with their caretaker. Patients are fully healed after eyelid surgery usually at about three to four months after the procedure. Anticipate visible swelling and bruising for the first two weeks. The incision itself on the upper lid tends to stay, what we call, red or lumpy bumpy for a series of several weeks, six to eight weeks and then the incision on the upper lid tends to turn into a very fine white line. But the process takes two to three months. Patients are certainly able to hide it because it’s in the natural crease and they put makeup on to cover that incision.

Top Questions About Blepharoplasty

#5 Asymmetrical eyelids, what to do about them?
Everyone has some degree of asymmetry on their eyelids, but some patients have more asymmetry than others. When performing eyelid surgery, asymmetrical surgery is frequently performed to adjust them to look more symmetrical. Some patients have more fat/ puffiness on one side of the eyelids or the other, so more fat is taken out of the puffy side than on the less puffy side. Some patients have excess skin on one side , usually due to the brow position, so at more skin is taken out of one side than the other to make them more symmetrical. When the eyebrows are significantly asymmetric, an eyebrow lift is required.

#6 What are the requirements to have medical insurance pay for an upper blepharoplasty?
Medical insurance will never pay for a cosmetic procedure on either the upper or lower eyelids. When there is significant excess skin on the upper lids touching the eyelashes creating a significant visual field obstruction, a medical insurance company may consider that a medical necessity and pay for the surgery. Chart notes, visual field obstruction tests, and photographs are all required to be submitted for pre-authorization to the patient’s medical insurance to determine medical necessity. Excess hooded skin is removed through an incision on the upper eyelid known as a blepharoplasty procedure.

#7 Browlift versus eyelid lift?
A browlift procedure is performed when patients have very low eyebrows. The brow lift procedure can also adjust asymmetrical eyebrows by lifting one more than the other when needed. The brow lift procedure can adjust the muscles of the forehead such as the frontalis and the corrugator complex which helps with with forehead wrinkles. An eyelid lift involves making an incision in the upper eyelid to remove the hooded excess skin on the upper eyelids to rejuvenate them. Eyelid surgery is performed when the eyebrows are in adequate position and there is excess hooded skin present.

#8 What is the recovery time after a blepharoplasty procedure?
In our practice, we tell patients to anticipate at least 2 weeks of bruising and swelling after the blepharoplasty procedure. The surgery itself is only minimally painful and patients only take a few pain pills in their entire postoperative course after their blepharoplasty procedure.

#9 Does eyelid surgery changed the shape of the eyes?
In our practice we do not change the shape of the eyes. The appropriate amount of skin is removed from the upper eyelids to rejuvenate them. The procedure on the lower lids involves removal of fatty deposits from the inside of the eyelids also known as a trans-conjunctival approach. When patients have excess skin present at rest, a pinch technique of excess skin can be performed to conservatively tighten the lower lid skin. It’s important not to change the shape of the eyelids.

#10 What is laser blepharoplasty?
A laser blepharoplasty is the same thing as a traditional blepharoplasty only using the laser as a cutting tool, not a knife or a scissors. Since the laser is a thermal burn, the advantage is that there is minimal bruising, however since it is a burn, the incision takes longer to heal and there is just as much swelling if not more then using a knife and scissors. The laser doesn’t offer a better result in the long run, since the surgery the same with the laser versus a knife. If the laser were to ever enter the eyeball, blindness could ensue.

#11 Traditional lower blepharoplasty versus trans-conjunctival blepharoplasty?
It’s very important not to change the shape of the lower lids, and a trans-conjunctival lower blepharoplasty can accomplish that goal. A trans-conjunctival approach does not violate the lower eyelid muscle, so it preserves the shape of the lower eyelids. When patient’s have excess fat on the lower lids, the incision to remove that fat and puffiness is from the inside of the lower eyelids, also known as a trans-conjunctival approach. For many patients this is all that is required to rejuvenate the eyelids. In patients over 50 years of age, a pinch of excess skin is usually required which is closed with tissue glue.

#12 What type of anesthesia is needed for blepharoplasty?
In our practice, we perform eyelid surgery under general anesthesia by a board-certified physician anesthesiologist for patient safety and comfort. The procedure is also performed in a Washington state licensed, Medicare certified outpatient surgery center.

Washington Ambulatory Surgery Center Association Washington State Medical Association American Academy of Facial Plastic and Reconstructive Surgery Real Self