1101 MADISON ST #1280 SEATTLE, WASHINGTON 98104 | (206) 624-6200
The Facial Plastic Surgery Center
Dr William Portuese - Board Certified Facial Plastic Surgeon

Eyelid Surgery Seattle WA – Blepharoplasty

There are three components that make up the eyelids; skin, muscle, and fat. Fat bulging creates a puffiness look ( bags ) on the lower lids as well as the upper lids. Excess skin can fold over on the upper lids, touching the eyelashes, creating visual obstruction when severe enough. On rare occasions, excess muscle on the upper lids can also be an issue and sometimes needs to be conservatively trimmed for cosmetic purposes. All three of these components must look good in a symmetrical fashion and allow for proper blink reflex and closure of the eyelids. Find out if you are a candidate for blepharoplasty in Seattle WA.

An upper blepharoplasty and a lower eyelid lift can be performed independently or together during blepharoplasty treatments.

Improving The Appearance

Cosmetic blepharoplasty in Seattle or eye lift surgery is done to improve the appearance of the upper or lower eyelids. The primary goal of an upper lid lift is to remove mostly excess skin and a little fat, whereas the goal of the lower lid surgery is to remove mostly excess fat and a little skin. The fat in the lower eyelids is a genetic trait and is referred to by many as “Puffiness” or sagging, or drooping. Excess skin on the upper lids creates the “Tired” look. Typically, patients will say that they look tired and older than they feel when they look in the mirror.

Blepharoplasty:  Eyelid Reductions in Washington State

With the aging process, the eyelid skin tends to relax, and become “hooded”  – hooding, and the fat around the lower eye tends to protrude and accumulate around the eyes, resulting in a “puffy” appearance.

The Incision

The incision for an upper blepharoplasty procedure is made following the natural eyelid crease. After the precise measurement of fat is removed, the incision is closed with dissolvable sutures. The lower lid blepharoplasty procedure involves two parts; for excess fat / puffiness, the incision is made on the inside of the lower lids and the fat is removed. If there is excess skin on the outside portion of their lower lids, our Seattle facial surgeon will remove a small pinch of skin just below the eyelash line. This incision is typically closed with a tissue glue adhesive and the incision is nearly unnoticeable about four weeks following blepharoplasty – eyelid surgery.

With respect to the lower lids surgery, the incision for the fat pad removal is done on the inside from the subconjunctival approach. There are three fat pads on the lowers and a small portion of this fat is removed to get rid of the tired look. Most patients over 50 years of age will need a small pinch of excess lower eyelid skin. If this is the case, this is a conservative 2-3 mm pinch that is taken directly at the subciliary line directly below the eyelashes and is covered by the lower curl of the eyelashes themselves. This incision, when necessary, is closed with Histocryl tissue adhesive that will fall off in 7 – 10 days after the procedure. When patients awaken in the recovery room, the eyelids are relatively numb.

Blepharoplasty Recovery Phase

Most patients experience some form of mild burning and headache after the blepharoplasty procedure, which is mild in the first few hours in the postoperative recovery phase. Some patients experience a headache after the first few hours of eyelid surgery, but that usually subsides with some mild pain relievers. The recovery at The Seattle Blepharoplasty Center typically takes about an hour to an hour-and-a-half. At that time, the patient can be discharged to home with their caregiver.


Our Seattle facial plastic surgeons will examine both eyelids during the blepharoplasty consultation. They will also take photographs of the eyelids and computer imaging can be performed at the eyelid consultation. The computer imaging is a communication tool ( not a guarantee of how patients will look ), but it gives an idea of what to expect. This is also an opportunity for patients to discuss expectations, healing process from the eyelid surgery procedure.


During the consultation for eyelid surgery in Seattle WA, our top facial plastic surgeons – Dr. William Portuese and Dr. Joseph Shvidler will review before and after photos of real patients from Washington State, Portland and surrounding areas. Our board certified facial plastic surgeons will also review the visual field obstruction test if it is performed prior to the examination by an ophthalmologist or oculoplastic surgeon. If there is a significant visual field obstruction, usually over 30′ in primary gaze, a patient’s insurance may cover a portion of the surgery. This will be determined by the visual field obstruction test.

Our Seattle facial surgeons will review the visual field obstruction test, will take pictures, and will submit a physical examination, all for preauthorization with the patient’s medical insurance prior to any insurance-related blepharoplasty work being done.

Blepharoplasty can be performed alone, or in conjunction with additional cosmetic surgery techniques such as a Facelift or Rhinoplasty – Nose Job. If you’d like to learn more about the benefits of upper lid surgery ( blepharoplasty ) , please don’t hesitate to contact our medical office located in Seattle WA today for more details.

Complications of a blepharoplasty

Irregularities of the skin are the most common occurrence after eyelid surgery. Patients can get little white heads, which need to be opened up, along the incision line on the upper lids. Sometimes these can actually turn into small pimples and have to be drained.

Postoperative Appointments

Examination of the upper and/or lower eyelids is performed and the incisions are cleaned. Our Seattle surgeons will make sure that all tissues on both lids are healing quite well. Our Seattle doctors will make sure that your vision is intact. The eyelids tend to be quite swollen, puffy, and bruised. At this point, about 7 – 10 days, patients can start applying makeup to their eyelids if they desire so that they can get back out into their work environment.

Other Procedures

Blepharoplasty can be done by itself or in conjunction with other facial procedures, such as a facelift or rhinoplasty.

Blepharoplasty  FAQ

#1 How are droopy upper eyelids fixed? The primary goal of an upper eyelid blepharoplasty is to remove extra skin creating the tired or hooded look. The blepharoplasty eyelid lift procedure for the upper eyelids includes removal of skin and fat from the upper lids to create a rejuvenated look. The incision is located in the upper eyelid crease. An upper eyelid lift blepharoplasty procedure is usually performed under a brief general anesthetic as an outpatient surgical procedure. Anticipate 2 weeks of bruising and swelling after the procedure.

#2 How much does eyelid surgery cost?
The cost of upper and lower eyelid surgery is more than just the cost of only the upper eyelids or only the lower eyelid surgery. The fees for an upper and lower blepharoplasty eyelid surgery are determined by the amount of time in the operating room, the time under anesthesia by an anesthesiologist, and the surgeon’s fees for performing blepharoplasty.

#3 Recovery time for eyelid surgery?
Due to gravity, the lower lids tend to bruise and swell more than the uppers. When patients perform both upper and lower eyelids, it usually requires 2 weeks of some degree of bruising and swelling to subside, but it can be quite variable depending upon the patient. We ask that patients refrain from strenuous activity and exercise for at least 2 weeks after the procedure. Full healing after an eyelid procedure takes 3 months.

#4 Are there any stitches placed in the eyelids?
In our medical practice in Seattle serving all areas of the Pacific Northwest including Bellevue, there are no stitches placed in the lower lids. The fat is removed through a trans-conjunctival approach from the inside of the eyelid. If there is extra skin, a small incision pinch technique is placed on the outside of the eyelids. This incision is closed with tissue glue. The upper lid lift Blepharoplasty incision is closed with sutures that are dissolvable and fall out/ dissolve in approximately one week.

Useful Links

Guide to the Best  Eyelid Rejuvenation – Blepharoplasty

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