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Droopy upper eyelids, puffy bags and excess fat below the eyes can make us look more tired than we feel, and can even interfere with vision. Eye surgery for saggy eyelids (also known as blepharoplasty) can help to reverse the signs of aging by giving the eyes a rejuvenated, relaxed and refreshed appearance. The following article will answer the question ‘what is blepharoplasty’, detail the various eye plastic surgery types, explore how to qualify for eyelid surgery, and assist potential candidates in determining the best eye plastic surgeon for them.

Eyelid Surgery Overview

Blepharoplasty is the surgical removal of fat, excess skin and muscle from the upper and lower eyelids. Eyelids surgery can improve the appearance of the eye area by eliminating heavy, hooded lids and baggy under eyes to create a rested, youthful appearance. Eyelid surgery can be performed on the upper eyelids (upper blepharoplasty) or lower eyelids (lower blepharoplasty), or both the upper and lower eyelids, depending on each patient’s individuals goals. 

Reasons for Eyelid Surgery

What does eyelid surgery do? Patients interested in pursuing eyelid blepharoplasty often seek to:

  • Eliminate fat pockets in upper and lower lids
  • Remove excess skin in the upper and lower lids
  • Remove excess skin and wrinkles from the lower eyelid 
  • Restore a youthful appearance to the eyelids
  • Reduce the extent and depth of crow’s feet
  • Improve confidence

Eligibility and Candidacy

You may be an ideal candidate for upper and lower blepharoplasty procedures if you have one or more of the following conditions:

  • Fat pockets in upper and/or lower eyelids
  • Excess skin in the upper and/or lower eyelids
  • Excess wrinkles in the lower eyelid
  • Tired or sad appearing eyes
  • Long lower lid length

Upper vs. Lower Eyelid Surgery

There are different techniques that may be employed during your eyelid lift surgery. Upper or lower blepharoplasty, or both, will be recommended depending on which areas require correction. The surgical technique used for the lower blepharoplasty will be determined by the extent and degree of skin laxity of the lower lid. The two lower lid blepharoplasty techniques employed by Dr. Barr are the transconjunctival lower lid blepharoplasty and the subciliary lower lid blepharoplasty. The upper blepharoplasty is performed through an incision hidden within the upper lid crease. Each patient has unique facial characteristics and Dr. Barr customizes upper and lower lid surgery to each patient’s aesthetic needs to create an optimal outcome.

Eyelid Surgery Procedure

Transconjunctival Lower Lid Blepharoplasty

This procedure is usually performed on younger patients with excessive eyelid fat but minimal skin laxity. A small incision is made within the pink (conjunctival) tissue, inside the lower lid. Through this incision, excessive fat can be easily removed or repositioned. It is often repositioned into the depression by the nose (often referred to as the tear trough) or into the cheek to smooth the transition from the lower lid to the cheek resulting is a very youthful mid face appearance.

Subciliary Lower Lid Blepharoplasty

Patients who have excessive lower eyelid skin in addition to excess muscle and fat are the best candidates for the subciliary surgical method. During this procedure the incision is made in the natural crease, just below the eyelashes. Through this approach, excess muscle, fat and skin is removed or repositioned. The lower lid is then secured to the tissues overlying the lateral orbital bone resulting in a smooth, youthful lower lid appearance.

Upper Blepharoplasty

During this procedure, a small incision is hidden in the natural upper eyelid crease. Excessive skin, muscle and fat are removed or repositioned using this technique. Fat can also be repositioned to create an aesthetic fullness in the upper lid. Upper blepharoplasty is a frequently pursued, and some refer to is as eye surgery for droopy eyelids.

Risks and Complications

Plastic surgery on eyes is very safe and there are very few risks related to these procedures. It is commonly performed under light sedation and local anaesthesia. Although the majority of blepharoplasty patients do not experience any complications, these will be discussed in consultation with Dr.Barr to ensure each patients awareness and comfort prior to choosing to pursue eyelid blepharoplasty.

Eyelid Surgery at Barr Plastic Surgery

As a plastic surgery eyelid specialist, Dr. Barr has performed upper and lower eyelid surgery on thousands of patients from Ontario and across Canada for over 29 years. When considering any plastic surgery procedure, it is important to consult a qualified surgeon.

  • Confirm that your prospective surgeon is a member of the Canadian Society of Aesthetic Plastic Surgeons and a member of the American Society of Aesthetic Plastic Surgeons. This ensures that your surgeon has extensive experience and proper training required to perform cosmetic / aesthetic surgery.
  • Confirm with your provincial college of physicians and surgeons that your prospective surgeon is licensed and whether disciplinary action has been taken against him/her.
  • Confirm credentials and training. While many cosmetic surgeons advertise they are “board-certified ” requirements vary greatly depending on which professional board is cited. In Canada, only the Royal College of Physicians and Surgeons certifies physicians and surgeons in medical specialties.
  • Peruse your prospective surgeon’s website and review their Before/After gallery to see their work.
  • Just as important as verifying credentials and reviewing their work, you must meet and feel comfortable with the surgeon you have selected. Be thorough when discussing your expectations with your prospective surgeon. Proper communication before surgery is key to achieving the best possible surgical outcome.


What is double eye lid surgery?

Double eyelids have a visible crease on the top eyelid when the eyes are open. Monolids, have an epicanthal fold that covers the bottom part of the eyelid and extends to the inside corner of the eye, creating the appearance of a single lid. Double eyelid plastic surgery creates an eyelid crease, resulted in the look of a larger, almond shaped eye. While the heaviness of hooded eyelids can give the appearance of a single lid, they are not monolids. Upper blepharoplasty may be pursued both by patients with monolids desiring a double eyelid or as an operation for droopy eyelids, or aged, tired looking eyes.

What does under eye surgery cost?

The cost of lower blepharoplasty depends on numerous factors, including whether you choose to schedule concurrent procedures. An accurate quote will be provided during your consultation, and various payment options will also be discussed at that time.

What does upper blepharoplasty cost?

Hooded eye surgery cost is dependent on whether or not you pursue additional procedures at the same time. Patients may choose to address other facial aging concerns during the same visit. These can be discussed in consultation with Dr.Barr, and an accurate quote will be provided.