What is an eyelid lift?
Blepharoplasty, the medical term for an eyelid lift, is surgery on the skin, muscle and fat of the eyelids. As skin loses collagen and elastin, and on the upper lid it drapes over the crease as a fold that hides the lid and swallows eyeshadow; below the eye, puffiness and bags develop with age or genetics, or from years of poor sleep, and read as tired or unwell. An eyelid lift removes the excess skin above and the fat that causes the bags below, and gives the eye area back its firmer contour without changing the shape of your eyes. Our page on hooded eyes explains how to tell a fold of skin from a low brow or a drooping lid, which need different operations.
What an eyelid lift treats
- Excess upper eyelid skin that hides the crease, makes the eyes look tired, and transfers eyeliner and eyeshadow within an hour
- Heavy upper lids that strain the forehead to stay open and narrow the upper field of vision
- Puffiness and bags under the eyes, from age, genetics or chronic lack of sleep
- Loose, wrinkled skin of the lower eyelid below the lash line
- Inherited excess eyelid skin, at any adult age
Who is a good candidate for an eyelid lift?
Most patients come to Dr. Cat because they look tired in every photograph, because eyeshadow vanishes into a fold, or because the lids feel heavy by evening. Age is the usual reason, but an eyelid lift can be done at any adult age: some patients inherit excess upper eyelid skin, and under-eye bags can come from genetics rather than years. The test that matters is the brow test: lift the tail of one eyebrow with a fingertip to where it sat in old photographs. If the hood mostly disappears, the brow is the cause; if the fold stays, the excess is lid skin, and that is an eyelid lift.
You may be a good candidate if
- A fold of upper eyelid skin hides the crease or defeats eyeshadow, with the brow still in place
- Puffiness or bags under the eyes are there in the morning and after a good night's sleep
- You are in good general health, with any blood thinners, fish oil, vitamin E and herbal supplements stopped two weeks before surgery
- You expect rested eyes that look like yours, not a different eye shape
Not yet, or a different plan, if
- The brow has dropped to the rim of the eye socket: removing lid skin alone leaves the heaviness, so a brow lift, alone or with the eyelid lift, is the plan
- The lid margin itself sits low over the pupil (ptosis): that is a stretched lifting muscle, corrected by tightening it, not by removing skin
- Mild hooding from a slightly low brow: a Botox brow lift raises the tail of the brow a few millimeters for three to four months
- A low or absent crease rather than a hanging fold, common in many East Asian eyes: that is a crease-forming operation, which our post on double eyelid surgery explains
- Uncontrolled thyroid eye disease, chronic dry eye or a bleeding disorder not yet evaluated
- You smoke and cannot stop: nicotine restricts the blood supply the thin eyelid skin needs to heal
Types of eyelid surgery
Upper eyelid lift (upper blepharoplasty)
The upper eyelid lift is the operation most of Dr. Cat's eyelid patients have, and she performs it herself. Through an incision placed in the natural crease of the upper lid, the excess skin is removed, with a sliver of muscle and a small pocket of fat where needed, and the incision is closed with small sutures so the scar sits inside the fold and is not seen with the eye open. Her instinct is conservative: enough skin to give the lid back, never so much that the eye looks hollow, surprised or unable to close. It is the shorter of the two operations, and the one that can widen the upper field of vision.
Lower eyelid lift (lower blepharoplasty)
A lower eyelid lift treats the bags and the loose skin beneath the eye. When puffiness is the problem, the fat that causes it is removed through a small incision on the inside of the lower lid, which leaves no external scar. When there is excess skin as well, a second incision runs just below the lash line, where the lashes hide it once healed, and the skin is trimmed. Some patients are better served by keeping the fat and moving it into the hollow under the bag, a fat repositioning technique that is decided at the consultation. Dr. Cat performs the lower eyelid lift herself, on its own or together with the upper lids in one session.
Upper and lower eyelid lift together
When both the fold above and the bags below have changed, treating them in one surgery means one anesthesia, one recovery and one quote, with the upper and lower lids balanced against each other. Combined surgery takes the longer end of the two-to-four-hour range and is a $30,000 surgeon's fee, with the operating room and anesthesia quoted at your consultation. If a dropped brow is part of the picture, a brow lift is planned with it.
How Dr. Cat does it
Dr. Cat is a board-certified plastic surgeon who completed two surgical residencies, one in head and neck surgery, microvascular and facial reconstructive surgery, and advanced training in general plastic and reconstructive surgery, Harvard-educated and UCLA trained, in private practice in Beverly Hills since 2010. She treats the eyes as part of the face rather than a feature on their own, which is how the "done" look is avoided.
Anesthesia: general, with a numbing solution
Surgery is under general anesthesia with a board-certified physician anesthesiologist, in Dr. Cat's QUAD A accredited surgery center on Rodeo Drive. She also places a numbing solution in the eyelids, so you wake comfortable, which is part of why most of her patients need only Tylenol afterwards. In the pre-operative area she goes over the plan with you once more and marks where the incisions will sit.
Precision under 3.5X magnification
Dr. Cat performs the eyelid lift under 3.5X magnification operating lenses, which is how the two sides are made to match and how the closure is kept so fine. She closes the incision with small sutures, using the technique she developed for scars that are undetectable once healed, and she takes her time with it, because the incision sits on the most looked-at part of the face. The sutures come out at five to six days.
Surgery day
An eyelid lift takes about two to four hours, depending on whether the upper lids, the lower lids or both are treated; an upper eyelid lift alone is the shorter operation. It is outpatient: after a short time in recovery you go home with someone to drive you and help for the first 24 hours. Whether the upper lids, the lower lids or both are treated, Dr. Cat performs every step herself.
Combining an eyelid lift with other procedures
Eyelid lift with brow lift
If the brow test erased most of your hood, the brow is the cause, and taking skin from a lid beneath a dropped brow pulls the brow further down. A brow lift repositions the brow through small incisions behind the hairline, or along the hairline when the forehead is high, and is often paired with an upper eyelid lift so the brow, the fold and the lid are corrected together.
Eyelid lift with Botox
Botox smooths the crow's feet and fine lines around the eyes that an eyelid lift does not touch, by relaxing the muscles that fold the skin, and for mild hooding a small dose at the tail of the brow lifts it for three to four months. At our practice Botox of the forehead and around the eyes is injected by Dr. Cat herself.
Eyelid lift with facelift
Heavy upper lids and under-eye bags do not move with a facelift, which treats the cheeks, the jowls and the neck, so the two are often paired, the facelift performed by our facial plastic surgeon, and an upper eyelid lift added to a facelift costs less than it does on its own. Patients whose complaint is the eyes rather than the jawline usually find the eyelid lift alone gives them the refreshed look they wanted, at a fraction of the cost and recovery.
Eyelid lift recovery timeline
Here is what recovery looks like for most of Dr. Cat's eyelid lift patients. The eyes heal fast, and the rules of the first two weeks, cold, elevation and no rubbing, keep the swelling short.
- The night of surgeryYou go home with someone to drive you and stay the first 24 hours. Expect tight, swollen lids; most patients need nothing stronger than Tylenol. Cold compresses, gently, for the first 48 hours, and sleep with your head raised on two or three pillows.
- Days one to fiveSwelling and any bruising peak and then fade. A little blurring from the ointment is normal, and lubricating drops help if the eyes feel dry or sensitive to light. No rubbing, no contact lenses, and no bending or lifting.
- Day five to sixDr. Cat removes the sutures at your visit. The incision is a fine pink line in the crease, and most of the swelling has gone with it.
- One weekMost patients are back at work and their regular activities within the first week, with concealer for any bruising that remains.
- Two weeksScar treatment starts with the products the office provides, contact lenses go back in, and moderate exercise such as walking or a stationary bike resumes.
- Four weeksVigorous exercise such as running or aerobics resumes. The eyes look rested rather than operated on.
- Three to four months, and one yearThe final result shows at three to four months, once the last swelling has left the lids. The scar keeps fading and is gone by about a year; keep the sun off the incisions for the first months.
Eyelid lift before and after photos
Photos answer what words cannot: how much lid shows afterward, whether the crease looks natural, whether the eyes still look like yours. Case ELF-0948 below is an upper eyelid lift by Dr. Cat photographed only one month after surgery, with the scar already barely visible in the crease; the same patient also had submental liposuction with Dr. Cat. Case ELF-0011 is a male patient, and the full eyelid lift before and after photos include Asian eyelid lift cases in which the original eye shape was kept. The eyes in every after photo should look rested, not changed.
Risks and safety
Every surgery carries risk, and the eyelids are thin and next to the eye. Here is what can happen and what Dr. Cat does to prevent it.
What can go wrong
- Bruising and swelling that last longer than the usual week, or a collection of blood under the skin
- Dry, irritated or light-sensitive eyes for a few weeks, and infection at an incision
- A visible or thickened scar, rare with the incision in the crease and a fine closure
- Asymmetry between the two sides, or too much skin removed: an eye that looks hollow or surprised, or lids that do not close fully at night
- After lower eyelid surgery, a lower lid pulled down or away from the eye, or a hollow where too much fat was taken
- Bleeding behind the eye that threatens vision: very rare, and an emergency
- Anesthesia risks, which the board-certified anesthesiologist reviews with you before surgery
How Dr. Cat reduces these risks
- Careful patient selection: the brow, the lid margin and the true skin excess assessed with the brow held in place, and dry eye, thyroid eye disease and bleeding problems asked about first
- Medical clearance and lab work, and a pre-operative appointment covering the blood thinners, fish oil, vitamin E, herbal supplements and alcohol to stop two weeks before surgery
- Surgery in a QUAD A accredited facility with a board-certified physician anesthesiologist and a numbing solution
- Conservative skin removal measured against your lid, with enough left for the eye to close, and fat removed from inside the lower lid whenever the skin is good
- Every incision and every suture under 3.5X magnification operating lenses, with a gentle technique that causes little bleeding and bruising
- Cold compresses, head elevation and no rubbing in the first days, sutures out at five to six days, and follow-up visits through the first months
How much does an eyelid lift cost in Beverly Hills?
Dr. Cat's surgeon's fee for an upper eyelid lift is $8,000 to $12,500, $15,000 for a lower eyelid lift, and $30,000 for upper and lower eyelid surgery together. The operating room and the board-certified physician anesthesiologist are quoted at your consultation, once Dr. Cat has examined you and set the operating time your surgery needs: operating time varies with your anatomy and with the areas treated together, so it is set by her, not by a price list. Surgeon's fees are typical ranges: a more complex case can cost more, and your fee is set at your consultation and is final only in your written quote. The quote is itemized in writing and includes your scar products and your follow-up visits, with no second invoice after surgery. The upper lift costs less because it is the shorter operation, and treating both lids in one session costs less than staging them, because you pay for one anesthesia and one facility and heal once.
The price reflects what is behind it: a surgeon who is never rushed, 3.5X magnification for every suture, a physician anesthesiologist and an accredited facility. Please do not fall for cheap or fast eyelid surgery: the eyes are the one place a visible scar or an over-resected lid cannot be hidden, and a revision costs more than the original surgery would have done well. Our blepharoplasty cost guide explains what a quote is made of and why published averages are not your number.
Consultation fee and financing
A consultation with Dr. Cat is $500, or $1,500 for a revision consultation, and the full amount is credited toward your surgery. To pay over time, the practice partners with Cherry, its primary financing partner, and also accepts CareCredit and Alphaeon Credit; see financing and payment plans. A cosmetic eyelid lift is not covered by insurance. When upper eyelid skin droops far enough to block the upper field of vision, a visual field test by an ophthalmologist can qualify the functional part of an upper eyelid lift for coverage; Dr. Cat's office does not bill insurance, but gives you the paperwork to submit a claim yourself after surgery.
Your consultation with Dr. Cat
It starts with a free 15-minute discovery call with our Patient Concierge, who books your consultation. Patients come to Dr. Cat's Rodeo Drive practice from across Los Angeles and from out of town; at the consultation, in person or, for out-of-town patients, by private video consultation through OnPatient, the HIPAA-secure patient portal, Dr. Cat examines the lids and the skin around the eyes, takes your medical history, and looks at three things in particular: where the brow sits, whether the lid margin itself is low, and how much true skin excess there is once the brow is held in place. From that she tells you which of an eyelid lift, a brow lift, both, or Botox fits your goals, and if an eyelid lift is not the right answer she says so. You leave with an itemized written quote.
