Eyelid Surgery: Q&A

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Upper or Lower Bleph? (photo)

I am trying to decide if I should do upper or lower eyelids? Right now I can only one or the other but maybe in a year or so i can do the other. I would love some opinions on which would be more beneficial as BOTH are really bad. Thanks for any help!

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18 Doctor Answers | Asked by jamie27223 in Colorado

Doctor Answers (18)
Community Comments (3)

Upper and lower blepharoplasty

The primary goal of upper eyelid surgery is to remove excess skin and a little fat. The primary goal on the lowers is to remove excess puffiness(fat) and a little skin. Both uppers and lowers are ready to do if the patient desires to do so. Most patients in our practice do them together since there is only one recovery period and there is a cost savings due to the operating room and anesthesia

Eyelid surgery

You should correct whichever bothers you the most. Your upper eyelids may be severe enough that insurance will pay for it, and then you could do both. Good luck.

Rejuvenation around the eyes is better if done completely

Jamie plastic surgery procedures are an effort for you as much as the surgeon . There is recovery, bruising, time taken off work, expenses, etc.. Your pictures are taken a little bit too close , but I could see benefit in doing simultaneous upper and lower bleph with other adjunctive procedures. My recommendation is to save up for one surgery and do it all at once. I think you will be happier when you see and overall improvement instead of just one area more

Upper Vs Lower Blephs

It always is easier to undergo upper blepharoplasty as the recovery is quicker and the results more impressive. However, some people like the look of hooded upper eyes and prefer not to have any bags in the lower eyelids. In essence, ask yourself what bothers you more, the upper eyes or lower and start with that. Regards Dr. J Disclaimer: This answer is not intended to give a medical opinion and does not substitute for medical advice. The information presented in this posting... more

Upper or Lower Bleph?

Based on the photos shown, there are strong indications for both upper and lower eyelid surgery. You can certainly have either one separately, but your level of satisfaction will be much greater by addressing the aesthetic concerns comprehensively. For patients seeking a step by step approach, upper lid blepharoplasty is easier, faster, and carries less downtime than lower eyelid surgery.

Strongly recommend combined upper & lower blepharoplasty; If you must choose, do lower eyelid surgery first

Preferred Recommendation: Be patient and do both together. If you can manage waiting a year, I would strongly recommend that you wait and do both upper and lower eyelid surgery together. It makes more sense for 3 reasons: It's usually more cost effective, with lower overall OR costs. You have only 1 recovery period to endure vs. 2. Patients are overwhelmingly much more satisfied with full rejuvenation of the eye area vs. partial if your condition warrants it, as yours... more

Doing both is ideal, but lower eyelids is the best option if you have to choose one

In my 20 years of practice, people have come to me with similar situations saying that they don’t like their lower eyelids. I would not push them to do anything else even though I noticed that their upper eyelids would also benefit from surgery. After I did their lower eyelids, they’d come back to me and ask why I didn’t advise them to have their upper eyelids done also. I would explain that they came in complaining only about their lower eyelids. If you have to make a choice, from... more

Nonsurgical Techniques Work Well For Easily and Quickly Rejuvenating the Upper and Lower Lid Regions

The region around the eye attracts so much attention on the part of the observer that anything we do to improve its appearance can make a disproportionately significant overall improvement in the way we look and how old we look. Happily, these days we can do a lot to improve the eye unit without having to resort to surgery or have to deal with the downtime and expense of surgery. For example, tear troughs, dark circles and hollow areas can be treated with fillers, my favorite for this... more

Benefits of Combining Upper and Lower Blepharoplasty

Although I can appreciate your desires to effect an immediate change on your appearance, I would have to agree with the other physicians that it is better to save your money and do both upper and lower blepharoplasty at the same time. You will benefit by having to only go through one recovery period instead of two. Your cost with regards to facility fees and anesthesia will also be lower. Good Luck

Upper or Lower Eyelid Surgery

Upper eyelid surgery would help. I would have to examine you and determine what bothers you in the lower eyelid area. I would probably recommend something additional or apart from lower eyelid surgery. In general, you save money by doing the procedures at once. Kenneth Hughes, MD Los Angeles, CA

Advantages of combined upper and lower blepharoplasty (quad-blepharoplasty)

You can benefit from both upper and lower blepharoplasty to achieve more youthful appearance. They are best done together as you only need to go through one recovery period. The cost of combined upper and lower blepharoplasty is also usually less than that if you separate the two.

Upper and Lower Eyelid Lift Together, for Harmony

Jamie, thank you for this great question and for posting your photos. Though you may feel financial pressure to only have the upper or lower eyelids lifted, the reality is that, when indications exist for both, it is better to do all four eyelids together. This improves the overall harmony of the result, and will also mean that you only have to recover once. Lastly, many surgeons will give a discounted price if you combine multiple procedures. Ask your qualified surgeon if this is available.... more

4 lid blepharoplasty

If you can only afford one it really is your choice, but it would probably be best to save to do both at the same time because you will only have to pay one facility fee.

Steven Wallach, MD

12 reviews

Manhattan Plastic Surgeon

Eyelid surgery, upper and lower

From the posted phptos, it appears that you would benfit from upper and/or lower blepharoplasty. Since you are planning to stage these operations you could consider upper eyelid first and have filler injected to the tear troughs to have some imprivements in the " baggy" lower lids while awaiting for the second stage. The other option is doing the lower lids first and consider botox injection to raise your eyebrows and reduce "hooding" anf fullness of the upper eyelids. more

Whether to do Upper or Lower Blepharoplasty

I, as a physician, should not advise you whether to do an upper or lower blepharoplasty when "BOTH are really bad." Our job is to advise you what can be done and what the results are most likely to be and what the risks and possible complications are. Only you can decide what to do. You should do whatever bothers you the most and fits your budget and your risk tolerance. You, of course, also need to understand that after surgery the upper and lower lids will look significantly out... more

Upper or Lower Eyelid Surgry First, How to Decide; Consider Forehead Lift as Well

As mentioned by other responders, judging from the photographs presented, you are a good candidate for both upper and lower blepharoplasty. However, in addition to excess upper eyelid skin, relaxation and descent of the eyebrows can contribute to fullness in the upper eyelid area. Simulate a forehead lift by using your hand to lift your eyebrows. You will notice a more open look to your upper eyelid area but you will probably still have excess upper lid skin... more

Upper or Lower Bleph?

As the other consultants have mentioned, it is probably most efficient in both money and time to save until you can do both upper and lower eyelid surgery at the same time. But if you are totally set on doing something now, do the uppers first as it will be the most beneficial surgery for you.

Which to have first: upper or lower blepharoplasty?

Based on the photos you've submitted you're a good candidate for both procedures. From both a cosmetic and functional standpoint you will probably immediately appreciate the results of an upper blepharoplasty. It will "open" your eyes and also likely improve your vision by removing the extra skin that hangs down over your eyelashes. This procedure can either be performed in the office under local anesthesia or in a surgery center under sedation depending upon your preference. You can then... more

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Comments (3)

jamie27223 22 Feb 2013

Dr. Sexton thank you for that suggestion. I now have an appointment with my Dr. feb 26th to see if I qualify for the upper. I so hope I do!

Jamie803 1 Apr 2013

Hey Jamie, did u find out if insurance will pay for the upper? Dr. Sexton is really smart. He is a brilliant surgeon. He did my breast augmentation 2 years ago. If u can't get em done at the same time & have to pick, I would say upper, just my opinion.

jamie27223 2 Apr 2013

Hi Jamie, Thanks for your opinion as I am still contenplating what to do, ugggh what a hard choice. I did ask my Dr. about qualifying for it for the insurance to pay for it and he thought I was crazy, lol. He said it is reserved for those with vision blocked from drooping eyelids and mine obviously do not block my vision yet. So onwards to a decision. I have care credit and I do not have enough to pay for both even though care credit did an increase for me they were unable to increase it enough for both upper and lowers. I'm happy for you that you are so excited about your surgery! Its always so nice to get good results after hearing some of these horror stories. I was thinking of doing just injections under the eyes and doing bleph for upper but i'm terrified to have anything stuck around my eyes. I had botox for the 11's and that was scary enough and has long since worn off but am thinking of a redo for that too. Of course hubby thinks i'm crazy for even doing anything because he sees nothing wrong with me, bless his heart. Thanks for asking!

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