Bruising Question with Upper Blepharoplasty. Thanks.

Does removing the skin only in an upper blepharoplasty operation typically result in less bruising versus removing/impacting the fat and the muscle?

Doctor Answers 18


Hi there.  Please note that either technique may result in bruising.  At the same time, more "extensive" approaches such as skin/muscle excision elevate the incidence.  Hope this is helpful.  Best wishes.

San Antonio Facial Plastic Surgeon
4.5 out of 5 stars 13 reviews

Bruising after an upper blepharoplasty

An upper blepharoplasty  addresses removal of herniated fat, excess skin, and redundant muscle. Each procedure is customized depending upon the needs, goals and anatomy of each eyelid. There is a direct correlation between the amount of surgery performed and the  amount of bruising. It's important to perform the  correct procedure for each individual patient  irrespective of the temporary bruising that may or may not occur after eyelid surgery. For many examples, please see the link below to our eyelid surgery  photo gallery

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 146 reviews

Blepharoplasty technique

Yes a simple skin removal technique should be less traumatic and have less bruising and swelling than a blepharoplasty that involves  muscle and fat removal. However the choice of technique is made on the basis of necessity. If you have excessive visible fat and there is a need to remove some obicularis muscle it should be done. You need to be prepared and accepting of the standard recover period for normal surgery or perhaps the timing is not right for you to have the surgery

Richard Galitz, MD, FACS
Miami Facial Plastic Surgeon
4.6 out of 5 stars 11 reviews

Bruising Question with Upper Blepharoplasty. Thanks.

The simple answer is YES. Please understand that the less invasive procedure, the less chances of bruising. However, will it get you the results that you wan? I have seen countless patients who have had previous upper blephs with little or no fat removal. It is always obvious particularly towards the inside of the upper lid where it meets the nose. I have often found bulging fat that gives a very unattractive look to the patient. Bruising will go away.................fat that is not removed, does not. All the best in your journey.

Jose Perez-Gurri, MD, FACS
Miami Plastic Surgeon
4.9 out of 5 stars 233 reviews

Skin only blepharoplasty

yes, in general a skin only blepharoplasty would have a better healing time versus one that included excision of muscle and or fat.  No matter how invasive or less invasive surgical procedure is you always want to plan accordingly.  You could absolutely still have bruising with this procedure and should probably work under the assumption that you will just to be safe.  For a skin only blepharoplasty you will probably have your sutures are removed anywhere from 5-8 days after surgery depending on what the surgeon used to close the incisions.  You will certainly still have swelling at that time but likely it will not be terribly noticeable.

Chase Lay, MD
Double board-certified facial plastic surgeon

Chase Lay, MD
Bay Area Facial Plastic Surgeon
4.9 out of 5 stars 76 reviews

Bruising Question with Upper Blepharoplasty.

In general, less invasive procedures have a lower risk of bruising. However, having a skin only upper blepharoplasty still puts you at risk for bruising. I would never promise someone a no-bruising blepharoplasty regardless of the approach as bruising can result from something as simple and universal as the injection of lidocaine at the beginning of the procedure. I hope this information is helpful for you.

Stephen Weber MD, FACS
Denver Facial Plastic Surgeon

Stephen Weber, MD, FACS
Denver Facial Plastic Surgeon
4.9 out of 5 stars 129 reviews

Bruising Question with Upper Blepharoplasty?

Bruising is generally less with an upper lid skin only removal, but varies significantly from patient to patient. Patients who have a history of easy bruising may bruise more than patients who don't have that history.

I would suggest that you find a surgeon certified by the American Board of American Plastic Surgery and one who is ideally a member of the American Society for Aesthetic Plastic Surgery (ASAPS) that you trust and are comfortable with. You should discuss your concerns with that surgeon in person and have him or her give you a  list of medications, herbs, supplements that you should avoid before surgery or that you can take in order to minimize bruising. 

Robert Singer, MD FACS

La Jolla, California

Robert Singer, MD
La Jolla Plastic Surgeon
4.6 out of 5 stars 19 reviews

Bruising with upper eyelid procedures

Bruising can occur with skin only upper bleph or if muscle and fat are also removed. The eyelid skin is quite thin and is closely adherent to the underlying orbicularis oculi muscle (the muscle that surrounds the eye). This muscle can cause bruising just from injecting around it. So to answer your question, you can expect bruising either way and the pre op and post op instructions from your surgeon will give you methods to minimize the risk of bruising. 

Dilip D. Madnani, MD, FACS
New York Facial Plastic Surgeon
4.8 out of 5 stars 90 reviews

Extent of blepharoplasty

Skin only upper lid blepharoplasties are more straightforward and may result in less bruising; however, in any procedure, if adequate hemostasis  (stopping the bleeding) is not obtained, bruising will develop.  Procedures where muscle is removed are less common as we have recognized the important of maintaining volume in the upper lid.  In procedures where fat is removed, adequate control of bleeding is very important to avoid a hematoma that may impair vision.  Bruising can develop even in the most controlled procedures.  My recommendation is to follow your postop instructions carefully to obtain the most expeditious recovery.

John Michael Thomassen, MD
Fort Lauderdale Plastic Surgeon
4.9 out of 5 stars 52 reviews

Bruising after blepharoplasty

There is at least one study that suggests there may be less initial bruising when skin only upper blepharoplasty is performed, compared with removal of skin and muscle. That being said the study was done with only a small number of patients, and there was no difference in the final outcome. There have been other studies which have found conflicting results.

I make the decision on whether to remove skin or skin and muscle based on whether the eyelids are bulky or hollow. Leaving the muscle in place tends to produce more fullness in the upper eyelid and can minimize hollowing from tissue removal. I usually remove some muscle in patients who have a lot of bulk in their upper eyelids.

Reference to study:
Upper blepharoplasty with or without resection of the orbicularis oculi muscle: a randomized double-blind left-right study.
Damasceno RW, Cariello AJ, Cardoso EB, Viana GA, Osaki MH.
Ophthal Plast Reconstr Surg. 2011 May-Jun;27(3):195-7.
RW, Cariello AJ, Cardoso EB, Viana GA, Osaki MH.
Ophthal Plast Reconstr Surg. 2011 May-Jun;27(3):195-7.

Mitesh Kapadia, MD, PhD
Boston Oculoplastic Surgeon
5.0 out of 5 stars 167 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.