How much does it cost for eyelid surgery? Do I need surgery or can be done with injection? (Photo)

Doctor Answers 12

It appears you would need both: surgery for the puffiness under the eyes, and injections for adjacent hollowing due to aging

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Thank you for your question. You submitted a single photo with your eyes looking upward, asking how much it costs for eyelid surgery, or if your eyelids can be treated with just an injection.

I can share with you my initial impression with this limited photo, and what I believe you’re drawing attention to. A little background: I’m a Board-certified cosmetic surgeon and Fellowship-trained oculofacial plastic and reconstructive surgeon. I have been in practice in Manhattan and Long Island for over 20 years, and helping people with the under eye and cheek area is something I do every day in my practice.

I suspect you are trying to draw attention to the under eye area and the puffiness pushing forward, which is expressed more when you look up. From that respect, we should identify the anatomy causing this. What you are looking at are fat pockets referred to as lower eyelid fat prolapse, meaning  fat pockets normally around your eyes pushed forward to create these bulges. This is a very common issue with facial aging, and also typically genetic form, so it tends to run in families. I have operated on the same family in 3 generations, so it’s very common.

The question of whether to do surgery or injection, if we’re dealing with facial aging as an overall issue, chances are you would be a candidate for both. If you have under eye puffiness, and want to see if you can hide it a little better with an injection, that is possible, but it may not be optimal. The principle behind using filler to help with the appearance of under eye bags is the placement of filler in an area called the tear trough and the lower part of the eye socket,  which we refer to as the V deformity. Placing filler in this area can sometimes soften that transition between the lower eyelid fat prolapse and the area adjacent because the puffiness can make the hollow look deeper.

In many patients, there’s a combination benefit if they do the surgery and filler at the same time, but not necessarily in the same area. One of the things we have to understand with facial aging is people always understand wrinkles and sagging, but something not understood is volume loss, not just from skin and fat, but also bone. This is very important because one of the things we do in our practice is something called structural volumizing, which uses long-lasting fillers such as Juvederm Ultra Plus or Juvederm Voluma placed on the bone structure around the cheek and under eye area. This restores some of the lost volume from the receding bone structure. One can argue that the puffiness under the eyes is further accentuated by this recession of the bone structure, and the further widening of the eye socket. This is difficult for a lot of people to grasp, but the solutions revolve around this strategy.

When I evaluate someone like yourself, I take photos from multiple angles, and place them on the screen so we go over the different angles to show what are fat pockets and prolapse, just to be complete about the options besides fillers. We do something called lower eyelid transconjunctival blepharoplasty which is a surgical procedure where I approach the fat pockets from the inside of the eyelid. This is an extremely effective procedure because the shape of the eye is maintained, and the main issue of fat pockets  pushed forward and creating puffiness is addressed with minimal trauma - we’re reducing, shaping, and repositioning the fat. On top of that, we often do a combination of platelet-rich plasma (PRP) which is derived from your own blood to stimulate the collagen and improve skin quality to address some of the facial aging and environmental skin issues. We often combine an energy-based device like a radiofrequency such as Pelleve for darker skin types, or a laser such as fractional CO2 laser or Erbium laser for lighter skin types -everything is always customized. On top of that, structural volumizing for the cheekbones can also be beneficial.

I think it’s important you meet with qualified, experienced cosmetic surgeons to learn about your options, and about what makes sense to you. You have to think about the outcome you want, and what procedures will get you there. You may want to do everything at one, or take it in small steps. In our practice, my patients have been with me for years, so we look at things from a long view rather than just a single procedural outcome. We have so many options these days, a lot of ways to solve issues, a lot of strategies that can be optimized and customized to your needs. I think it’s very important you just get that flavor by meeting with doctors and seeing what you’re comfortable with. Everyone has their own style, so it’s important your personal style and your doctor’s style really are in sync. I hope that was helpful, I wish you the best of luck, and thank you for your question.

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Cost and Candidate for Blepharoplasty

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Based on the photo, you appear to be a candidate for blepharoplasty. Consult in person with 3 experienced and expert board certified plastic surgeons to understand your options.Pricing for surgical fees vary considerably across country and even in the same county. We currently charge for Upper and Lower Eyelidplasty $2500. Fees include surgical fees, preoperative care, and postoperative care. MD Anesthesia Costs (if necessary) are additional. Fees in most plastic surgeon's offices (including ours) are reviewed monthly. 


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Hello and thank you for your question. Based on your photograph, you may be a good candidate for lower lid blepharoplasty.  Cost varies based on geographic region and surgeon expertise.  Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and evaluate their results.  The most important aspect is to find a surgeon you are comfortable with. I recommend that you seek consultation with a qualified board-certified plastic surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

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Cost of eyelid surgery

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without any scars or sutures the cost for transconjunctival lower lid surgery to remove the bags is $2500 all included with anesthesia, surgery room and all follow ups.  Upper is $800 to $1800 depending on what is needed.


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setsat, not sure what you are trying to achieve from these photos but it looks like you need your forehead lifted not your upper lids operated on. See a specialist and you can always try Botox first. Watch the video. Good luck!

M. Sean Freeman, MD
Charlotte Facial Plastic Surgeon
4.7 out of 5 stars 52 reviews

cost of eyelid surgery

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The cost of eyelid surgery directly related to the amount of time it takes to perform the procedures under anesthesia monitored by a physician anesthesiologist, the amount of time it takes to perform the procedure in an operating room, and the surgeon's fee for  performing the eyelid surgery, along with all of the postoperative follow-up appointments. Performing both upper and lower eyelid surgery cost more than just the uppers or the lowers. For more information, many examples and our current price list, please see the link and the video below 

Your eyes

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Any price over the internet will either low ball you or be totally inaccurate. From your photos it looks like you might benefit from a lower eyelid lift. At your complimentary consultation you will be told what is best and the prices for everything. 

Lower lid

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The photos are only partially helpful but it looks like your lower lids may have excess herniated fat. A lower lid blepharoplasty may be beneficial. Best to be evaluated in person.  Pricing will be determined by what might be necessary.

Eyelid Surgery vs. Injections

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It all depends on what bothers you in regard to your current eyelids.  In general, injectables (such as Botox) can help to lift the upper eyelid somewhat, and fillers in the lower tear troughs can fill the hollows; however, I have seen some very difficult effects of filler in the tear-trough area from patients who find me from other offices after the problem has developed.  For this reason, I advise you to seek someone who can *cautiously* guide you through the options so that you don't have complications later down the road, meaning a board certified plastic surgeon with many years of experience.

Nonsurgical eyelid rejuvenation

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Your photos don't show the forehead; many perceived eyelid issues result from ptosis there.  It is possible to correct with injections. Surgery is certainly an alternative. See a board certified plastic surgeon to discuss your options.  Both methods have advantages and drawbacks which can be discussed. Best wishes.

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