Turning fifty - upper eyelid surgery and laser on lower lids. (photos)

I am wondering if I would benefit from an upper eyelid Blepharoplasty and fractal or other laser on my lower lids. I think I have extra skin on the upper lids, and on the lower lids, the wrinkles bother me most. Would the cost be less than Blepharoplasty on both eyelids? Can good results be achieved without a lower Blepharoplasty?

Doctor Answers 11

Eyelid surgery , laser resurfacing and filler?

Judging by your pictures, an upper blepharoplasty would be a good choice, would eliminate the excess skin and rejuvenate the upper eyelids. I feel that the lower eyelids could benefit from CO2 laser resurfacing and filler. I do not see any excess fat that would warrant removal so I would avoid that. Sunken lower eyelids after fat removal do not produce a youthful look, so that is best avoided. I would also add filler to your cheeks and tear trough areas

Annapolis Oculoplastic Surgeon
4.2 out of 5 stars 6 reviews


I agree with the upper eyelid blepharoplasty.  However laser resurfacing of the lower eyelid will likely not be enough.  A conservative lower eyelid blepharoplasty to remove herniated fat and a small amount of skin would likely have nicer results.  

John Michael Thomassen, MD
Fort Lauderdale Plastic Surgeon
4.9 out of 5 stars 49 reviews

Do I need a Blepharoplasty?

In my opinion, looking at only your photos, I would suggest a blepharoplasty of both the upper and lower lids. This will provide a much better overall aesthetic result, because, in addition to skin removal, you will also have significant improvement in your tear trough lines. Laser of the lower lid alone will tighten the skin, but will not address the fat bags bulging out beneath your eyes or the tear trough line. The cost difference is probably minimal, but the improvement would be tremendous. Laser resurfacing of the lower lids alone is best mostly for younger patients that need only slight resurfacing of the lower lids and have no need to address the bags or the tear trough. I hope this helps, thank you for your question. 

Erez Sternberg, MD
Jacksonville Plastic Surgeon
4.9 out of 5 stars 32 reviews


You have some excess skin especially laterally which can be removed with a blepharoplasty.  It looks like you have some extra skin in the lower lid too.  Need to be seen in person if this will do well with just laser resurfacing or if you would need some skin excised as well.    

John J. Martin, Jr., MD
Coral Gables Oculoplastic Surgeon
5.0 out of 5 stars 27 reviews

​ It appears that you could be a great candidate for upper and lower eyelid surgery.

Hello, and thanks for sharing your question. Based on your photos, it seems that you would benefit much more from a combination upper and lower eyelid surgery than only an upper eyelid procedure combined with a laser treatment. While laser treatments can help to address fine lines and wrinkles, eyelid surgery can provide much more comprehensive results by also removing any excess fatty deposits that can create a puffy appearance, as well as removing or tightening the loose skin in this area that causes wrinkles. My advice would be to schedule a consultation with a board-certified plastic surgeon so that you can discuss your needs and goals in depth and get a thorough assessment. Best of luck!

Brian Vassar Heil, MD
Pittsburgh Plastic Surgeon
4.8 out of 5 stars 19 reviews

Combination upper lid blepharoplasty and lower lid skin resufacing

I agree that an upper blepharoplasty will help remove the excessive upper eyelid skin. As far as the lower eyelids its hard to tell whether a laser resurfacing alone will help enough with your lower eyelids. I definitely think the laser should be part of the lower lid procedure as you have significant lower lid wrinkles that are best improved with a resurfacing procedure. I often do that in conjunction with fatty tissue removal from the lower eyelids. However, you may not need that and often the laser alone will suffice. Good luck in your area.

Scott Trimas, MD
Jacksonville Facial Plastic Surgeon
5.0 out of 5 stars 20 reviews

Surgery for 2 or 4 eyelids? Can Laser an option for lower?

I see a severe deformity in your both eyelids; upper and lower and to correct them all and give you a younger looking eyes, I plan combined upper and lower blepheroplasty at once. This will help getting the complete result at once. 

I both perform Madonna eyelift which is performed by Smartxide laser and it has dramatic effects non-surgical in correct indications, however in your eyelids, I advise a surgery to both eyelids at the same time - if not, I don't think you can get a satisfactory result. Just to be sure you are in the safe hands, so prefer an experienced surgeon on eyelid surgery.

All my best,

Dr. Turker Ozyigit

Turker Ozyigit, MD
Turkey Plastic Surgeon
5.0 out of 5 stars 1 review


ljleavell, hard to ever give a definitive answer without an exam but in your age group and after looking at your photos I would be inclined to recommend a "SOOF lift blepharoplasty" and an endoscopic brow lift. See the video and good luck! Do make sure you see an experienced specialist.

M. Sean Freeman, MD
Charlotte Facial Plastic Surgeon
4.7 out of 5 stars 48 reviews

Blepharoplasty and Laser

Congratulations on making it to 50! In my experience, upper lid blepharoplasty and lower lid laser have worked well for people such as yourself. A word of warning however...the lower lid skin is very thin, and needs to be addressed very gently with the laser. I tell my patients I would rather laser the lower lids lightly and have to repeat it down the road, than laser aggressively and suffer the consequences.

Daniel Lensink, MD
Redding Oculoplastic Surgeon
5.0 out of 5 stars 4 reviews

Turning fifty - upper eyelid surgery and laser on lower lids.

Thank you for your question.  An upper blepharoplasty will remove the excess skin from the upper eyelids and should give you a nice result.

You need in examination to determine if laser resurfacing is safe on your lower eyelids.  If there is laxity or looseness of the eyelid laser resurfacing can result in ectropion or a downward pole of the eyelid which could be very dangerous.  My rough guess looking at the lower eyelids is that a blepharoplasty might be a better option.  However he needed an personal examination to be certain.  To understand eyelid surgery better please read the following link:

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.