Upper and Lower Blepharoplasty Fresh look, clear field of vision, reduced signs of fatigue

Dr. Davide Costantino
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Upper and Lower Blepharoplasty

Blepharoplasty is a functional and aesthetic surgical procedure that refreshes and rejuvenates the eyes by eliminating the heavy appearance caused by excess skin, fatty bags, and sagging eyelid tissues.

In the case of upper blepharoplasty, the goal is to correct dermatochalasis (the drooping of the eyelid), which, in more severe cases, can even limit the field of vision.

Lower blepharoplasty, on the other hand, targets the bags under the eyes and the malar grooves, restoring brightness and definition to the periocular area.

Over time, the skin of the eyelids loses elasticity, and the fatty tissues tend to protrude, giving the face a tired or aged appearance. The procedure allows for the opening of the eyes, lightens the features, and restores the natural harmony of the face, without altering its expressiveness.

It is suitable for both men and women, typically after the age of 35-40, but also earlier when genetic predisposition causes early bags or significant excess skin.

Pre-operative evaluation

The evaluation phase is essential for planning a safe and personalized result. During the visit, the surgeon analyzes several parameters:

presence of ptosis (drooping of the upper eyelid);

the extent of excess skin and laxity of the orbital septum, the thin membrane containing the periocular fat;

tone of the lateral canthus (canthal tone) and potential dry eye or abnormal tearing;

possible use of contact lenses or ocular conditions.

These evaluations help determine the most appropriate technique — upper, lower, or combined — and whether to integrate additional procedures, such as lipostructure of the tear trough, for a more uniform and natural result.

Surgical technique

Upper blepharoplasty involves a small incision along the natural eyelid fold, through which excess skin is carefully removed, and, if necessary, small amounts of fatty tissue are also removed. The scar remains hidden in the fold and becomes almost invisible over time.

Lower blepharoplasty can be performed with two different approaches:

Transconjunctival, when the issue is solely due to the presence of fatty bags, without excess skin; in this case, the incision is internal and therefore not visible;
Subciliary, when there is a need to remove slight excess skin or improve the tone of the lower eyelid.

In some cases, the removed fat is not simply eliminated but redistributed to fill the tear trough and reduce the shadow, giving a more relaxed and even appearance.

The procedure lasts from 45 minutes to 1.5 hours, depending on the complexity and combination of upper and lower eyelid surgery.

Anesthesia and recovery time

Blepharoplasty is generally performed under local anesthesia with sedation, a method that allows the patient to undergo the procedure in complete comfort, without pain or anxiety.

At the end of the procedure, small light dressings are applied, without bandages, and the patient can return home the same day.

In the following days, swelling and bruising may appear, which reduce progressively. Sutures are removed between the 5th and 7th day, while social recovery typically occurs after about a week.

To facilitate recovery, lubricating eye drops, cold compresses, and strict sun protection are prescribed to avoid residual pigmentation in the treated area. It is important to avoid strenuous efforts, exposure to heat, and intense physical activity for the first few days.

Risks and frequently asked questions from patients

Will I have a “pulled” effect?
No. The goal of blepharoplasty is precisely to preserve the naturalness of the gaze, eliminating the signs of fatigue without altering individual features.

Can I wear makeup after the procedure?
Yes, but only after the sutures are removed and with the surgeon’s recommendation. It is important to use gentle and hypoallergenic products to avoid irritating the skin during the healing process.

Will the result last?
Yes. The effects of blepharoplasty last for many years. The aging process continues naturally, but the eyes will maintain a more open and youthful appearance compared to the natural course of time.

Will the scars be visible?
The incisions are placed with great care along the natural eyelid folds and around the ear, where the natural lines of the face make them almost imperceptible. Over time, they become thin and barely visible.

Upper and lower blepharoplasty is not just an aesthetic gesture, but a true act of functional harmony: it allows you to free the gaze, improve vision, and restore the face’s authentic vitality. With modern techniques and minimal incisions, the result is fresh, natural, and stable over time, fully respecting personal expressiveness.