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Fillers or Blepharoplasty: What is the Best Option for You?

Tuesday, January 22nd, 2019


Blepharoplasty Highlands, NCThe eye area is a point of concern for many adults. Several different problems under the eyes can cause frustrating problems, such as puffy bags, lines or dark circles. These can be caused by the stretching of the eyelid skin, descent of the tissues or loss of supporting tissues. You may have heard of filler treatment for under-eye problems like these and that there is a surgical procedure, lower blepharoplasty, that can improve the appearance of the under-eye. Both provide an excellent opportunity for a younger, fresher looking face, but it is likely that one is a better option for you based on your desired outcome, what caused the problem and your preferences. Here, we discuss details of blepharoplasty and fillers to set you on your best path.

Procedural Similarities and Differences

Blepharoplasty is an eyelid surgery that is performed as an outpatient procedure. It is best for those who have too much skin in the under-eye. In most cases, unless cheek elevation also needs to be done, the procedure can be done in the office with local anesthesia. Our blepharoplasty techniques are conservative, focusing on removing excess and repositioning tissue to achieve an excellent, long-lasting contour beneath the eyes. Lower blepharoplasty surgery can take anywhere from an hour to several hours, depending on the degree of change needed to achieve the desired outcome. Recovery is rapid. Sutures are removed in 3-5 days and most swelling and bruising resolve in 10 days to 2 weeks. You can resume most activities in several days.

Filler treatment is done in the office and can be done with local anesthetic if needed or a topical numbing cream can be applied to the skin. The treatment itself usually takes less than an hour, and all fillers we use contain a numbing medication so any sensation is minimized. They are ideal for those who have simply lost volume and have minimal excess skin. A filler below the tear trough at the upper cheek can restore volume to the area and diminish the appearance of both hollowness and puffiness. By smoothing the area, shadows and highlights are eliminated reducing “dark circles.” You do not need to take time off work or social obligations to recover from filler treatment. If, instead of an off the shelf filler, you opt for fat grafting, recovery is almost the same.

In some people, a combination of treatment may be the most reasonable. In fact, we have stopped doing cheek lifts and, instead, combine Blepharoplasty and filler or fat grafting.

The results of blepharoplasty last years. The eyes will always look younger than they would have had a blepharoplasty never been performed. However, the area will continue to age over time and further treatment may be desired again in the future. Fillers, on the other hand, are partially absorbed naturally by the body over time. This means that some of the filler is permanent having been used by the body to create new collagen, the building block of the tissues. Because the filler we use for eyelid rejuvenation is the longest lasting one available, it lasts minimally two years and has lasted significantly longer, in one case, well over 4 years.

There are pros and cons to both forms of eyelid rejuvenation and each has a specific problem where it is ideal. For further information and to find out whether fillers or blepharoplasty would be best for you, call our Highlands office at (828) 526-3783.


Thank you for your business over the years! Dr. Buchanan is closing his practice and the Center For Plastic Surgery's last day open will be January 31, 2023.

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