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Eyelid Surgery | Highlands, NC

Eyelid Surgery (Blepharoplasty)

blepharoplasty highlands NC

Since “the eyes reveal the soul,” what do yours say about you? Do they convey your inner emotion and vitality, or do they make you look sad, tired or both? As we age:

  • the tissues around the eyes stretch and descend as far as ligaments between the skin and bone allow,
  • forming “bags” and an elongated looking lower lid as the process continues,
  • the soft tissues including fat and, to some extent, the bone atrophies,
  • the skin wrinkles,
  • the area under the eye looks dark from shadows and the ability to see the underlying muscle through the thinned skin,
  • in extreme cases, sagging upper lid skin can interfere with vision,
  • the fat becomes prominent in the lower lid and in the medial upper lid,
  • attachments to bone create the characteristic bags and elongated lower lid,
  • All this causes us to look sad, tired and/or listless, hiding our inner vitality.

Some of us inherit excess fat that further hides our normal sparkle. Whether from congenital excess fat or the result of aging, blepharoplasty can rejuvenate your puffy, sagging or tired-looking eyes by:

  • removing congenital excess fat or repositioning prominent fat from aging,
  • removing and tightening loose or sagging skin and underlying tissues,
  • tightening the sagging lid itself,
  • correcting the bags under the eyes,
  • and removing fine wrinkles.

Upper blepharoplasty is typically a cosmetic procedure but can also improve vision by lifting droopy eyelids out of your field of vision. Older techniques removed significant fat from the upper lid. Today, we rarely do this since it creates a defect that later requires fat grafting. Both blepharoplasty and fat grafting are almost always done as an outpatient and in the office.  If you have surrounding problems, we can occasionally:

  • raise your eyebrows some,
  • reduce the appearance of wrinkles between your eyebrows,
  • make you look less tired,
  • or correct some crow’s feet through an upper blepharoplasty incision with modifications of the procedure.

If you have obstructed upper vision, we can correct this by the blepharoplasty procedure if the problem is caused by the weight of the excess skin on the upper lid (mechanical ptosis) as the extra skin is removed. If instead you have droop of the upper lid caused by laxity of the levator muscle that raises the lid (muscular ptosis), the muscle can be shortened through the blepharoplasty incision. This markedly corrects the “tired” look of the upper lids.

» Questions? Contact us and let us exceed your expectations.

Why consider a Lower blepharoplasty procedure?

Lower blepharoplasty will usually correct the dark circles under your eyes allowing you to look younger and more vibrant. Newer techniques give you better results that last longer and avoid many of the problems of the older methods. Today we rarely remove any of the lower lid fat, as loss of fat in the area is one of the main reasons the cosmetic problem exists. Fat removal, in fact, leads to worse problems in a few years that are harder to correct. The previous surgical method to treat severe “bags” required significant manipulation of the tissues of the lid. This had to be done under major sedation or general anesthesia. Since this has a high rate of problems, we now do a less extensive but very safe and effective office procedure and treat any residual deformity with fat grafting or fillers. This not only provides superior cosmetic results but also markedly reduces problems from the surgery. You can combine this procedure with others such as a Today’s Liquid Lift, forehead lift and/or BOTOX® Cosmetic treatments to achieve other desired results. You should be able to wear makeup and return to the public in 4-5 days. The fine incisions usually virtually disappear within several months.

While many people will require full surgical correction to achieve rejuvenation of the upper and/or the lower eyelids, others may obtain excellent correction using fillers like Juvéderm™Voluma and other Injectables, including fat. These are also excellent in correcting post surgical deformities in both the upper and lower eyelids from previous blepharoplasty, especially in those where fat has been removed.

Before and After – 49 Year Old with Lower Blepharoplasty

Before and After – 69 Year Old with Upper and Lower Blepharoplasty

Before and After – Early 60’s with Upper and Lower Blepharoplasty

Before and After – Blepharoplasty with correction of Ptosis


muscular ptosis highlands NCClick here and request an appointment or for more information on Blepharoplasty, also known as Eyelid Surgery


The American Society of Plastic Surgeons provides more general information and 3-D Animation

Eyelid Surgery FAQs

How Long Is The Procedure?

Blepharoplasty is a term for a procedure to improve the cosmetic appearance of the eye area. Therefore, the time that it takes depends on exactly what procedure is done. A simple upper blepharoplasty that corrects excess skin and, occasionally, fat of the upper lids, takes about 1.5 – 2 hours total in the office. Extra time is required to remove the muscles between the eyebrows so you no longer need Botox® there or to tack the eyebrows up to prevent or correct their descent. Lower eyelid lift takes a similar time. Both are done under local anesthesia in the office, though mild oral sedation can be used if desired.

What Is The Recovery Like? When Will I Be Able to Return To Work After The Procedure?

Recovery also varies depending on what is done. Sutures are usually removed in 3-5 days. The majority of swelling usually also resolves in about that time, though some may remain for about a month. Bruising can take longer but can be covered with camouflage make-up so you can return to normal activities. We also supply medications that reduce the amount of bruising and speeds its resolution and the camouflage make-up.

Is Blepharoplasty Painful?

Most people require only Tylenol to control the minor discomfort after the procedure. If required, something stronger but, generally, not an opioid can be prescribed.

Where Are The Incisions Made for Blepharoplasty?

The incision for upper blepharoplasty, including reduction of the glabella muscles and tacking the brow up, is in the crease where the skin folds at the upper extent of the flat of the lid above the margin and extending outward a variable amount. The entire scar is, therefore, only visible when the lid is closed. The lower lid incision is just under the margin of the lid to the lateral corner of the eye and then in a natural smile crease.

Are There Scars That Result From Eyelid Surgery?

Scars result from any surgery. However, within 2-6 months, the scars from this procedure become almost invisible.

Are There Any Risks Or Complications That Can Occur With Blepharoplasty?

There are possible risks and complications to any procedure. However, over the years Dr. Buchanan has modified the blepharoplasty procedures to make them as simple as possible to allow them to be done in the office under local anesthesia. This has also made them safer by eliminating or reducing most of the major risks. It has also markedly reduced the recovery time. The most common, though still unusual post-op problem is residual though significantly reduced tear trough. This, however, can be corrected by use of a filler or fat injection. Though many surgeons prefer to do this at the time of blepharoplasty, we find it frequently unnecessary.

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.