Can I get upper and lower eyelid surgery done at the same time? Cosmetic upper and
lower eyelid surgery or blepharoplasty is a very popular procedure throughout
the world the goal of these procedures is to improve the aesthetics of the eyes
by addressing excess and sagging upper eyelid skin often associated with
genetics and aging as well as the appearance of puffy under eye bags other
issues which can be addressed in the eye area include upper and lower eyelid
hollowing wrinkles and dark circles which may be addressed non-surgically

I’m Dr. Amiya Prasad I’m a board-certified cosmetic surgeon and
fellowship trained oculofacial plastic and reconstructive surgeon I’ve been in
practice in Manhattan and Long Island for over 20 years as an oculoplastic
surgeon specializing in aesthetic procedures I perform a wide range of
cosmetic eyelid procedures I also treat complications of eyelid surgery
originally performed by other doctors I have throughout my career developed
several techniques in eyelid surgery to allow for minimal incisions save for
anesthesia and quicker recovery it’s important to understand some basic
principles in a younger person the skin quality tissue volume and bone structure
gives the upper eyelids a youthful appearance the supporting structures can
change due to genetics aging and medical issues the upper eyelid area can have
fat pockets prolapse forward hollowing and excess skin referred to as
dermatochalasis.

Under eye bags which are caused by lower eyelid fat prolapse is
often associated with genetics and if many young people under eye bags that
are also often seen with facial aging it’s common to see both sagging skin in
the upper eyelids as well as under eye bags at the same time another issue
affecting the upper eyelids which is commonly associated with aging is upper
eyelid ptosis ptosis means that the upper eyelid position is lower than it
should be and this position is unrelated to the physical weight of the upper
eyelid skin ptosis has to do with the muscle that raises the eyelid called the
levator muscle like the word elevator without the letter e the condition needs
to be identified before any cosmetic procedure so the muscle which lifts the
eyelid is addressed at the time the surgery is performed to get the best
outcome for many people the appearance of excess skin on the upper eyelids
puffiness in the upper eyelids and hooded eyes can be very frustrating many
of our patients note how it’s difficult to apply makeup to the upper eyelids
being perceived as older or lacking in energy is also a common complaint
expressed by patients during consultation in fact the appearance of
looking tired even when well-rested is one of the most common reasons for
inquiring about eyelid procedures these conditions affecting both the upper and
lower eyelids often occur concurrently so wanting to have both upper and lower
eyelids procedures done at the same time as a frequent request there are specific
procedures used to address hooded upper eyelids and puffy under eyes depending
on the underlying causes and the degree of severity
for example the appearance of hooded upper eyelids may be improved non
surgically I’ll be it temporarily with the procedure called Botox
brow lifts if the upper eyelid fullness is caused by eyebrow position
only if the eyebrow position has descended more significantly while
surgical brow lifting options may be considered as well if there is excess or
sagging skin over the eyes the more definitive and long-term solution is an
upper eyelid blepharoplasty an upper eyelid blepharoplasty is a procedure for
restoring the upper eyelids shape and contour creating a more rested and
refreshed appearance excess upper eyelid skin is carefully measured a design is
drawn to address the excess skin and additional tissue below the skin is
artistically contoured so the eyes look refreshed and natural afterwards gentle
handling of this delicate tissue with meticulous care allows for minimal
bruising and swelling after surgery resulting in quicker recovery as far as
under eye bags are concerned there are usually two approaches which are
considered these are the transcutaneous approach or the transconjunctival
approach the transcutaneous approach involves making an incision right below
the eyelashes to get to the fat pockets it typically leaves an external scar and
an approach that can be potentially lead to complications due to compromise of
lower eyelid support structures in addition unnecessary skin removal can
contribute to problems such as lower eyelid ectropion and lower eyelid
retraction for most of my patients regardless of age and ethnicity

I prefer the transconjunctival approach this procedure is considered technically more
complex but in my hands has proven to be safe with minimal risk of complications
patients find this approach particularly advantageous as I’m able to maintain the
natural shape of the eyes and avoid the rounded look which is seen all too
commonly after eyelid surgery preserving the shape of the eyes allows me to
provide my patients with the feeling of confidence about retaining their
character while looking more refreshed specialized procedures for upper eyelid
ptosis or drooping upper eyelids due to a weakened levator muscle can be
performed at the same time when addressing the excess upper eyelid skin
as well as under eye bags specialized surgery like ptosis correction is done
almost exclusively by oculoplastic or oculofacial plastic surgeons like myself
this is not usually done by general plastic surgeons or cosmetic surgeons

I routinely perform upper and lower eyelid surgery with any of the advanced or
additional procedures and necessary all at the same time all procedures are
performed using local anesthesia with light intravenous sedation which means
easier recovery and less downtime in comparison to eyelid surgery performed
under general anesthesia the upper eyelids heal extremely well and the area
where sutures are placed blends very well with the adjacent skin even when
the eyes are closed upper and lower eyelid surgery when performed together
usually takes less than two hours to perform minimal bruising and swelling
are typical after upper or lower eyelid surgery and my patients routinely go
back to work in one week upper and lower eyelid surgery can be performed at the
same time with minimal risk and quick recovery

I recommend meeting with qualified and experienced oculofacial plastic and
reconstructive surgeons who specialize in cosmetic eyelid surgery so you can
learn about your options I hope you found this information helpful thank you
for your question