Eyelid Surgery (Blepharoplasty)

ACPS surgeons perform upper and lower blepharoplasty to address excess eyelid skin, drooping upper eyelids (dermatochalasis and ptosis), under-eye puffiness from fat prolapse, and hollow tear troughs. Upper blepharoplasty removes redundant skin and, where indicated, a small strip of orbicularis muscle and prolapsed fat, restoring a more open, refreshed appearance to the upper eyelid. Lower blepharoplasty may address fat pad prominence through a transconjunctival approach (no external scar), or excess skin and fat through a subciliary incision. Results are long-lasting and may also improve peripheral vision where upper eyelid hooding is functionally significant.

Blepharoplasty at the Aesthetic Center for Plastic Surgery Houston is one of the most commonly requested facial procedures, reflecting the significant rejuvenating effect that eyelid refinement can have on overall facial appearance. The periorbital region is typically the first area of the face to show visible signs of ageing — thin eyelid skin loses elasticity early, the orbital fat compartments may prolapse forward, and the brow position descends, all of which contribute to a tired, aged, or heavy-looking appearance. ACPS surgeons address upper eyelid concerns through upper blepharoplasty, which involves an incision placed precisely within the natural upper eyelid crease — making the scar imperceptible once healed — through which excess skin, a thin strip of orbicularis oculi muscle, and prolapsed orbital fat are excised. The amount of skin removed is carefully calibrated to restore an open, refreshed eyelid platform while preserving adequate skin for full eyelid closure. Where eyebrow ptosis (drooping brow) is a contributing factor, ACPS surgeons may recommend a concurrent brow lift to address the primary source of upper eyelid fullness; removing too much upper eyelid skin without correcting brow ptosis risks over-correction or failure to achieve the desired improvement. Lower blepharoplasty at ACPS addresses the two primary lower eyelid concerns: fat pad prominence (creating under-eye puffiness or 'bags') and excess lower eyelid skin (creating a wrinkled or crêpe-paper appearance). The transconjunctival approach — accessing the fat compartments through an incision on the inner surface of the lower eyelid — leaves no external scar and is ideal for patients whose primary concern is fat pad prominence without significant skin excess. Where skin removal is required, a subciliary incision placed immediately below the eyelash line allows concurrent skin excision with a scar that heals to near-invisibility within the natural shadow of the lash line. Fat repositioning — redistributing prolapsed fat over the tear trough depression rather than simply excising it — is employed where hollowness beneath the fat pad contributes to a shadow effect. Blepharoplasty is frequently combined with facelift, brow lift, and laser skin resurfacing at ACPS for comprehensive periorbital and facial rejuvenation. Recovery involves bruising and swelling over one to two weeks, with most patients comfortable returning to social activity at ten to fourteen days.