Eyelid Surgery (Blepharoplasty)

The Oaks Plastic Surgery Houston performs upper and lower blepharoplasty (eyelid surgery) to address excess upper eyelid skin that creates a heavy or hooded appearance, and lower eyelid puffiness and hollowing caused by fat prolapse and volume loss. Upper blepharoplasty removes the redundant skin fold to restore a more open, alert eye appearance; lower blepharoplasty redistributes or removes herniated orbital fat and tightens lax lower eyelid skin. Both procedures may be performed together for comprehensive periorbital rejuvenation. Upper blepharoplasty may qualify for partial insurance coverage when excess upper lid skin demonstrably impairs the superior visual field.

Blepharoplasty at The Oaks Plastic Surgery Houston targets the periorbital region — one of the most expressive and age-sensitive areas of the face — using precise surgical techniques to restore a more rested, youthful, and open-eyed appearance without altering the fundamental character of the eyes. Upper blepharoplasty addresses dermatochalasis: the accumulation of excess upper eyelid skin that descends over the eyelid crease, narrowing the visible aperture of the eye and creating a hooded, tired, or heavy look. In advanced cases, the redundant skin may encroach sufficiently on the superior visual field to impair peripheral vision — a functional finding that, when documented by visual field testing (Humphrey perimetry), may support partial insurance reimbursement of the surgical costs. The procedure involves marking a precise ellipse of excess skin above the existing eyelid crease, excising the redundant tissue along with a small amount of orbicularis oculi muscle where indicated, and optionally addressing the medial fat compartment if puffiness is present. The resulting scar is concealed within the natural eyelid crease. Lower blepharoplasty addresses the hollow-bag complex that develops in the lower eyelid: herniation of the orbital fat through the weakened orbital septum creates prominent under-eye bags, while simultaneous volume loss in the tear trough and malar region produces shadowing that makes the eyes appear fatigued regardless of sleep. Transconjunctival lower blepharoplasty (incision inside the eyelid, no visible external scar) allows fat repositioning or removal with no external incision — ideal for younger patients with good skin elasticity and primarily fatty herniation. Transcutaneous lower blepharoplasty (external incision just below the lash line) is used when skin excision is also needed to address significant excess lower lid skin laxity. Fat repositioning — moving herniated fat over the orbital rim to fill the tear trough hollow — is often preferable to simple fat removal for creating a smooth, shadow-free lower lid contour. Upper and lower blepharoplasty are frequently combined with facelift and brow lift at TOPS for patients seeking comprehensive facial rejuvenation, as the procedures complement one another anatomically.