Upper vs Lower Blepharoplasty: Cost, Results & Recovery

By: Dr. Chip Cole 01/09/2026

Key Takeaways

• Upper blepharoplasty corrects drooping eyelid skin, while lower blepharoplasty addresses under-eye bags, puffiness, and hollowing.
• Upper blepharoplasty typically costs $4,000 to $6,000, and lower blepharoplasty runs $7,000 to $9,500, with oculofacial specialists and laser techniques commanding the higher end.
• Upper blepharoplasty results last 12 to 15 years, while lower blepharoplasty results often last even longer since repositioned fat tends to remain stable.
• Dr. Cole's Inside/Out™ technique at Oculus Plastic Surgery uses precision lasers through concealed access points to deliver blepharoplasty results with no visible scarring.

Upper vs Lower Blepharoplasty: An Overview

Blepharoplasty is eyelid surgery designed to refresh the eye area, but upper and lower procedures treat different concerns. While both improve the appearance of tired or aging eyes, they focus on separate parts of the eyelid anatomy.

Upper blepharoplasty removes excess skin from the upper eyelid to correct drooping or hooding, sometimes improving peripheral vision. Lower blepharoplasty targets under-eye bags, puffiness, and hollowing caused by fat displacement and skin laxity.

Both procedures can dramatically refresh the eye area, but they differ in purpose, recovery, cost, and surgical approach. In this guide, we compare upper and lower blepharoplasty so you can understand which procedure may best address your concerns.

Oculus Plastic Surgery: Atlanta's Premier Scarless Facelift & Eyelid Specialist 40,000+ Surgeries Performed | 4.9★ Google Rating Look Naturally Refreshed, Not "Worked On": Dr. Harvey "Chip" Cole III's trademarked Inside/Out™ Facelift uses incisions through the mouth, eyelids, and nostrils, leaving zero visible facial scars. Advanced $200K laser technology means minimal bruising and a one-week recovery versus the standard three weeks. Why Patients Choose Dr. Cole: ✓ Quadruple board-certified with ophthalmology expertise ✓ Specializes in rescue surgery and fixing botched procedures ✓ Ideal for keloid-prone skin and revision cases ✓ Blepharoplasty volume leader: more weekly than most do yearly 60% of his practice is corrective work. Get it done right the first time. Schedule Your Consultation →

What Is Upper Blepharoplasty?

Upper blepharoplasty, also called an upper eyelid lift, is a surgical procedure that corrects drooping or sagging skin on the upper eyelids. As the skin above the eye loses collagen and elasticity over time, it can fold downward, sometimes to the point where it obstructs peripheral vision. This condition is called dermatochalasis, and it makes upper blepharoplasty one of the few cosmetic procedures that can also have a functional, medically necessary application.

During the procedure, a surgeon makes a precise incision along the natural crease of the upper eyelid. Excess skin, and in some cases fat, is removed or repositioned. Because the incision is placed directly in the eyelid fold, scarring is minimal once healed.

Who Is Upper Blepharoplasty For?

Upper blepharoplasty is ideal for patients experiencing one or more of the following: 

• Heavy or hooded upper eyelids that make the eyes appear tired or aged.
• Excess skin folding over the upper lash line.
• Peripheral vision obstruction caused by drooping eyelid skin.
• Asymmetry in the upper eyelid area.

What Is Lower Blepharoplasty?

Lower blepharoplasty is a surgical procedure that targets the under-eye area. It addresses the most common under-eye complaints: puffiness, under-eye bags, excess skin, wrinkles, and hollowing caused by fat displacement over time.

In most cases, surgeons make an incision just below the lower lash line. In some patients, a transconjunctival approach is used instead, where the incision is made inside the lower eyelid, leaving no visible external scarring. The choice depends on how much excess skin needs to be removed versus how much fat redistribution is required.

Fat is typically repositioned rather than simply removed, which creates a smoother transition between the lower eyelid and the cheek. This avoids the hollowed-out appearance that older techniques sometimes produced.

Under-eye puffiness, fine lines, and hollowing due to fat displacement are the primary concerns addressed by lower blepharoplasty.

Who Is Lower Blepharoplasty For?

Lower blepharoplasty is suited for patients dealing with:

• Under-eye bags caused by fat prolapse beneath the eye
• Puffiness that does not resolve with rest or lifestyle changes
• Fine lines and wrinkles along the lower eyelid
• Loose or crepey skin beneath the eye
• Dark shadows created by structural hollowing rather than pigmentation.

Upper vs Lower Blepharoplasty: Side-by-Side Comparison

Anesthesia Requirements

Both upper and lower blepharoplasty are typically performed under local anesthesia with sedation, meaning you are relaxed and comfortable but not fully unconscious. 

General anesthesia can be used when both procedures are combined or when a patient prefers it, and this decision is made in consultation with your surgeon and anesthesiologist.

Incision Placement & Scarring

For upper blepharoplasty, most patients find their scars are virtually invisible within a few months of healing. 

Lower blepharoplasty offers two incision options. The subciliary approach places the incision just below the lower lash line, which heals discreetly but leaves a faint external scar. 

The transconjunctival approach places the incision within the lower eyelid, resulting in no visible external scar. The transconjunctival approach is preferred when fat redistribution is the primary goal and excess skin removal is not needed.

Expected Results

After eyelid surgery, you can expect your eyes to look more open and brighter. Upper blepharoplasty results typically last 12 to 15 years. In functional cases, peripheral vision improves measurably. 

Lower blepharoplasty results last in a similar range, though longevity may vary with skin quality and fat behavior.

How Much Does Blepharoplasty Cost?

Blepharoplasty is one of the more accessible cosmetic surgeries from a cost perspective, though pricing varies based on several factors.

Blepharoplasty cost depends on the surgeon's experience and technique.

Upper Blepharoplasty Cost

Upper blepharoplasty typically costs between $4,000 and $6,000. This procedure is the less complex of the two, which keeps costs at the lower end of the blepharoplasty price range.

Lower Blepharoplasty Cost

Lower blepharoplasty costs more than upper due to greater technical complexity. Most patients pay between $7,000 and $9,500. The transconjunctival approach and fat repositioning require a higher level of surgical precision, which contributes to the higher price.

Eyelid Lift Cost Factors

Here are the factors that can influence the final costs of the blepharoplasty procedure:

• Surgeon Experience: Board-certified plastic surgeons with extensive blepharoplasty experience typically charge more. Surgeons using advanced techniques like laser blepharoplasty command the higher end of the range because of their specialized training and precision instrumentation. 
• Geographic Location: Practices in major metropolitan areas like New York, Los Angeles, or Miami generally have higher overhead and fee structures than suburban or rural practices.
• Anesthesia Type: Local anesthesia with sedation costs less than general anesthesia. The anesthesiologist’s fee is separate from the surgeon’s fee.
• Surgical Facility: Hospital-based procedures cost more than those performed in an accredited outpatient surgical center or in-office suite.
• Procedure Complexity: Significant fat repositioning, asymmetry correction, or combining upper and lower surgery increases operative time and cost.

Does Insurance Ever Cover Eyelid Surgery?

Upper blepharoplasty is the only form of eyelid surgery that has any realistic path to insurance coverage, and only under specific conditions. 

If a patient can demonstrate through a formal visual field test that their drooping upper eyelid is obstructing their vision, the functional portion of the surgery may qualify for medical insurance. The cosmetic component, if any, would remain the patient’s responsibility.

Lower blepharoplasty is not covered by insurance. It is classified as a purely elective cosmetic procedure without exception.

Recovery Timeline: What to Expect After Each Procedure

Most patients return to light daily routines within one to two weeks after blepharoplasty.

Upper Blepharoplasty Recovery

In the first 48 hours after upper blepharoplasty, swelling and bruising around the eye are expected. Most patients feel comfortable returning to light desk work within 7 to 10 days. 

Stitches are typically removed within the first week. Strenuous activity, heavy lifting, and anything that increases blood pressure around the eyes should be avoided for at least three weeks.

Lower Blepharoplasty Recovery

Lower blepharoplasty tends to produce more noticeable swelling in the under-eye area during the first week. The lower eyelid tissue is particularly sensitive, and some patients experience temporary chemosis, a jelly-like swelling of the conjunctiva that resolves as inflammation subsides. 

Most patients can return to light daily activities within two to four weeks. Patients who undergo the transconjunctival approach often experience an easier recovery since there is no external incision to heal.

Upper vs Lower Blepharoplasty: Comparison Table

Why Choose Oculus Plastic Surgery for Your Blepharoplasty

Dr. Harvey "Chip" Cole III is a quadruple board-certified oculofacial surgeon whose career began in ophthalmology and later expanded into facial plastic surgery. He holds certifications from the American Board of Ophthalmology, the American Board of Facial Cosmetic Surgery, the American Board of Laser Surgery, and the American Board of Cosmetic Surgery.

Dr. Cole performs scarless eyelid surgery backed by 40,000+ procedures and quadruple board certification.

Dr. Cole performs blepharoplasty using his trademarked Inside/Out™ technique, which uses precision lasers and endoscopic instruments to remove excess skin and reshape the eyelids through concealed access points. 

For upper blepharoplasty, the incision is hidden in the natural eyelid crease. For lower blepharoplasty, the approach is transconjunctival, entering through the inside of the lower eyelid. The laser cauterizes while it cuts, which reduces bleeding, minimizes bruising, and leaves no visible scarring.

60% of Dr. Cole's surgical schedule consists of rescue surgery to repair unsatisfactory results. His ophthalmology foundation and his role as a fellowship director at Vanderbilt make him uniquely qualified to address disorders of the eyelid that general cosmetic surgeons may not be trained to correct. With over 40,000 procedures completed across more than 35 years, Dr. Cole performs more blepharoplasties weekly than most surgeons do in a year. 

Schedule your blepharoplasty consultation at Oculus Plastic Surgery today.

Frequently Asked Questions (FAQs)

Can upper and lower blepharoplasty be done at the same time?

Yes, and for many patients, combining both procedures in a single surgical session may be the most practical approach. Because both procedures use similar anesthesia protocols and target adjacent areas of the eye, performing them together does not significantly increase surgical risk or complexity. 

You recover once, pay one anesthesia and facility fee, and achieve a more complete transformation than either procedure could deliver alone. 

How long do blepharoplasty results last?

Upper blepharoplasty typically maintains visible improvement for 12 to 15 years. Lower blepharoplasty results often last even longer since repositioned fat tends to remain stable over time. 

The tissue removed during surgery does not return, which is why results are long-lasting, though the natural aging process continues. Factors like sun exposure, smoking, significant weight fluctuations, and genetics all influence how long your results remain at their best.

What is the difference between blepharoplasty and an eyelid lift?

Blepharoplasty and an eyelid lift are the same procedure. “Blepharoplasty” is the clinical, surgical term, while “eyelid lift” is the common consumer-friendly name for the same operation. Both refer to a surgical procedure that removes or repositions excess skin, muscle, and fat around the eyelids to restore a more youthful, rested appearance.

It is worth noting that a non-surgical “eyelid lift” using radiofrequency, plasma devices, or injectable treatments is an entirely different category.

How painful is blepharoplasty recovery?

Most patients describe blepharoplasty recovery as surprisingly manageable. The procedure is performed under anesthesia, so there is no pain during surgery. Afterward, the most common sensations are tightness, mild soreness, and sensitivity around the eyes. 

Over-the-counter pain relievers are typically sufficient for managing post-operative discomfort, though surgeons may prescribe something stronger for the first day or two if needed.

What makes Inside/Out™ blepharoplasty different from traditional eyelid surgery?

Traditional blepharoplasty uses a scalpel to make incisions and remove tissue. Dr. Cole's Inside/Out™ technique uses precision lasers that cauterize while they cut, which means less bleeding, less bruising, and faster recovery. 

For lower blepharoplasty, he enters through the inside of the eyelid rather than making an external incision, leaving no visible scar. His background in ophthalmology gives him a level of understanding of eyelid anatomy that most cosmetic surgeons do not have.


*Note: This article is for education only and does not replace a medical consultation. Treatment suitability, safety, pricing, and results vary based on your individual anatomy and health conditions. Always discuss your options with a qualified surgeon. Visit Oculus Plastic Surgery for more info.