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Eyelid Surgery FAQ

Written by Dr. Jacobs

Below are just a few of the many questions we get about blepharoplasty. If you have a question that isn't answered here, we are available to provide assistance. You can contact us online or call 212-570-6080 to schedule a personal consultation.

woman's face, eyes of womanSee Before & After Eyelid Lift Photos

  • I’m young but have bags under my eyes, should I consider surgery?

The bags you see beneath your lower eyelids are fat deposits, and their appearance tends to be genetically determined. There’s not much you can do about them except to have them surgically removed. If you do not have any lax skin, those fat pockets can be removed through tiny incisions inside your lower lids.

  • Is it possible to have blepharoplasty without general anesthesia?

Yes, we perform eyelid surgery in NY using twilight sedation for almost every patient. This means we sedate you intravenously. You are fully and comfortably asleep, and you awaken quickly and easily after surgery. The main benefits include reduced grogginess and almost no chance of post-op nausea.

  • What is transconjunctival eyelid surgery?

Transconjunctival blepharoplasty is performed on the lower lids through small incisions inside the eyelid, leaving no trace of surgery on surface skin. This is the preferred method for most young patients. When there is excess skin present, a small incision is made under the lashes to facilitate removal of the redundant skin.

  • I have pronounced tear troughs—how are these treated?

There are two leading ways to improve tear troughs, which run from the inner corner of the lower lid down alongside the nose. For some patients, it makes sense to reposition fat from below the lower lid to fill the troughs through a transconjunctival blepharoplasty. For others, a filler such as Restylane® or JUVÉDERM® is a good choice. Some patients benefit from a combination of both approaches.

  • Will eyelid surgery improve dark circles under my eyes?

For many, dark patches under the eyes are due to hereditary hyperpigmentation of the skin. If this is the case for you, a chemical peel may very well be the best treatment. Sometimes darkness under the lower lids is due to shadows created by fat pockets. In this case, blepharoplasty can certainly help. Dr. Jacobs will evaluate your case in the consultation room and give you his recommendation.

  • Is laser eyelid surgery better than surgery with a scalpel?

Lasers make incisions just like scalpels—some surgeons prefer one or the other, some use both. One thing plastic surgeons generally agree on: the most important factor in successful cosmetic surgery is the skill of your plastic surgeon. Tools are important, but they’re just tools.

  • Can I have just the upper or lower lids done?

Yes, you can elect to have either upper or lower lids operated on, or both. Dr. Jacobs will examine you in the consultation room and offer his recommendations, but the final decisions are yours to make.

  • Will insurance pay for eyelid surgery?

Experience with patients seeking eyelid surgery in NY has shown us that insurance companies will not cover blepharoplasty of the lower lids. This procedure is always considered cosmetic. If you consult an optometrist or ophthalmologist and find that you are suffering significant vision loss due to upper eyelid ptosis (sagging), it is possible your insurance company may cover upper eyelid surgery.

  • Must I get an eye exam before blepharoplasty?

Yes, in every case we have our patients get an eye exam to check for conditions like glaucoma, excessive dryness and so on. We want to make sure your eyes are healthy and ready for a cosmetic procedure!

  • How can I avoid complications from blepharoplasty?

Eyelid surgery complications are rare, but it is natural to worry about risks. For one thing, the eyes are so important that the thought of surgery can be anxiety provoking. In addition, when a disastrous result occurs—such as a patient who can’t close her eyes—it tends to be sensationalized. Plastic surgeons agree that the most important factor in assuring success is to choose your doctor very carefully. Consult more than one board certified plastic surgeon, perform extensive research and background checks and so on. Once you have found the right plastic surgeon, follow his or her advice exactly and you should experience no problems.

  • Can surgery help thinning eyelashes?

No, surgery cannot help thinning eyelashes, but a new product called Latisse has provided significant length and growth for many patients’ lashes. Speak to Dr. Jacobs about a possible prescription for it.

  • Can BOTOX® help around the eyes?

BOTOX® can do things that surgery cannot do – and vice versa. BOTOX® Cosmetic treats the vertical “worry lines” between the eyebrows and is excellent treatment for crow’s feet. It can even slightly elevate the tail of the eyebrow. But BOTOX® has no effect on excess skin or fat bags. The use of BOTOX® should be considered as a wonderful “finishing touch” for eyelid surgery.

  • I have some skin growths around my eyelids. Can these be removed at the same time as cosmetic eyelid surgery?

Oftentimes, when possible, the incisions used in upper and lower eyelid tucks can be altered somewhat to encompass and remove some skin lesions. This possibility is determined on an individual basis.


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Plastic Surgery Manhattan - Dr. Elliot W. Jacobs, M.D. specializes in Breast Augmentation, Liposuction, Rhinoplasty and other Plastic Surgery procedures serving Manhattan, New York City and the surrounding area. Phone: (212) 570-6080

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