Blepharoplasty or cosmetic eyelid surgery primarily treats the puffiness from fat and excess eyelid skin of the upper and lower eyelids. All patients undergoing cosmetic eyelid surgery should know what it will help with and what it will not help with. Puffiness and excess skin of the eyelids is blepharoplasty’s main target. There are however, five things that blepharoplasty or eyelid lifting will not treat.

Eyelid Ptosis

Eyelid Ptosis is a term to describe drooping of the eyelid. It creates the appearance of the eyes being half shut or “sleepy”. It is due to a problem of the eyelid muscle of the upper eyelid. To fix this problem, the upper eyelid muscle needs to be tightened. A Blepharoplasty will not treat this problem.

Figure 3: Before and After photo of a patient with ptosis or drooping of the eyelid of the right eye. She also had an upper eyelid blepharoplasty of both eyelids to remove excess skin. As one can see the right eye is more open after surgery. The surgery to open the eyes is called ptosis If skin alone had been removed, the eye on the right would not have been more open after surgery.

Festoons are bags in the cheek below the eyelids. Festoons are not treated with blepharoplasty surgery but instead are treated with other surgical procedures, cauterization, or injection of medications.

Brow Ptosis

Drooping of the eyebrows over time is called Brow Ptosis. Blepharoplasty surgery will not raise the eyebrows as there are separate procedures to raise the eyebrows themselves. Sometimes drooping of the eyebrows can cause the upper eyelid skin to fold more and eyebrow lifting needs to be done at the same time as a blepharoplasty

Dark Circles under Eyes

Dark Circles under the eyes are due to pooling of blood under the eyes. There are blood vessels under the eye that are more prominent in some patients. Removing fat or skin does not make the under eye circles less prominent. Dark circles can be difficult to treat. Skin discoloration causing dark circles can be treated with laser or creams at times but will not be improved after a blepharoplasty.

Crow’s feet

Crow’s feet or wrinkling of the sides of the eyes are not treated with blepharoplasty. They are caused by contraction of the muscle used to close the eyelid. Botox can often soften their appearance.