Upper vs Lower Blepharoplasty: Choosing the Right Approach
Drooping eyelids or under-eye bags are more than a cosmetic issue. In addition to giving you a tired and aged look, these issues can interfere with your vision, making daily life more difficult. But with upper and lower eyelid procedures available, how do you know which approach is the right one for you?
At Younger Facial Surgery Centre in Vancouver, Dr. Ritchie Younger brings over 30 years of expertise to help patients navigate these decisions. His patient-first philosophy ensures that every recommendation is tailored to your unique anatomy and aesthetic goals, never pushing unnecessary procedures. Whether you’re bothered by hooded upper lids, puffy lower lids or both, understanding the differences between upper and lower blepharoplasty is key to a successful experience that delivers results.
Understanding Upper Blepharoplasty
As the name implies, upper blepharoplasty is a procedure that addresses concerns affecting the upper eyelid region. Excess skin tends to accumulate in this area with age, sometimes creating a hooded appearance that can make you look tired or upset. In more advanced cases, sagging skin can interfere with peripheral vision.
The Procedure
During upper eyelid surgery, Dr. Younger precisely creates small incisions along the natural crease of the eyelid. This strategic placement helps scars become virtually invisible once healed. Through these incisions, he carefully removes excess skin and repositions or removes fat deposits as needed. If the levator muscle responsible for lifting the eyelid has weakened significantly, he may also tighten it to restore proper eyelid function.
Recovery Time and Results
The procedure typically takes one to two hours and can be performed under local anaesthesia with sedation. The recovery process is straightforward and not extensive, with most patients resuming work and social schedules within one to two weeks. Bruising and swelling are minimal compared to more invasive facial procedures, and the results can last for years.
How Lower Blepharoplasty Works
Also true to its name, lower blepharoplasty targets the under-eye area, where puffiness, bags and loose skin can create an artificially aged or fatigued appearance.
Surgical Approaches
Dr. Younger employs one of two techniques for lower eyelid surgery, depending on each patient’s presentation. The transcutaneous approach involves making an incision just below the lash line, allowing Dr. Younger to remove excess skin, reposition fat deposits and create a smoother under-eye contour.
The transconjunctival approach offers an alternative for patients with good skin elasticity who primarily need fat removal or repositioning. This technique involves making an incision inside the lower eyelid, leaving no visible external scar whatsoever. It’s particularly effective for younger patients or those with minimal skin laxity.
In some cases, Dr. Younger may recommend fat grafting to fill hollows beneath the eyes rather than removing fat, creating a more youthful, refreshed appearance. This technique restores lost volume that contributes to the tired, sunken look some patients develop as they age.
Recovery and Results
Lower blepharoplasty typically requires one to two weeks of recovery, with most swelling and bruising subsiding within this timeframe. The procedure can dramatically improve your appearance if you’re bothered by under-eye bags or puffiness, notice hollowing or a tired look in the lower lid area or want to achieve a more rested, youthful look.
Which Approach Is Right for You?
For every patient, making the choice between these two procedures (or, as we will review below, choosing both) starts with a thorough evaluation. During your initial consultation, Dr. Younger will carefully assess your eyelid’s structure, your skin quality and your aesthetic goals to formulate the most effective approach.
If your main concern is heavy, hooded upper lids that make you look tired or interfere with your vision, upper blepharoplasty is likely the better choice. However, if you’ve noticed under-eye bags, puffiness or dark circles that don’t respond to getting more rest, lower blepharoplasty may be the solution you need.
Your age and overall skin quality also influence which approach may be best for you. Younger patients with good skin elasticity may be better suited for more conservative options, whereas patients with poor skin elasticity may require a more intensive approach, including combined blepharoplasty.
Do You Need Both Upper and Lower Procedures?
Unfortunately, the aging process is an uncharitable one that often causes several unwanted developments at the same time. Genetic and lifestyle factors can also influence whether or not you experience upper and lower eyelid skin laxity, hollowing, and other issues mentioned above.
If this sounds like you, combination blepharoplasty may be the best approach. Combining upper and lower blepharoplasty into a single treatment offers patients several advantages. First, it creates a more well-rounded result that harmonizes more smoothly with the surrounding areas of the face. It also allows you to undergo a single recovery period rather than scheduling separate surgeries, and is generally more cost effective than having the procedures done separately.
Not everyone requires or is eligible for both procedures. Dr. Younger carefully evaluates each patient’s anatomy and concerns to determine whether a single approach or combination surgery is most appropriate.
What to Expect During Your Treatment
Consultation
Your blepharoplasty experience begins with a comprehensive consultation where Dr. Younger will examine your eyelids, discuss your goals and recommend a personalised treatment plan. He’ll explain the specific technique best suited to your needs, review potential risks and benefits, and ensure you have realistic expectations about your results.
Procedure
On the day of surgery, you’ll arrive at Dr. Younger’s state-of-the-art surgical facility. The procedure typically takes one to three hours, depending on whether you’re having upper, lower or combined surgery. Immediately after your procedure, you’ll spend time in a comfortable recovery area before heading home with detailed aftercare instructions.
The Recovery Process
Recovery best practices typically include keeping your head elevated, applying cold compresses as directed to reduce swelling, and using prescribed eye ointments or drops. Most patients experience mild discomfort, swelling and bruising that gradually subsides over the first week or two. Stitches, if used, are typically removed within five to seven days.
Results
The results of blepharoplasty can be dramatic, taking years off your appearance and restoring a more alert, refreshed look. Early results will be visible as swelling subsides in the first days and weeks following your procedure, with final results typically settling in around three to six months post-surgery.
Find Your Blepharoplasty Expert
At Younger Facial Surgery Centre, we treat every procedure as a partnership that works towards achieving your vision. Dr. Younger’s artistic eye, combined with over three decades of experience, ensures results that look natural and harmonious with your unique features.
Whether you need upper blepharoplasty, lower blepharoplasty or a combination of both, Dr. Younger’s expertise and ethical approach ensure you’ll receive honest guidance and exceptional care throughout your journey.
Ready to discover which eyelid surgery approach is right for you? Book your consultation with Dr. Ritchie Younger today at 604-738-3223 or visit us online to begin your transformation towards a more refreshed, youthful appearance.
