Eyelid Surgery (Blepharoplasty) St. Louis

The Window to the Soul

People tend to be fascinated by eyes. The eyes are such an important part of our daily interaction and communication. Fresh, open, beautiful appearing eyes suggest happiness and energy. Sagging, wrinkled skin around the eyes can give a more tired, sad appearance that masks your sparkling personality. The eyelid skin is some of the thinnest in the body, thus even fine lines and wrinkles can become quite prominent. Eyelids are also one of the first areas of the face to show signs of aging. It is no wonder why eyelid rejuvenation is one of our most requested plastic surgery procedures.

Removing excess upper eyelid skin is a quick way to brighten up your appearance, displaying a more refreshed appearance. Any additional bulges or fat herniation can be corrected at the same time. Similarly, lower lid bags or “festoons” occur when the tissues get lax and under-eye fat bulges out. This can be corrected with or without skin tightening to soften the transition from the lower eyelid to the cheek. Complimentary procedures such as browlift, facelift, Botox, fat grafting, or fillers can help enhance the result, delivering a much more youthful appearance.

During your consultation, your surgeon will inquire about eye dryness, prior vision or eye procedures, and any ocular medication requirements. They will evaluate your upper and lower eyelids, assessing the skin, tissue laxity, areas of excess fat, and how your upper facial muscles are functioning. Everyone ages differently and no two eyelids are the same. Thus your surgeon will devise a personalized approach to help you regain that rejuvenated look.


  • Length: 45-60 minutes
  • Anesthesia: Local, sedation, or general anesthesia
  • Outpatient, same day surgery
  • Recovery: 7-10 days
  • Side Effects: Bruising, swelling, dryness


  • Remove excess eyelid skin
  • Rid unwanted eyelid bulges
  • Brighten appearance
  • Help with applying makeup


  • Length: 1-2 hours
  • Anesthesia: Sedation or general
  • Outpatient, same day surgery
  • Recovery: 7-10 days


  • Remove excess eyelid skin
  • Rid unwanted eyelid bulges
  • Brighten appearance
  • Smooth the eyelid-cheek transition

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Smoking should be stopped at least 2 weeks prior to surgery.

Any medications and supplements which cause an increased risk of bleeding should also be stopped 2 weeks prior to any major surgery. Please see our list of medications and supplements to avoid. As always, make sure to check with your doctor before stopping any medications.

Medications to Avoid.


Upper eyelid surgery alone can sometimes be performed in the office under local anesthesia but is often combined with other procedures in the operating room with sedation or general anesthesia. Prior to the procedure your surgeon will mark out the planned incision along your natural upper eyelid crease, and incorporate the excess skin for removal. The goal is an optimal balance to create that refreshed appearance without restricting eyelid closure. A numbing medication will be injected, then the skin and fat will be excised. The incision will be meticulously closed along the natural upper eyelid crease and is nearly imperceptible within a few months. Cold packs will be applied and sutures will need to be removed from the office 1 week later.

Lower eyelid surgery is performed in the operating room under deeper sedation or general anesthesia. Depending on each patient’s unique anatomy and goals, an incision will be made either just underneath the eyelashes or inside the lower eyelid. Excess fat will be removed or repositioned along the cheekbones to provide a smooth appearance. The lower lid itself may be supported with internal sutures that will not require removal. Loose skin will be excised as needed, and any external sutures will need removal 1 week later. Additional tapes or massage techniques may be instituted at that time to help support the tissues in the early stages of healing.



The eyelid skin is extremely thin. Thus swelling and bruising are expected to be visible immediately after surgery. This will typically resolve after 5-10 days and may be minimized with the use of cold packs for 5-10 minutes every 1-2 hours in the first few days of recovery. Both upper and lower eyelid incisions heal almost imperceptibly after 3-6 months. Upper eyelid surgery recovery is often fairly quick, but lower eyelid surgery can have prolonged swelling or edema that may last for several months. Be sure to follow your surgeon’s recommendations including any taping, massage, and positioning instructions to help expedite your recovery.

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A: Older techniques tended to remove as much fat from the upper eyelid as possible. Our surgeons are trained to avoid this and instead focus on producing much more natural-appearing results. Sometimes they will incorporate fat or fillers to volumize patients that are unhappy with their results from these older techniques.
A: No. Blepharoplasty is considered a cosmetic procedure in all but the most extreme cases of excess eyelid skin significantly obstructing vision.

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