At a glance
Blepharoplasty is a surgical procedure that removes or repositions excess skin, muscle, and fat around the eyelids to improve their appearance or function.
As skin ages, it loses elasticity and can sag. Around the eyes, this sagging can make the upper eyelids look heavy and hooded, while pouches of fat push forward beneath the lower eyelids, creating bags. During blepharoplasty, the surgeon makes small incisions along the natural creases of the eyelid, removes or redistributes the tissue causing the problem, and closes the incisions with fine sutures. The result is a flatter, firmer eyelid contour.
Medical Condition
Blepharoplasty is used for both medical and cosmetic reasons, and a patient may need it on the upper eyelids, lower eyelids, or both at the same time.
- Dermatochalasis (excess upper eyelid skin that droops low enough to block part of the field of vision)
- Heavy, hooded upper eyelids that cause eye fatigue or make the face look much older than the patient feels
- Lower eyelid bags caused by fat pouches pushing forward under the skin
- Fine wrinkles and loose skin on the lower eyelid that do not respond to other treatments
- Ectropion (lower eyelid turning outward) or entropion (eyelid turning inward), when caused by excess skin or laxity of the lid
- Repair after trauma or previous surgery that has distorted the eyelid shape
Blepharoplasty is not suitable for everyone. Doctors generally advise against it in the following situations.
- Uncontrolled thyroid eye disease, which causes the eyeball to protrude and the tissue to be inflamed
- Dry eye syndrome (insufficient tear production) that is severe, because surgery can worsen it
- Uncontrolled glaucoma (high pressure inside the eye)
- Unrealistic expectations about what the surgery can achieve, particularly expectations that it will remove all wrinkles or change the fundamental bone structure of the face
- Active skin infections or wounds near the eye area
- Blood clotting disorders that cannot be safely managed before surgery
Risks & Complications
Blepharoplasty is generally considered a low-risk procedure, but like all surgery around the eye it carries specific complications that patients should understand before consenting.
- Bruising and swelling, which are almost universal and usually settle within two to three weeks
- Dry or irritated eyes in the weeks after surgery, often managed with lubricating eye drops
- Temporary blurred or double vision in the first few days
- Difficulty closing the eyes completely (lagophthalmos), usually temporary but occasionally requiring further treatment
- Asymmetry, where the two eyelids heal to slightly different heights or contours
- Noticeable scarring, though incisions placed in natural creases usually fade well over several months
- Infection at the incision site
- Bleeding or haematoma (a pocket of blood) under the skin
- Ectropion (the lower lid pulling away from the eye), more common after lower blepharoplasty
- In very rare cases, vision changes or vision loss caused by bleeding behind the eye. This is a recognised but uncommon complication, and surgical teams monitor for it closely
Preparation & Procedure
Preparation for blepharoplasty begins days or weeks before the operation and covers what to eat, what to stop taking, and how your overall health is assessed.
Patients are usually asked to stop blood thinners (including aspirin and anti-inflammatory tablets) about one to two weeks before surgery, because these raise the risk of bruising and bleeding around the eye. Smoking reduces blood flow to healing tissue, so most surgeons ask patients to stop for at least a few weeks before and after the procedure. Alcohol is best avoided in the days immediately before surgery. Your surgical team will give specific timing guidance.
Fasting is required if the operation is done under general anaesthesia (full sleep). In most hospitals this means nothing to eat or drink, including water, for several hours before the procedure. When blepharoplasty is performed under local anaesthesia with light sedation, fasting rules may be less strict, but the team will clarify this in advance.
Before the day of surgery, you will usually have some or all of the following tests and assessments.
- A visual field test to measure how much the drooping eyelid actually restricts your field of vision, which can also be relevant for insurance purposes
- A slit-lamp examination (a detailed eye assessment using a microscope with a bright light) to check the surface of the eye and tear production
- Blood tests including clotting time and general health markers
- Photographs of the eyelids taken from standard angles for surgical planning and records
- A review of all current medications, supplements, and herbal remedies
- An anaesthesia consultation if general anaesthesia or sedation is planned
On the day of surgery, the procedure itself typically follows these steps.
- You change into a hospital gown and an intravenous (IV) line is placed in your arm
- The anaesthesia team gives local anaesthetic injections around the eyelids, sometimes combined with sedation to keep you calm and comfortable, or general anaesthesia if planned
- The surgeon marks the incision lines on the skin using a fine pen while you are sitting upright, so gravity is accounted for
- Small incisions are made along the natural upper eyelid crease and, for lower lids, just below the lash line or inside the lower lid depending on the technique
- Excess skin, a small amount of muscle, and fat are removed or repositioned through these incisions
- The incisions are closed with very fine sutures, surgical tape, or skin glue
- Antibiotic ointment is applied and, in some cases, a light dressing is placed over the area
- You are moved to a recovery room where the team monitors you as the anaesthesia wears off
Aftercare
Most blepharoplasty patients go home the same day, but the recovery period around the eyes requires specific care to protect the incisions and get the best result.
- Cold compresses applied gently to the eyes in the first 48 hours help reduce swelling and bruising
- Antibiotic ointment or drops are usually prescribed for a week or two to prevent infection along the incision lines
- Keeping the head elevated, including during sleep, reduces fluid pooling around the eyes in the early days
- Sutures are typically removed in the clinic about five to seven days after surgery if non-dissolving stitches were used
- Driving is not permitted until vision is clear and comfortable, which usually takes at least a few days
- Screen time (phones, computers, television) should be limited in the first week as it dries the eyes and causes strain
- Strenuous exercise, heavy lifting, and bending at the waist should be avoided for two to four weeks, as these raise blood pressure around the eyes
- Sun exposure around the eyes should be minimised and sunglasses worn outdoors; incision scars are sensitive to UV light and can darken permanently if burned
- Contact lens use is usually paused for at least two weeks, or until the surgeon confirms the eye surface has healed
- A follow-up appointment is scheduled within the first week, then again at around one month to assess healing and discuss the final result
- Final appearance, including full scar fading, typically takes several months to settle
Cost & What Determines It
The cost of blepharoplasty varies considerably depending on whether the surgery is purely cosmetic or medically necessary, which eyelids are being treated, and where the procedure is performed.
- Scope of the procedure: upper lids only, lower lids only, or all four lids at once each carry a different price, and combining blepharoplasty with other facial procedures in the same session will add cost
- Complexity of the case: significant drooping that also requires repair of the levator muscle (the muscle that lifts the upper lid) is more technically demanding than a straightforward skin removal
- Anaesthesia type: local anaesthesia with sedation typically costs less than general anaesthesia, which also adds an anaesthesiologist's fee
- Hospital or clinic class: a private tertiary hospital charges more than a day-surgery clinic, and pricing differs significantly between countries
- Surgeon's experience and specialisation: a board-certified plastic surgeon or oculoplastic specialist (a surgeon trained in both ophthalmology and plastic surgery) generally commands a higher fee
- Length of stay: most patients leave the same day, but any overnight stay adds a room charge
- Pre-operative tests: visual field testing, slit-lamp examination, and blood work are billed separately in many facilities
- Post-operative medications: antibiotic ointments, lubricating eye drops, and any oral medications prescribed after discharge
- Follow-up consultations: some packages include one or two post-op visits, while others bill each separately
Hospital packages abroad often bundle the surgeon's fee, operating room use, anaesthesia, one or two nights in hospital if needed, and basic post-operative medications. Items that tend to be billed separately include pre-operative consultations, laboratory tests, any revision procedure if a touch-up is required, and accommodation and travel costs.
For Indonesian patients, BPJS Kesehatan covers blepharoplasty only when it is documented as medically necessary, for example when the drooping eyelid clearly restricts vision, and only at approved domestic facilities. Most private Indonesian insurance policies follow similar rules and do not cover cosmetic indications at all. Treatment abroad for any indication is almost never covered by BPJS or standard local insurance, so patients typically pay out of pocket or through international private health insurance that includes medical travel. Before travelling, ask the hospital for a written itemised cost estimate. This protects you from unexpected charges and allows you to compare what is and is not included across different hospitals.
Frequently Asked Questions
How long does blepharoplasty surgery take?
Blepharoplasty usually takes between one and three hours, depending on whether one or both pairs of eyelids are being treated. Upper eyelid surgery alone tends to be quicker, while combining upper and lower eyelid work in the same session takes longer. Your surgeon will give you a more specific estimate during your consultation.
How much does eyelid surgery cost?
The cost depends on several factors specific to this procedure, including whether you are having upper eyelids, lower eyelids, or both treated, the complexity of any excess skin or fat removal, the class of hospital you choose, and the fees of your surgical and anaesthesia team. Requesting a written itemised estimate directly from the hospital is the most reliable way to know what you will pay.
What is the recovery time after blepharoplasty, and when can I go back to work?
Most people feel ready to return to a desk job within one to two weeks, once the initial swelling and bruising have settled enough to feel comfortable in public. Heavier physical work or exercise usually needs to wait around four to six weeks, depending on how your healing progresses. Your surgeon will assess your eyelids at follow-up appointments and confirm when each activity is safe to resume.
What warning signs should I watch for after eyelid surgery?
Contact your surgical team promptly if you notice sudden or worsening vision changes, severe pain that does not ease with prescribed pain relief, bleeding that soaks through dressings, or signs of infection such as increasing redness, warmth, or discharge from the wound. Some swelling, bruising, and mild tightness around the eyes are expected in the first week and are not a cause for alarm on their own. Knowing the difference between normal healing and something that needs attention helps you act quickly if a problem arises.
This page is general information, not a substitute for medical advice. Every case is different. Your doctor decides what is right for you.
