What’s The Difference Between Upper and Lower Blepharoplasty?

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Posted by: Missouri Eye Institute in Blog on October 3, 2025

Have you ever stood in front of your mirror and wondered why you look so tired, even after getting a good night’s sleep? Are sagging upper eyelids and puffy lower lids making you appear older than you feel?

If you are unhappy with the appearance of your eyelids, blepharoplasty, also frequently called eyelid surgery, may be able to help. Keep reading to learn more about the procedure, including the differences between lower and upper blepharoplasty.

What is an Upper Blepharoplasty?

An upper blepharoplasty is performed on the upper eyelid to address excess or sagging skin or muscle. For many people, this can affect the appearance of their eyes and cause cosmetic concerns.

In some cases, the excess skin might be so heavy that it causes your eyelids to droop and impact your field of vision. During an upper blepharoplasty, any drooping skin is trimmed, and deposits of excess fat are removed.

The incision created during an upper blepharoplasty is usually hidden within the deep crease of the eyelid. Once healed, any scarring typically blends seamlessly with the eyelid’s natural folds.

What is a Lower Blepharoplasty?

A lower blepharoplasty is performed on the lower eyelids and targets bulging or puffy skin below the lash line. The procedure removes unwanted fat deposits and tightens the skin.

A lower blepharoplasty is almost always considered an elective cosmetic procedure. It is a popular way to address common signs of aging around the eyes, such as fine lines, wrinkles, and discoloration.

What are the Differences Between Upper and Lower Blepharoplasty?

The most notable difference between the two procedures is the area of the eye each one treats. An upper blepharoplasty improves the eyelids above the eyes, while a lower blepharoplasty treats the area below the eyes.

Another difference can be the objective of the surgery. Upper blepharoplasty can be performed for functional or cosmetic reasons, or both, but lower blepharoplasty is almost always performed for aesthetic reasons.

Because an upper blepharoplasty can be a medically necessary procedure if it impacts your vision, it may be covered by insurance in some cases. Lower blepharoplasty is usually considered an elective procedure and is an out-of-pocket expense, even when performed at the same time as an upper blepharoplasty.

What Can I Expect After Blepharoplasty?

While individual results can vary, the typical results of both an upper and lower blepharoplasty are tighter, brighter, and more open eyes. After the procedure, patients often say they look more alert, better rested, and some even feel like they look younger.

If an upper blepharoplasty is performed for functional reasons to correct heavy eyelids that droop and impact your vision, the procedure can restore a full range of vision. By removing heavy, sagging skin it can make reliable clear vision less of a burden.

Who is a Good Candidate for Blepharoplasty?

The ideal candidate for blepharoplasty is someone in good overall health with realistic expectations about the procedure’s outcomes. For upper blepharoplasty, good candidates often have excess skin that creates a hooded appearance, fat deposits that cause puffiness, or drooping that interferes with vision.

Lower blepharoplasty candidates typically struggle with under-eye bags, puffiness, or loose skin that creates a tired appearance. Age isn’t necessarily a determining factor, as some people develop these concerns in their 30s while others may not need intervention until their 60s or beyond.

However, it’s important that patients have realistic expectations and understand that while blepharoplasty can create dramatic improvements, it won’t stop the natural aging process.

The only way to know for sure if you’re a good candidate is to schedule a consultation with your eye doctor at Missouri Eye Institute. During this appointment, your doctor will assess your individual situation and determine whether the procedure may be covered under insurance due to functional vision concerns or if it would be considered a cosmetic procedure requiring out-of-pocket payment.

Do you want to learn if you might be a good candidate for upper or lower blepharoplasty? Schedule a consultation at Missouri Eye Institute in Springfield, MO, today!