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Best Procedure to Tighten Sagging Skin Around the Eyes

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Best Procedure to Tighten Sagging Skin Around the Eyes

Eyelid plastic surgery, also called blepharoplasty, is growing in popularity. As we get older, it’s possible to develop loose, sagging skin over the eyes. Also, you can get baggy, puffy skin under the eyes too.

If either of these problems are happening to you, upper or lower eyelid surgery could be viable. Some of the reasons to consider eyelid surgery include:

  • If you have hanging, extra skin covering the upper eyelid folds
  • If you have sagging skin hanging from your upper eyelids over your eyelashes
  • If the upper and lower eyelids look puffy and baggy so that you look older and tired
  • If there are deep grooves under both eyes

There also can be medical reasons for eyelid surgery:

  • Skin irritation from extra eyelid skin rubbing together
  • Discomfort in the forehead from tired muscles that strain to lift the excess skin above the eyelids

Below is more information about upper and lower eyelid surgeries that can make you look years younger.

How Eyelid Surgery Is Performed

As noted earlier, your surgeon can perform eyelid surgery on the upper, lower, or both eyelids. Based on an examination of your facial structure, bone structure, and eyebrow symmetry, your plastic surgeon will recommend how much muscle, fat, and skin to take off.

The procedure generally goes as follows:

  • The surgeon makes markings on your upper and lower eyelids to determine which tissues should be removed.
  • On the upper eyelid, the surgeon will make incisions that are obscured in the natural folds of your upper eyelids.
  • On the lower eyelid, the incisions are hidden below your lower lashes. Also, if extra fat will be removed, incisions can be made inside the lower eyelids. This is called a transconjunctival incision. Your surgeon may use a laser, as well, to tighten your lower eyelid skin.
  • The surgeon will cut away tissue with surgical instruments through the incisions. Some of the tools used include surgical scissors, scalpels, lasers, and radiofrequency cutting devices.
  • Fat can be moved around into the lower lids to reduce bulges and puffiness. The surgeon also can make tweaks to muscle laxity to tighten things up.
  • Your surgeon will put sutures around the eyelids and eyebrows. They are hard to see and usually leave almost no scarring.
  • The surgeon also could use a laser to resurface the skin and smooth wrinkles in the eyebrows and eyelids.

Upper Eyelid Surgery

The surgeon puts the incision at the eyelid crease. Through that incision, he will take out extra fat, muscle, and skin. Lasers also can be used to remove excess tissue to reduce bruising and swelling.

Lower Eyelid Surgery

Your surgeon can choose several options to do this surgery:

  • The most frequent method is to put the incision under the eyelashes, then cutting away extra fat and skin, followed by tightening muscles under the eye.
  • Using the transconjunctival approach, which can reduce lower lid puffiness and bags, the surgeon makes incisions inside your eyelids. He can take out extra fat with this method, but not excess skin.
  • There also is the ‘skin pinch’ eyelid surgery that takes out a small patch of skin. This can be effective if you have strong support in the lower eyelids and only a little extra skin.
  • Another option is to use hyaluronic acid fillers in the lower lids, such as Juvederm or Restylane. This non-surgical treatment can reduce bags and puffiness under the eyes, but it only lasts about six months.

Incisions and Scarring

Many patients are concerned about how much scarring they’ll have:

Upper Eyelid Surgery

The surgeon marks the natural creases and lines of the lids and will make the scars as hard to see as he can. Delicate stitches are used to close them, so the scars should be nearly invisible.

Lower Eyelid Surgery

In regular lower eyelid surgery, the surgeon makes incisions in a hard-to-see area, such as near the lash line and smile crease of your lower lid.

In the transconjunctival method, the surgeon improves eyelid puffiness due to excess fat by making the incisions inside your lower eyelids. This method doesn’t need an external incision, but it only removes extra fat, not skin.


After either eyelid surgery, your doctor will apply antibiotic ointment on your incisions to prevent infections.

The first day after surgery, it’s recommended to use cold packs in the eyes for 10-15 minutes each hour that you’re awake. The next day, apply the cold packs every 3-4 hours for the same amount of time.

After two days, you can use warm compresses to speed healing.

You will have some swelling and bruising for a few days. The sutures usually dissolve after four to seven days.


Most patients enjoy excellent results without significant complications. However, it’s important to note that one possible issue can be difficulty closing the eyelids. This could make your eyes dry. Usually, the condition goes away after a few weeks, but you’ll need to use eye drops and humidifiers to keep your eyes moist.

Other possible complications of eyelid surgery:

  • Infection
  • Vision loss
  • Double vision
  • Scarring that doesn’t fade as much as expected
  • Eyelid numbness
  • Overcorrection or undercorrection

Book Your Blepharoplasty Procedure Today

Once you’re ready to take the next step and book your consultation, there’s no turning back. The results you’ve dreamed of are within your grasp. Stop delaying, and schedule a Philadelphia blepharoplasty procedure with Dr. Stark today!

You won’t regret your decision!


Philadelphia plastic surgeon Dr. Ran Stark brings decades of experience and training to each consultation. When you meet with Dr. Stark, he takes the time to give you information and options, so you can have confidence in your decision to move forward with the best procedure for you. Confidence. Personalized care. Impeccable results. That’s the Stark Difference. Discover that difference yourself by scheduling a consultation with Dr. Stark today.

135 South Bryn Mawr Ave, Suite 220, Bryn Mawr, PA 19010

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