Eyelid
Upper eyelid surgery to remove excess hooding skin (and fat) — functional (visual-field) or cosmetic, with the incision hidden in the lid crease.
Medically reviewed by Ronald W. Kristan, MD, FACSOculoplastic SurgeonLast updated June 2026
Part of our complete guide to Blepharoplasty (Eyelid Surgery) — this page covers upper eyelid blepharoplasty in depth.
Upper eyelid blepharoplasty (upper eyelid surgery) removes the strip of excess skin — and, when present, the herniated fat — that accumulates over the eyelid crease with age. The result is a more open, rested eye and, when heavy skin has been obstructing vision, a wider field of view. Incisions are hidden within the natural upper-lid crease and typically fade to a fine, well-concealed line in the crease.
Upper blepharoplasty sits at the intersection of function and aesthetics:
A drooping upper lid is not always excess skin. True ptosis (a low lid margin from stretching or weakness of the levator muscle/aponeurosis) is a different problem and is sometimes corrected at the same time. See also Brow Lift vs. Blepharoplasty.
What insurers ask for (functional coverage)
Criteria vary by plan — confirm specifics with Dr. Kristan's office.
Good candidates for upper eyelid surgery typically have one or more of the following:
Healthy adults with realistic expectations are generally good candidates. Dry-eye disease, thyroid eye disease, and brow or lid-margin position are assessed beforehand, since they shape the plan and because pre-existing dry eye can be worsened by skin removal — sometimes a ptosis repair or brow lift is combined for the best result. A careful pre-operative evaluation distinguishes true excess skin from a low brow or a drooping lid margin.
Procedure at a Glance
After marking the crease with the patient seated upright, the surgeon excises the measured skin ellipse, opens the orbital septum to address any prolapsed fat, achieves meticulous hemostasis, and closes with fine sutures. Conservative removal is essential — leaving enough skin for complete, comfortable eyelid closure.
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Bruising and swelling peak around 48 hours and settle substantially over 1–2 weeks; most patients are presentable in public by 10–14 days, with the final result stable by about 3 months. Temporary dry eye, mild asymmetry, and lid swelling are the most common issues; serious complications such as retrobulbar hemorrhage are rare but can threaten vision — seek emergency care immediately for sudden severe pain, marked swelling, bulging of the eye, or any change in vision. For a full day-by-day guide, see Blepharoplasty Recovery.
Patients of Asian heritage may prefer a technique that preserves or creates a defined crease — see Asian Blepharoplasty. To treat both the upper and lower lids together, see Four-Lid Blepharoplasty.
Schedule a consultation with Ronald W. Kristan, MD, FACS to learn if this procedure is right for you.
