Your eyes are often the first feature people notice when they meet you, and one of the most expressive parts of your face. For many patients, aging of the eyelids may occur before other signs of facial aging, making patients appear older than they really are.
Excess upper eyelid skin makes your eyes appear smaller, makes you look more tired, and for women, makes it difficult to apply makeup around your eyes. Excess lower eyelid skin and periorbital fat create wrinkles and excessive bulges even in patients who are otherwise thin. These changes can occur together or independently and worsen as we age, but sometimes present in patients in their 20s and 30s, particularly those with a genetic predisposition to early periorbital aging.
Patients describe it consistently: they look tired when they are not, they look older than they are, or their eyes don't match the rest of their face. Eyelid surgery, or blepharoplasty, corrects the specific anatomical changes in the eyelids, restoring an appearance that is alert, rested, and genuinely yours. For almost 30 years, board-certified plastic surgeon Dr. Don Griffin, MD, FACS has performed eyelid surgery in Nashville with exceptional attention to proportion and a commitment to results that look natural, because in an area this visible and this expressive, natural is everything.
Blepharoplasty is surgical correction of the upper eyelids, the lower eyelids, or both, performed to remove the excess skin, fat, and in some cases muscle tissue that accumulates around the eyes with age, creating a heavy, tired, or aged appearance. Upper blepharoplasty removes the drooping skin on the eyes, often the first visible sign of facial aging and one that can progress to the point of interfering with peripheral vision. Upper blepharoplasty is sometimes combined with brow lifting if the brow position is low and there is excess eyelid skin even when the brow is elevated. Lower blepharoplasty addresses the excess skin, puffiness, and bags beneath the eyes.
Lower eyelid blepharoplasty is often combined with laser and/or fat grafting depending on your particular lower lid and cheek anatomy. The procedures can be performed individually or together depending on what your anatomy requires. Dr. Griffin evaluates the upper and lower eyelids independently and recommends only what he sees clinical cause to address, never assuming both areas need correction simply because a patient has come in for the conversation.
These procedures address distinct anatomical concerns. Many patients need only one; others benefit from both performed together.
Upper eyelid surgery removes excess skin and herniated fat from the upper lid to restore a more open, youthful eye contour. Upper eyelid surgery is the appropriate procedure when excess skin and/or fat bulging is present on the upper lid. The incision is placed precisely within the natural crease of the upper eyelid, making the resulting scar essentially imperceptible once healed. Excess skin, and fat where appropriate, is removed, and the lid is restored to a more open, youthful position. Brow lifting is sometimes combined with upper blepharoplasty when the brow descends and drops the brow below the bony rim above the eye.
Lower eyelid surgery corrects loose skin, excess orbicularis muscle, and herniated periorbital fat that create persistent bags and puffiness beneath the eye. Depending on what is driving the appearance, Dr. Griffin may approach this from the inside of the eyelid, called the transconjunctival approach, leaving no external scar, or through a fine incision just below the lower lash line, used when excess skin and muscle need to be removed. Laser resurfacing and fat grafting or transposition may be combined with lower blepharoplasty. In some patients, volume loss beneath the eye creates hollowing that is better addressed by repositioning the existing fat or supplementing it with fat grafting, a technique that transfers your own fat to restore natural fullness rather than simply removing tissue. The choice is made based on your specific anatomy during your consultation.
Combined upper and lower blepharoplasty produces the most complete refresh of the entire eye area and is performed in a single surgical session. For patients in whom the brow has also descended, adding to the appearance of upper lid heaviness, Dr. Griffin will evaluate whether a brow lift should be incorporated into the plan. Curious which approach is right for your eyes? Schedule a consultation with Dr. Griffin to find out.
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*Every result is unique.
Most patients take 6 to 10 days away from work and social activity, with bruising and swelling improving progressively throughout that time. Sutures, if present, are removed in 6 to 7 days. By seven to ten days, most patients feel comfortable in public, particularly with sunglasses or light concealer. The final result continues to refine over several months as residual swelling fully resolves and the incision lines mature. Results from upper blepharoplasty typically last ten or more years. Lower eyelid results are generally long-lasting as well, though the natural process of aging continues. Dr. Griffin's team checks in with you regularly throughout recovery. Because the eyes are among the most visible and expressive parts of the face, we take the healing period seriously and stay closely involved.
"This entire place is AMAZING. Every single person I've dealt with in this office is the friendliest ever. Dr. Griffin: his skills are out of this world. I'm still amazed by the precision of my surgery incision. He is calming and comforting. I never feel rushed. He thoroughly explains his plans. Highly recommended!"
No. Preserving your natural eye shape is a primary objective of Dr. Griffin's surgical planning. The goal is to remove what is excessive while keeping everything that defines your eyes as yours. A result that looks operated on, pulled, or artificially wide is a failure of planning, not an inevitable outcome of the procedure.
Upper eyelid results typically last a decade or more. Lower eyelid results are generally long-lasting as well. The natural aging process continues after surgery, but for most patients, the improvement is sustained well into the following decade before any consideration of revision becomes relevant.
Upper eyelid surgery that significantly obstructs the superior visual field may qualify as a functional procedure rather than a purely cosmetic one. If you believe your upper eyelid drooping is affecting your vision, we recommend a visual field examination with your ophthalmologist before consultation. That documentation may support a coverage discussion with your insurer. Please note that Dr. Griffin does not bill insurance directly; our team can help you understand the documentation process and what financing options are available.
The cost of blepharoplasty varies based on the specific combination of procedures: upper lids, lower lids, or both, as well as whether complementary procedures such as laser resurfacing or fat grafting are incorporated. Because every surgical plan is customized to your anatomy and goals, pricing is discussed during your personal consultation after Dr. Griffin has evaluated your eyelids and developed a specific plan. Our team can also discuss financing options at that time.
Yes, this is a common combination. A facelift addresses the mid and lower face; a brow lift addresses the forehead and brow position; blepharoplasty addresses the eyelids themselves. Together they provide a comprehensive rejuvenation of the entire face. Dr. Griffin evaluates all three areas at consultation and recommends only the combination that your anatomy and goals support.
Incisions are placed within the natural creases and anatomical landmarks of the eyelid, and once fully healed, they are virtually imperceptible. Upper lid scars rest within the existing crease and are invisible when the eye is open. Lower lid scars, when an external approach is used, sit just below the lash line and are similarly well concealed.
This is exactly what your consultation is for. Dr. Griffin will evaluate both areas and tell you what he sees and what he recommends, and why these procedures are the right ones for your anatomy. Many patients come in expecting to need both and require only one. Some come in focused on one area and benefit from addressing both. The recommendation will be based on your anatomy, not on a predetermined plan.
Receive the aesthetic care you deserve from one of the best plastic surgeons in Nashville. Contact NCS today to schedule your private consultation with Dr. Don Griffin.
