Two different problems, two different surgeries
Upper eyelid surgery and lower eyelid surgery treat different parts of the eye. They are not interchangeable procedures, and which one applies is decided by where the actual concern sits, not by age alone.
A search for "eye lift" can mean either one, or both together. The distinction matters because the two surgeries use different incision locations and treat different structures.
Upper blepharoplasty removes loose skin and fat above the eye. This is the surgery people search for when they mean hooded eyes: skin that folds down over the lash line and makes the eye look smaller or tired.
Lower blepharoplasty treats the area below the eye: fat that bulges forward as a bag, and skin that has lost tension. It does not treat dark circles caused by skin pigment, which is a separate concern from shape (American Society of Plastic Surgeons).
Hooded eyes: an upper eyelid problem
Hooded eyes describes excess upper eyelid skin that overhangs the natural crease. It happens with age, as skin loses elasticity, and it can also be present earlier in life depending on the shape of the brow and eyelid.
Upper blepharoplasty removes that excess skin, and the fat pad beneath it when present, through an incision placed in the natural crease line so the scar sits inside a fold that already exists. Full technique detail for this practice is on the eyelid surgery page.
Both apply. Hooded eyes that block side vision is one indication for this surgery. It is also done to restore a more natural, younger-looking appearance to the eyes.
Under-eye bags: a lower eyelid problem
Lower blepharoplasty addresses puffiness caused by fat pushing forward under the eye, and skin that has lost its tightness. It does not lift the eyebrow and does not correct crow's feet — those are separate areas treated by separate procedures.
This is decided case by case. Excess fat is removed when it is present. Excess skin is removed when it is present. Which applies depends on the individual case.
Can upper and lower be done together?
Some patients have both concerns: heavy upper lids and bags below. Whether both are addressed in one operation, or separately, is a decision made for each patient.
This also depends on the case, and on whether the patient is a candidate for both procedures.
Which one do you actually need?
A simple way to separate the two:
- Skin folding down over the lash line, or eyes that look smaller than they used to → upper eyelid surgery.
- A bulge or bag sitting under the eye, with the upper lid otherwise unaffected → lower eyelid surgery.
- Dark circles with no bulge, and skin that looks thin rather than loose → not corrected by eyelid surgery, and worth raising as a separate question at consultation.
A consultation is where this is confirmed by examination, not by comparing a photograph to another patient's result.
Recovery
Recovery details — including anaesthesia, suture removal, and when swelling and bruising resolve — are described on the eyelid surgery page for this practice, and apply to both upper and lower procedures unless stated otherwise at consultation.
Recovery after upper and lower eyelid surgery follows a similar pattern. Swelling and bruising are strongest in the first days and fade over about 1–2 weeks. Most people take about two weeks off work. After lower eyelid surgery, strenuous activity is usually avoided for the first two weeks. Any tightness or redness of the scar can take a few months to settle. Healing varies from person to person.
Questions
FAQ
Is upper or lower eyelid surgery more common?
Both are performed, and which one applies depends on where the concern is: above the eye (upper) or below it (lower). A consultation determines which — or whether both — applies to a given case.
Does eyelid surgery treat dark circles?
No. Dark circles caused by skin pigment or thin skin are not corrected by blepharoplasty, which addresses excess skin and fat, not skin colour (American Society of Plastic Surgeons).
Will upper eyelid surgery change my eye shape?
It removes excess skin and fat from the upper lid. It does not reshape the eye itself, and it does not lift the eyebrow — a separate area.
Can hooded eyes be treated without surgery?
Non-surgical options exist for some causes of a heavy-looking upper lid, but skin that overhangs the crease is corrected with surgery, since skin excess is not something a non-surgical treatment removes.