The skin around your eyes is some of the thinnest on your body, which is why it tends to show your age before anywhere else does. Heavy upper lids can make you look tired even after a full night of sleep, and lower-lid puffiness often lingers no matter how much water you drink. At Tarola Plastic Surgery in Murfreesboro, TN, board-certified plastic surgeon Dr. Nicholas Tarola helps patients across Middle Tennessee address these changes with individualized eyelid surgery.
What Is Blepharoplasty?
Eyelid surgery, or blepharoplasty, is typically performed to remove excess skin and fat from the upper and lower eyelids, restoring a more youthful appearance. Drooping of the upper eyelid may be corrected at the same time, if necessary. Blepharoplasty is often combined with other procedures of the face such as a brow lift or facelift.
Although eyelid surgery is usually performed later in life, young adults who suffer from “puffy” lower eyelids usually seek out this procedure as well. The scars that result from eyelid surgery usually fade quickly and are inconspicuously located. As with any cosmetic procedure, the ideal candidates are healthy individuals with realistic expectations. Doctor Tarola will review the details of the procedure and postoperative recovery course during your consultation.
What Eyelid Surgery Treats
- Excess upper eyelid skin. Loose skin can hang low enough to rest on the eyelashes or block the outer edges of your vision, making reading and driving harder. This drooping skin, called dermatochalasis, develops as the eyelid tissue loses elasticity with age.
- Puffy, tired-looking lower lids. On the lower lids, weakened muscle and shifting fat create the bags and shadowing that make the whole face look tired. Blepharoplasty removes or repositions this skin and fat so the eyes open more fully and look rested.
- Vision blocked enough to be functional. Research on patients who met medical guidelines for this procedure found measurable improvement in the upper visual field after surgery, which is why some cases qualify as functional rather than purely cosmetic. Dr. Tarola evaluates both concerns during your visit.
Types of Eyelid Surgery
Blepharoplasty is adjusted for the patient based on which eyelids are involved and whether the concern is aesthetic or functional. Dr. Tarola may recommend one of these approaches or a combination to get the best results.
Upper Eyelid Surgery
Upper eyelid surgery is used for loose skin that makes the upper lids look heavy or hooded. Dr. Tarola places the incision within the natural crease of the lid so the line is hidden after the healing process. Through this opening, he removes excess skin. In most cases, he preserves the underlying fat to keep a soft, natural contour. Fat is rarely removed from this area. This procedure takes around an hour, and recovery tends to be fast.
Lower Eyelid Surgery
Lower eyelid surgery addresses the puffiness and loss of skin elasticity below the eyes. Often, the issue is bulging fat. Dr. Tarola can work through an incision hidden inside the lower lid, which leaves no visible scar. When excess skin needs to be removed, the incision will be just beneath the lash line. Sometimes, the fat is repositioned rather than removed to create a smoother surface between the lid and the cheek.
Combination Surgery
Changes can happen in both of the lids at the same time, and treating all four eyelids in a single session is possible. Combining procedures means you only have to go through anesthesia once (if using general anesthesia) and you only have one recovery period, which most patients find to be easier on their schedule and budget. The upper and lower lids age differently, so Dr. Tarola plans each surgery carefully to keep your eyes balanced with each other and the rest of the face.
Functional vs Cosmetic Eyelid Surgery
Cosmetic blepharoplasty is chosen to refresh the appearance of the eyes, while functional blepharoplasty is focused on correcting upper-lid skin that has drooped far enough to interfere with vision. The two use similar techniques, but the reason behind the surgery changes how a case is documented. To be considered functional, the drooping skin needs to block a measurable portion of your upper visual field, which can be determined with an eye test.
How to Prepare for Eyelid Surgery
Once you schedule brow lift surgery with Dr. Tarola, you will be given a procedure-specific surgical packet, which includes medications to avoid before your procedure, postoperative instructions, and information on what to expect in the weeks and months following your procedure. Doctor Tarola and Tarola Plastic Surgery will also provide you with all of your prescriptions so that they may be filled in advance of the procedure day.
What Happens During Eyelid Surgery
Eyelid surgery is done as an outpatient at Tarola Plastic Surgery. On the day of your procedure, you will arrive early to the surgery center to speak with your board-certified anesthesiologist and be prepared for surgery. Doctor Tarola only performs surgeries at fully accredited surgery centers. The procedure will be performed under general anesthesia or local anesthesia with IV sedation, both for your comfort and to provide Dr. Tarola with the ideal conditions to perform your surgery in order to achieve optimal results. When you wake up, you will be sore but kept comfortable in the recovery room. Typically, showering and shampooing are allowed after 24 hours.
Blepharoplasty Recovery
Strict adherence to Dr. Tarola’s postoperative instructions is critical to your result. You can expect swelling for the first couple of weeks. Doctor Tarola will review your postoperative instructions to hasten your recovery and ensure an excellent result. The guidance below covers what most patients can plan for.
- Use cold compresses early on. For the first 48 hours, gently apply cool compresses around the eyes to limit swelling and bruising. Keep them light so there is no pressure on the incisions.
- Keep your head elevated. Sleep with your head raised on two or three pillows, or in a recliner, for the first several nights. Staying elevated helps fluid drain away from the eyes.
- Take it easy for the first week. Avoid bending at the waist, heavy lifting and anything that strains or increases pressure in your head until Dr. Tarola clears you.
- Care for the incisions as directed. Keep the incision lines clean and apply any ointment exactly as instructed. Do not rub, scratch, or pick at the healing skin.
- Expect your sutures to come out around day six. Most patients return to the office six days after surgery to have sutures removed. This quick visit also lets Dr. Tarola check that you are healing on schedule.
- Soothe dryness and irritation. It is normal for the eyes to feel dry, gritty, or watery for a while. Use only the lubricating drops or ointment Dr. Tarola recommends, and avoid contact lenses until he says it is safe.
- Hold off on eye makeup and pause certain medications. Wait to wear eye makeup until you are cleared, usually a couple of weeks in. Also avoid aspirin, ibuprofen, and other blood-thinning products unless Dr. Tarola has approved them, as they can worsen bruising.
- Protect your eyes from sun and strain. Wear dark sunglasses outdoors to shield the incisions from sunlight and wind. Give your eyes frequent breaks from screens and reading during the first week.
- Ease back into activity gradually. Light walking is encouraged early to support circulation, but wait on exercise and swimming until Dr. Tarola gives the go-ahead, typically after two to three weeks.
- Know when to call the office. Reach out to Dr. Tarola if you notice severe or worsening pain, sudden vision changes, bleeding that will not stop, or signs of infection such as spreading redness, warmth or fever.
Eyelid Surgery Results
Most of the swelling happens within the first couple of weeks. Results sharpen over the following months as your tissues have time to heal and settle. Once all of the swelling and bruising fades, you will look less tired and more approachable, and there will be no signs that you have had surgery.
A study of more than two thousand patients showed that they had major and long-lasting improvements six to twelve months after upper blepharoplasty. Upper-eyelid results tend to be the longest lasting because the skin that was removed does not come back, even though the tissue continues to age naturally.
Are There Non-Surgical Eyelid Treatments?
Not everyone is ready for surgery, and some early changes respond well to less invasive care. Tarola Plastic Surgery offers several treatments that refresh the eye area without invasive measures.
Upneeq
Upneeq is a once-daily prescription eye drop that temporarily lifts a drooping upper eyelid. It stimulates a small muscle in the lid to contract, which raises the lid margin by a millimeter or two for several hours. The effect is subtle and reversible, so Upneeq suits patients who have mild drooping or who want to preview the kind of lift surgery could provide. Dr. Tarola can confirm whether your eyes are a good match for this drop.
Ultherapy
Ultherapy warms the tissue through ultrasound energy to help prompt more collagen production in the area around the eyes over the following months. It can be used to lift and tighten the brow and the skin above the lids to nonsurgically soften a heavy, hooded look. Because it reaches a depth that creams cannot, Ultherapy offers more noticeable firming for those who have more moderate skin laxity but aren’t ready for skin removal. Results are gradual and last close to a year, with no recovery.
Under-Eye Filler
Under-eye filler uses a soft hyaluronic acid gel to smooth the hollow groove between the lower lid and the cheek. When puffiness comes from a lack of volume rather than excess fat, filler can help. The treatment takes only a few minutes, and results are visible right away with little downtime. Filler placed here generally lasts up to a year before a touch-up is needed.
SkinMedica Skincare
SkinMedica is a professional skin care line that Tarola Plastic Surgery carries in the office for patients who want to work on the eye-area skin at home. Its eye creams and serums combine retinol with growth factors and peptides to improve firmness and smooth fine lines. While topical products cannot remove excess skin or fat, they can strengthen the thin eyelid skin and improve tone, which helps maintain surgical results or delay the need for a procedure. Staff can match the right products to your skin type.
Can Blepharoplasty Be Combined With Other Surgeries?
Blepharoplasty is frequently done alongside other facial procedures, which lets Dr. Tarola address several concerns in one operation and one recovery. A few pairings come up often.
Canthopexy
Canthopexy is a procedure that tightens and supports the outer corner of the eye, where the upper and lower lids meet. As the lower lid loosens with age, that corner can sag or round outward and make the eye look more droopy. Adding a canthopexy during lower eyelid surgery reinforces the lid so it sits snugly against the eye, which lowers the risk of the lid pulling down as it heals. Dr. Tarola may recommend it when a patient has weak lid support or wants a subtle lift to the outer eye.
Brow Lift
A heavy brow often makes upper-lid skin look worse than it is, because a sagging forehead pushes tissue down onto the eyes. In these cases, a brow lift raises the eyebrows to their natural position and relieves some of the weight resting on the upper lids. Pairing a brow lift with blepharoplasty can produce a more complete result than eyelid surgery alone, since it treats the source of the heaviness as well as the excess skin at the lid itself.
Facelift and Other Facial Procedures
Eyelid surgery refreshes the eyes, but it does nothing for a heavier jawline or a loosening neck. Patients who want broader rejuvenation often combine blepharoplasty with a facelift or neck lift so the whole face is in balance. Fat grafting is another common addition, using your own fat to restore lost volume in the temples or midface. Because Dr. Tarola performs surgery in a private, on-site operating room, combining procedures can be handled comfortably in one visit.
Why Choose Tarola Plastic Surgery
Dr. Nicholas Tarola is a board-certified plastic surgeon who completed his general surgery residency at Thomas Jefferson University and his plastic surgery training at Vanderbilt University Medical Center. He has practiced in Middle Tennessee since 2011, building a reputation for careful facial work and a straightforward, honest approach. Dr. Tarola listens first and tells you plainly whether surgery is the right choice for your goals. If you are not a good candidate, he will tell you.
Surgery is performed in a private operating room built into the practice, so your care stays in one place from consultation through recovery, away from a crowded hospital or surgery center. Dr. Tarola hand-picks the anesthesia and recovery team he trusts for every case.
Frequently Asked Questions About Eyelid Surgery
Is eyelid surgery covered by insurance?
Cosmetic eyelid surgery is paid for out of pocket, but functional upper-lid surgery may qualify for partial coverage when sagging skin blocks part of your sight. Coverage depends entirely on your individual plan and its requirements. Our office can help gather the findings your insurer asks for and verify your benefits before anything is scheduled.
How much does eyelid surgery cost?
Cost depends on whether you treat the upper lids, the lower lids or both, and whether other procedures are combined in the same session. Anesthesia and facility fees also factor in. Dr. Tarola gives a personalized quote at your consultation, and the practice offers financing so payments can be spread over time.
Is there an ideal age for eyelid surgery?
There is no single right age for blepharoplasty. It depends on your skin and health and what bothers you. Some patients are ready in their thirties while others wait until their sixties, and Dr. Tarola weighs each case on its own merits.
Does eyelid surgery hurt?
The eye area feels tight and sore for the first few days, and any discomfort is usually handled with over-the-counter medicine or the prescriptions Dr. Tarola provides. For most people, swelling and light bruising are more noticeable than actual pain.
What are the risks of eyelid surgery?
Like any surgery, it carries some risk, including temporary dry eye, blurred vision, lingering swelling or, in rare cases, a lower lid that heals slightly lower than planned. Choosing an experienced board-certified surgeon keeps these risks low.
Will eyelid surgery get rid of dark circles?
It depends on the cause. When dark circles come from puffy fat pads casting a shadow, lower eyelid surgery can improve them. When the darkness comes from pigment or from thin skin revealing the vessels underneath, surgery does less, and other options work better.
Are eyelid surgery scars noticeable?
Scars from eyelid surgery are among the most forgiving on the face, because eyelid skin is thin and tends to heal cleanly. A line may look faintly pink for the first few months before fading to a mark most people never notice. Sun protection and Dr. Tarola’s aftercare help it settle.
Schedule Your Eyelid Surgery Consultation
For more information about blepharoplasty, call Tarola Plastic Surgery at 615-713-1695 to schedule your consultation with Dr. Tarola in Murfreesboro, TN. You can also request an appointment through our online form. We serve patients throughout Murfreesboro and the greater Nashville area.
