Blepharoplasty is eyelid surgery. It removes or repositions the excess skin, muscle and fat that collect around the eyes with age, and it can be done on the upper lids, the lower lids, or both.
For many patients the goal is appearance — a less tired, less heavy look around the eyes. For others the goal is function, because loose upper eyelid skin has started to block the upper part of their vision. Both are valid reasons to have the operation, and the surgical plan is different for each.
At Kalpana Aesthetics, these procedures are performed by Dr. Vishal Purohit (M.B.B.S., M.S., M.Ch. Plastic Surgery). The aim is a result that suits your own face and still looks like you.
For the complete picture, read our full guide to blepharoplasty.
The Two Surgical Approaches
There are two ways to reach the tissues of the eyelid, and the names are often confused.
Transcutaneous (through the skin). The incision is placed in the natural crease of the upper lid, or just below the lash line on the lower lid. Because it gives direct access to skin, muscle and fat, this is the approach used whenever excess skin needs to be removed. It is the standard approach for upper eyelid surgery.
Transconjunctival (through the inner lining). The incision is made on the inside surface of the lower eyelid, against the conjunctiva, so there is no external scar at all. This approach reaches the fat pads but cannot remove skin. It is therefore used for the lower lid in patients whose main problem is bulging fat and whose skin still has good tone — often younger patients. Some surgeons refer to it as “closed” blepharoplasty, though that terminology is inconsistent in the literature.
Which approach suits you is decided at examination, not in advance. It depends on how much skin is redundant, where the fat sits, and the tone of your lower lid.
What Blepharoplasty Does — and What It Does Not Do
Eyelid surgery treats volume and laxity. It removes redundant skin, and it removes or repositions herniated orbital fat so the transition between the lower lid and the cheek is smoother. The result is usually a more open, more rested appearance, and this holds up because the change is structural rather than superficial.
It is equally important to be clear about the limits.
- It does not treat crow’s feet or fine lines. Those wrinkles are caused by muscle movement and sun damage. They respond to botulinum toxin, resurfacing or chemical peels, not to eyelid surgery.
- It does not lift the eyebrow. If a heavy brow is contributing to the hooding, removing more upper lid skin will not fix it, and may make the brow sit lower. A brow lift is a separate operation.
- It does not remove dark under-eye circles. Pigmentation and thin skin are different problems, though correcting a shadow cast by a fat bulge can make circles look better.
- It does not raise the eyelid margin. More on this below — it is the single most common misunderstanding.
Dermatochalasis Is Not the Same as Ptosis
This distinction changes the operation, so it is worth understanding before your consultation.
Dermatochalasis is excess, loose upper eyelid skin. The eyelid itself opens normally; there is simply too much skin draping over it. This is what blepharoplasty corrects.
Ptosis is a droop of the eyelid margin itself, usually because the levator muscle has stretched or detached from the tarsal plate. The lid sits low over the iris, and the eye looks smaller or sleepy even when the skin is lifted away.
The two often occur together. If ptosis is present and only the skin is removed, the eye will still look heavy afterwards — a disappointing and entirely avoidable outcome. Ptosis needs a separate manoeuvre, usually a levator advancement or a Müller’s muscle–conjunctival resection, performed through the same incision. Part of the purpose of the pre-operative examination is to measure your lid position and tarsal platform show so that this is identified before, not after, surgery.
Upper vs. Lower Blepharoplasty
| Feature | Upper Blepharoplasty | Lower Blepharoplasty |
|---|---|---|
| Primary target | Upper eyelid skin, sometimes a strip of muscle and medial fat | Lower eyelid fat pads, and skin if lax |
| Main concern addressed | Hooding, heaviness, obstruction of upper visual field | Eyelid bags, lid–cheek step-off, tear trough shadow |
| Usual approach | Transcutaneous, incision in the natural crease | Transconjunctival if skin is good; transcutaneous if skin must be removed |
| What it will not do | Raise the lid margin, or lift the brow | Remove pigmentation or fine lines |
| Realistic result | A lighter, less hooded upper lid and a clearer crease | A smoother, less shadowed lower lid contour |
Lower Eyelid Bags: Preserving Fat Rather Than Simply Removing It
The older approach to lower eyelid bags was straightforward fat removal. It works in the short term, but over the following years the mid-face continues to lose volume, and patients who had generous fat resection in their forties can look hollow and skeletonised in their sixties.
Current practice has moved towards fat preservation. Rather than excising the herniated fat, it is released and repositioned over the orbital rim to fill the tear trough hollow, so that the bulge and the groove correct each other. Selective, conservative resection still has a place where the fat volume is genuinely excessive, but it is now used judiciously rather than as the default.
This matters because periorbital skin thins and loses elasticity with age, and an over-resected lower lid is difficult to correct later.
Risks and Complications
Blepharoplasty is generally safe and well tolerated, but it is real surgery on a delicate structure, and you are entitled to know what can go wrong before you consent.
Common and usually temporary:
- Swelling and bruising, occasionally marked, and often asymmetric between the two sides
- Dry, gritty eyes and sensitivity to light, typically for a few weeks; some patients need lubricating drops for longer
- Blurred vision from ointment and swelling in the first days
- Chemosis — a jelly-like swelling of the conjunctiva that can take several weeks to settle
- Numbness or altered sensation along the incision
Less common:
- Visible or thickened scarring, or a small cyst along the suture line
- Asymmetry, or residual skin or fat, sometimes needing a minor revision
- Lower lid malposition — the lid pulling downward or outward (retraction or ectropion), which is the most significant aesthetic complication of transcutaneous lower blepharoplasty. Careful assessment of lid laxity beforehand, and canthal support where indicated, reduce this risk
- Difficulty closing the eyes fully, usually transient
- Infection, or a wound that separates
Rare but serious:
- Retrobulbar haemorrhage — bleeding behind the eye. It is uncommon, but it is a surgical emergency, because untreated it can threaten vision. Sudden severe pain, rapidly increasing swelling or loss of vision after surgery must be reported immediately, at any hour.
- Permanent visual change. This is very rare, but it is not zero, which is why the warning signs above are taken seriously.
Who Is Not a Good Candidate
Some patients should delay surgery, or avoid it. At consultation we specifically look for:
- Thyroid eye disease that is active or not yet stable, and other causes of proptosis
- Significant dry eye or previous LASIK, both of which make post-operative dryness worse
- Uncontrolled hypertension, diabetes or bleeding disorders, and anticoagulant or antiplatelet medication that cannot safely be paused
- Active smoking, which impairs wound healing
- Glaucoma or other ongoing eye disease, which may need ophthalmology input first
- Expectations that surgery cannot meet — for example, expecting eyelid surgery to change the shape of the eye, remove dark circles, or produce a specific celebrity result
If the assessment suggests you would not benefit, we will say so.
The Functional Side: When Eyelid Surgery Is Not Cosmetic
A number of patients arrive assuming this is purely an aesthetic operation, and are surprised to learn their symptoms have a name. When redundant upper eyelid skin hangs low enough, it obstructs the upper visual field. Patients describe lifting their eyebrows to see, tired or aching foreheads by evening, difficulty reading, and trouble with overhead signage while driving.
This is assessed objectively with a visual field test comparing the field with the lid taped up and untaped. Where the obstruction is documented, the surgery is functional rather than cosmetic, and it may be covered by insurance — worth checking with your insurer before you plan.
Anaesthesia and the Recovery Timeline
Most upper eyelid procedures are done under local anaesthesia with or without light sedation, as day surgery. Four-lid surgery, transconjunctival lower lid surgery, or blepharoplasty combined with another procedure is often more comfortable under sedation or general anaesthesia. This is decided with you and with the anaesthetist.
| Phase | What to expect | What you can do |
|---|---|---|
| Days 1–2 | Swelling and bruising build to a peak; cold compresses, head elevated | Rest; no bending or lifting |
| Days 5–7 | Sutures removed; bruising begins to change colour and fade | Light daily activity; screen work in short spells |
| Days 7–10 | Swelling substantially reduced | Most desk-based work; makeup usually permitted once healed |
| Week 2–3 | Presentable in most social situations; some residual puffiness, often uneven | Light exercise resumed on advice |
| Week 4–6 | The majority of swelling resolved; scars still pink | Full exercise; sun protection for scars |
| Months 3–6 | Scars soften and pale; final contour settles | Final review |
Two honest caveats. First, swelling resolves at very different rates between individuals and between the two sides of the same face, so do not judge symmetry early. Second, the lower lid takes longer than the upper. Scar maturation and the last of the deep swelling run to three to six months, so the result you see at one month is a good result, but not the final one.
Follow-up visits are scheduled through this period. Our detailed guidance on managing swelling and bruising covers the practical side at home.
Why the Choice of Surgeon Matters
The eyelid has very little margin for error. A millimetre of over-resection on the upper lid can prevent the eye closing; a few millimetres of unsupported lower lid can produce a lasting malposition. Judging how much to take, and how much to leave, is the substance of the operation.
Dr. Vishal Purohit holds an M.Ch. in Plastic Surgery and practises periorbital and facial aesthetic surgery in Jaipur. The approach here is conservative — assessment first, a plan matched to your anatomy and your reason for seeking surgery, and a frank conversation about what the operation will and will not change.
You can read what happens at your first consultation before you book.
Cost and Consultation
The cost of blepharoplasty in Jaipur varies with whether one or both lids are treated, whether ptosis correction or canthal support is needed, and the type of anaesthesia and facility required. A single quoted figure would be misleading before examination. You will receive a written estimate covering the surgeon’s fee, anaesthesia, facility charges and follow-up after your consultation, with no obligation to proceed. Where the surgery is functional, we can help you document the visual field findings for your insurer.
Frequently Asked Questions
Is the blepharoplasty procedure painful?
Discomfort is generally mild. The anaesthetic covers the procedure itself, and most patients manage afterwards with simple oral analgesia for two to three days. A tight, gritty sensation is more common than actual pain. Persistent or increasing pain is not expected and should be reported.
How long is the recovery after blepharoplasty?
Most people return to desk work at seven to ten days, once the sutures are out and the bruising has faded enough to cover. Being comfortable in social or client-facing settings usually takes two to three weeks. Full exercise waits until around four weeks, and the final refinement of the result continues for three to six months.
Will I have visible scars after blepharoplasty surgery?
Upper eyelid incisions are placed within the natural crease and are difficult to see once healed. Lower lid transcutaneous incisions sit just under the lash line. The transconjunctival approach leaves no external scar at all. Eyelid skin heals well, but scars do exist — they are pink initially and pale over several months, and they need sun protection during that time. Rarely a scar thickens and needs treatment.
How long do the results last after blepharoplasty?
The change is long lasting because tissue is removed rather than merely tightened, and upper eyelid surgery often does not need repeating. Ageing continues, however, so skin gradually loosens again over the following decade or more. Lower eyelid results tend to be more durable when fat is repositioned rather than simply removed.
Will my results look like someone else’s after a cosmetic eyelid surgery?
No, and that is intentional. Eyelid anatomy varies considerably, including crease height and shape, which differ between individuals and across ethnic groups. The plan is built around your anatomy and your goals. Photographs of other patients are useful for discussing what is achievable, not for choosing a result to copy.
Can blepharoplasty be combined with other procedures?
Frequently. It is commonly combined with brow lift, ptosis correction, tear trough filler or fat grafting, or resurfacing of the lower lid skin. Combining procedures is discussed at consultation, since it affects anaesthesia, cost and recovery.
This page is for general information and does not replace an individual consultation. Outcomes vary between patients, and no surgical result can be guaranteed.
To discuss your case or arrange a consultation, contact Dr. Vishal Purohit in Jaipur at +91-7718183535.
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