Blepharoplasty • DermaBlue Asheville

Upper eyelid blepharoplasty results are among the most long-lasting in facial surgery — for most patients, the results are permanent in the sense that the removed skin does not return. Some patients may notice gradual changes in the surrounding area over the years and choose a touch-up or complementary procedure, but the original correction holds well. Lower blepharoplasty results are similarly long-lasting, particularly for fat repositioning or removal. Skin quality, sun exposure, and genetics all influence how the area around the eyes continues to age.

Upper blepharoplasty may be covered by insurance when excess eyelid skin is documented to impair peripheral vision — a condition called dermatochalasis. If that’s the case, you’ll typically need a visual field test performed by an ophthalmologist to confirm functional impairment before coverage is approved. Cosmetic blepharoplasty — performed to improve appearance rather than restore vision — is generally not covered. Lower blepharoplasty is almost always considered cosmetic. During your consultation, we can discuss the documentation process if you think a functional claim may apply to you.

Upper blepharoplasty addresses excess skin and, if needed, fat or muscle on the upper eyelids — the common cause of a heavy, hooded look. It’s performed through an incision hidden in the natural lid crease. Lower blepharoplasty targets under-eye puffiness caused by fat migration, as well as loose or wrinkled skin on the lower lid. It can be performed through an incision just below the lower lash line, or internally (transconjunctival approach), which leaves no visible external scar. Both can be done in the same session, and many patients choose to address upper and lower lids together for a more complete result.

Blepharoplasty has one of the more comfortable recoveries in facial plastic surgery. Most patients feel ready to be seen in public — particularly with sunglasses — by the end of week two. The first week involves the most noticeable swelling and bruising around the eyes, which fades significantly by day 10. Sutures are typically removed at day 5 to 7. Screen time should be limited in the first few days, as the eyes may feel tired or dry. Most patients are back to their regular routine by weeks three to four, with final results continuing to refine through 3 to 6 months.

Done well, blepharoplasty should make you look more rested, refreshed, and like a better version of yourself — not like someone who had surgery. The most common thing patients hear afterward is that they look great or well-rested, with no one pinpointing why. The key is conservative, precise removal of what’s actually excess, with careful attention to maintaining natural eyelid contour and not over-correcting. Dr. Levine’s approach prioritizes results that look natural from the very first conversation about what you want to achieve.