Patients researching an eyelid lift Chicago IL surgeons perform often use the term as if it describes one operation, but upper and lower blepharoplasty address genuinely different problems and are frequently performed independently of one another. At Evolve Your Life, with locations in Chicago, Peoria, and Oak Brook, IL, Dr. Amir Dorafshar, MD, FACS, evaluates the upper and lower eyelids separately before recommending which, or both, a patient actually needs.
Upper Blepharoplasty: Excess Skin and Hooding
Upper eyelid surgery removes excess skin, and sometimes a small amount of underlying fat, that has stretched and begun to droop over the eye. According to Mayo Clinic, this excess skin is typically excised through an incision placed within the natural upper eyelid crease, which conceals scarring effectively once healed. In more pronounced cases, hooding from the upper lid can be significant enough to affect the visual field, making this the version of eyelid lift surgery most likely to carry a functional, and not purely cosmetic, benefit.
Lower Blepharoplasty: Puffiness and Under-Eye Bags
Lower eyelid surgery addresses a different problem entirely: bulging fat pads, under-eye bags, and sometimes loose lower lid skin that create a tired or puffy appearance regardless of how well-rested a patient actually is. Cleveland Clinic notes that lower blepharoplasty can involve repositioning fat rather than removing it, smoothing the transition between the lower lid and cheek instead of leaving a hollow. Because upper and lower eyelid concerns stem from different tissue changes, a patient can reasonably need one without the other, which is why a symmetric “eyelid lift” recommendation for both lids isn’t always the right plan.
Eyelid heaviness is also sometimes misattributed entirely to the eyelid when the brow itself has descended. The distinction matters for surgical planning, and patients unsure which structure is actually responsible can review What Is the Difference Between a Brow Lift and an Eyelid Lift? for a side-by-side comparison, or ask about combining a brow lift with blepharoplasty when both structures are contributing.
Some patients also assume any correction to the eyelid area must be surgical, but for very mild cases limited to fine crepiness or minimal fat bulging, a surgeon may recommend skin-focused nonsurgical treatments first and reserve blepharoplasty for once the change becomes more structural. That kind of staged, honest recommendation, rather than defaulting straight to surgery, is part of why a thorough in-person consultation matters more than a quick photo review.
The American Society of Plastic Surgeons recommends avoiding contact lenses, strenuous exercise, and swimming for a period during early healing for either procedure, with bruising and swelling typically most noticeable during the first week. Patients who have documented vision impairment from upper lid hooding can also review Does Insurance Cover Eyelid Surgery If It Affects My Vision? separately for coverage-specific guidance.
Because the eyelids are thin, delicate, and central to facial expression, precision is critical, and Dr. Dorafshar’s fellowship training in craniofacial surgery supports a careful, symmetry-focused approach to both upper and lower eyelid lift procedures. Patients in downtown Chicago’s Gold Coast area, near the practice’s office at 60 East Delaware Place, as well as Peoria and Oak Brook, can schedule a consultation to determine which eyelid procedure, or combination, fits their concerns. Learn more on the About Dr. Amir Dorafshar page.
