Can upper and lower blepharoplasty be performed at the same time?
To give you the bottom line first: when both the upper and the lower eyelid have drooped, it is possible to perform upper and lower blepharoplasty at the same time, and in practice this is an option I often consider in mid-life eyelid surgery. Whether the two areas should be addressed together, however, can be judged differently depending on the degree of droop and the individual's tissue condition, so it is not a criterion that applies uniformly to everyone.
■ Why consider doing both at once?
With age, eyelid droop often progresses in the upper and the lower lid at the same time. If only the upper lid is corrected, the lower-lid droop remains as it was and the balance of the eyes can look awkward; conversely, if only the lower lid is corrected, the heavy impression of the upper lid remains and the overall improvement can feel limited. For this reason, when droop is present above and below together, performing both at once is considered.
■ What performing both at once involves
Upper and lower blepharoplasty are procedures that incise different lines (the double-fold line and the subciliary line), and because the incision sites do not overlap, it is structurally possible to perform them together in a single session. That said, since two areas are being addressed at once, a plan that manages the swelling and the recovery process in an integrated way is needed.
■ When doing both at once is considered vs. when the procedures are staged
■ Points to consider when doing both at once
Addressing the upper and lower lids together is counted as an advantage in that the overall balance of the eyes can be set in a single session, but by the same token the swelling and the burden of early recovery can appear in both areas at once. It is therefore important to confirm in advance whether the schedule can be arranged around the recovery period and whether the patient's general health can handle a combined procedure. Even when the procedures are staged, the balance of the final result can differ depending on the order and the interval chosen, so an individually tailored plan is necessary.
■ FAQ
Q. If upper and lower blepharoplasty are done at the same time, does the recovery period double?
A. Not necessarily. In that the entire course can be completed in a single session rather than by doing each area separately, there are in fact cases where the total recovery time is managed more efficiently. That said, early swelling can appear in both areas at the same time.
Q. Are there cases where doing both at once is difficult?
A. Depending on the individual's skin elasticity, the condition of the eyelid tissue, and their general health, there are cases where a staged approach is recommended over doing both at once. This needs to be judged on an individual basis through a detailed consultation.
Q. Can lower eyelid fat repositioning also be done at the same time?
A. When under-eye bulging or dark circles are also present, lower blepharoplasty and lower eyelid fat repositioning are considered together, and there are cases where upper blepharoplasty is included as well. However, as the number of areas addressed in one session increases, a detailed assessment of the individual's tissue condition must come first.
■ In closing
Whether upper and lower blepharoplasty should be performed at the same time is a question that varies with the site and degree of the droop and with the individual's tissue condition. If droop is present both above and below, doing both at once can be considered, but this is a matter that must be judged individually after a detailed examination.
