Blepharoplasty (Eyelid Surgery)
on Long Island

Blepharoplasty is a surgical procedure that removes excess skin, muscle, and fat from the upper and/or lower eyelids. It is performed to treat excess eyelid skin that impairs vision (dermatochalasis; a low eyelid margin, or ptosis, needs a different lifting-muscle repair, sometimes at the same visit) as well as cosmetic concerns including heavy upper lids, under-eye bags, and a tired or aged appearance. At Belaray Dermatology, blepharoplasty is performed by Dr. Rachel Ellis, a fellowship-trained oculoplastic and reconstructive surgeon — the only such specialist at a dermatology practice on Long Island offering this service alongside Mohs surgery.

Upper Blepharoplasty

Upper blepharoplasty removes excess skin (dermatochalasis) and/or fat from the upper eyelid. Indications include:

• Functional ptosis: Drooping skin that hangs over the lash line and obstructs the superior visual field. This is documented with a formal visual field test and may qualify for insurance coverage.
• Cosmetic: Heavy upper lids that create a tired or aged appearance without functional impairment.
• Post-Mohs reconstruction: Scar or defect repair after Mohs skin cancer removal from the upper eyelid.

The incision is made in the natural eyelid crease, leaving a scar that is effectively hidden. Surgery is performed under local anesthesia with optional oral sedation in the office.

Lower Blepharoplasty

Lower blepharoplasty addresses under-eye bags, puffiness, and hollowing. Dr. Ellis performs lower blepharoplasty using the transconjunctival approach:

• Transconjunctival approach: The incision is made inside the lower lid, so there is no external scar. Fat is removed or repositioned to smooth under-eye bags and hollowing, and it suits patients with good skin elasticity.
• When skin tightening is also a goal: Rather than an external lower-lid incision, the surrounding skin is tightened and smoothed with laser or CO₂ resurfacing or RF microneedling, which can be layered with the procedure for the best result.

Lower blepharoplasty is typically a cosmetic procedure and is not covered by insurance.

Blepharoplasty for Mohs Reconstruction

Skin cancer on the eyelid — particularly the lower lid and inner canthus — requires careful coordination between the Mohs surgeon (who removes the cancer) and the oculoplastic surgeon (who reconstructs the eyelid). At Belaray, both are under one roof, allowing Mohs excision and oculoplastic reconstruction to be coordinated — generally the same day when appropriate. See our guide on Mohs surgery near the eye.

Recovery Timeline

• Days 1–3: Swelling and bruising peak. Cold compresses, head elevation, and rest.
• Days 5–7: Sutures removed. Most patients feel comfortable appearing in public.
• Week 2: Bruising mostly resolved. Light activity resumed.
• 4–6 weeks: Full activity. Final scar appearance assessed at 3–6 months.

Frequently Asked Questions

Is upper blepharoplasty covered by insurance?

Upper blepharoplasty may be covered by insurance when excess skin causes documented functional visual field obstruction. This requires a visual field test demonstrating superior field loss. Dr. Ellis will perform the evaluation and assist with prior authorization if medically indicated. Cosmetic cases are not covered.

How long do blepharoplasty results last?

Upper blepharoplasty results typically last 10–15 years or longer, though the eyelids continue to age. Lower blepharoplasty results are generally long-lasting, as fat repositioning or removal is permanent — skin laxity may recur over years.

Can blepharoplasty be combined with other procedures?

Yes. Blepharoplasty is commonly combined with Botox for crow's feet and brow lifting, filler for under-eye hollows, or laser resurfacing for skin quality improvement. Dr. Ellis will discuss which combinations best serve your goals and anatomy.

Is blepharoplasty the same as ptosis repair?

No. Blepharoplasty removes excess eyelid skin and fat (dermatochalasis). Ptosis repair tightens the muscle that lifts the eyelid when the lid margin itself sits too low. Some patients need both, which can be done at the same visit, and the evaluation determines which applies to you.