Blepharoplasty is the second most popular plastic surgery, but patients often don't understand the risks

By Claire Wolters | Fact-checked by Davi Sherman
Published January 18, 2024

Key Takeaways

  • Actress Amanda Bynes announced that she’d had a blepharoplasty.

  • Blepharoplasty, or double eyelid surgery, is the second-most popular cosmetic procedure, according to Vogue. 

  • The surgery has been around since the late 1800s and is known for creating a Western, open-eye look.

  • For some people, the procedure may have implications for their vision health.

Actress Amanda Bynes announced recently that she has undergone blepharoplasty,– a cosmetic surgery that removes excess eyelid skin to give the area a more open, pulled-back look. Those who are unaccustomed to the procedure may raise an eyebrow at the star’s decision, but Bynes is not the only one pursuing the “double eyelid” surgery. 

As reported in the November 2023 issue of Vogue, blepharoplasty is incredibly popular. It is the second-most requested plastic surgery after rhinoplasty ( a “nose job”). The procedure has been around for years and, according to some plastic surgeons, is here to stay.

“Blepharoplasty surgery has been around for many years; it is one of the procedures that will always be around due to the anatomy of the eyelid,” says Alexander Zuriarrain, MD, FACS, a quadruple board-certified plastic surgeon with Zuri Plastic Surgery in Miami. “As we age, the eyelid continues to sag, and the only effective treatment is removal of the excess skin.”

He adds that he performs about ten blepharoplasties a month.

Dr. Zuriarrain recommends the surgery for patients who are unhappy with skin redundancy, or sagging skin, around their eyelids and who are at least 35 years old. Bynes is 37.

Blepharoplasty’s Asian roots

Blepharoplasty was invented in 1896 by Japanese physician Kotaro Mikamo to address “Japanese women's new concerns with physical attractiveness” during social transitions and early Westernization in Japan, according to an English translation of an article by Mikamo. By creating a more defined crease and open eye look, the surgery has been viewed as a way to manipulate a traditional Asian-shaped eye into a more Western-looking one, according to Vogue.

Blepharoplasty also decreases the look of hooded eyes, Dr. Zuriarrain says. 

Blepharoplasty vs botox

Some facial cosmetic procedures can be replicated by fillers or Botox. However, Dr. Zuriarrain says that there is no other nonsurgical procedure that can remove skin from the eyelid with the same degree of effectiveness as blepharoplasty.

This is because, he explains, blepharoplasty isn’t just about reducing wrinkles and fine lines; it’s also about skin removal, contours, and tightness.

Risks of blepharoplasty

The eye is an incredibly sensitive area of the face, so this procedure does not come without risks.

A poorly done blepharoplasty could impact a person’s ability to close their eyes and/or add complications to their vision. For these reasons, surgeons do not recommend the procedure to younger patients or those who have already-taut skin around their eyes.

“The complications can be significant if the lid is unable to close properly,” Dr. Zuriarrain explains. (On the flip side, the surgery could improve vision for someone whose eyelids are exceptionally saggy, he adds.)

If talking to a patient about an upcoming blepharoplasty—or helping them decide whether or not to pursue one—Dr. Zuriarrain recommends in-depth conversations paired with physical examinations and eye-doctor referrals. He adds that it is imperative for the patient to see an ophthalmologist for an eye exam—with proper documentation—before undergoing surgery in order to assess skin redundancy, review the current state of their eye and vision health, and discuss how these things may be impacted by the procedure.

What this means for you

Blepharoplasty, or double eyelid surgery, has been around since the late 1800s and is known for giving patients an open eye look. If talking to a patient who is interested in undergoing this procedure, make sure that they see an eye doctor first.

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