The eyes are the first thing that communicate how we feel and, often, the first thing to reveal the passing of time. When the upper eyelid starts to feel heavy or bags appear beneath the eyes, the face can look tired even after a full night's rest. Blepharoplasty is the aesthetic surgery that addresses exactly this area, and it comes in two variants that solve different problems: upper and lower. This guide explains, with medical precision and no exaggerated promises, what each one corrects, how the techniques work, what recovery is like, and what the referential price is in Lima.
At Elyzea, surgery is performed by Dr. Geldres, plastic surgeon, on our own certified operating floor, inside the same Miraflores building that houses the aesthetic-medicine center. That means the assessment, the surgery and the follow-up visits all happen in one place, with a team that already knows your case. Non-surgical aesthetic medicine is led by Dra. Geldres, so when an eye concern doesn't actually need surgery, there is an alternative under the same roof.
What a blepharoplasty actually does
Blepharoplasty is a surgery that reshapes the eyelids by removing or repositioning the tissues that have become excessive over time: skin, muscle and, above all, the pockets of fat that surround the eye. It is not a filler procedure, nor does it tighten the skin of the whole face; it is a focused, delicate operation on one of the thinnest and most expressive areas of the face. That is why it calls for conservative surgical judgment: the goal is for the eyes to look rested and natural, never operated on.
The first step is always to understand where the problem comes from. Not every tired-looking gaze is solved with eyelid surgery. Sometimes what feels heavy is the brow, which has descended and pushes the lid downward; in that case the treatment is different. Other times there is true ptosis (a drooping lid caused by weakness of the levator muscle), which is a separate, functional problem corrected with a different technique. And many dark circles are not excess fat or skin at all, but pigmentation or loss of volume, which can improve without surgery. Telling these situations apart is exactly what happens during the plastic surgery consultation, and the quality of the result depends on getting it right.
Upper blepharoplasty: when the top lid feels heavy
Upper blepharoplasty addresses the top eyelid. Over the years, the skin in this area loses elasticity and an excess builds up that can form a fold hanging over the lash line. In marked cases, that excess skin reduces the lateral field of vision or makes the eyelids feel heavy by the end of the day.
Typical signs that motivate it:
- Excess skin on the upper eyelid that creates a hanging fold.
- A sense of heaviness, or having to "open the eyes more" to see comfortably.
- Difficulty applying eye makeup because the skin folds over itself.
- A gaze perceived as tired or more closed than one actually feels.
The technique consists of marking and removing the precise amount of excess skin and, when appropriate, a small portion of fat that bulges toward the inner corner of the eye. The great aesthetic advantage of this surgery is that the incision is designed hidden within the natural crease of the eyelid. Once healed, it stays tucked inside that fold and is virtually imperceptible when the eye is open. The approach is always conservative: removing too little and reviewing is preferable to removing too much, because an over-hollowed upper lid can make it hard to close the eye. You can see the details of this procedure on our upper blepharoplasty in Miraflores page.
Lower blepharoplasty: bags, excess skin and dark circles
Lower blepharoplasty works on the area beneath the eye, which tends to be more complex because three problems that are easily confused coexist there: fat bags, excess skin and dark circles. Understanding which of the three dominates is key to choosing the right technique and to setting realistic expectations.
- Fat bags: these are bulges that appear below the eye because the fat surrounding the eyeball shifts forward. They are the most common reason for consultation and respond very well to surgery.
- Excess skin: loose skin or fine wrinkles on the lower eyelid, characteristic of aging in the area.
- Dark circles: here we have to be honest. When the dark circle is caused by pigmentation (a darker tone of the skin) or by a hollow that casts a shadow, surgery does not eliminate it. In those cases, a non-surgical approach such as hyaluronic acid and dermal fillers to restore volume to the groove, or treatments for pigmentation, is usually more appropriate. Only when the shadow is caused by the fat bag itself does removing it also improve the look of the dark circle.
Transconjunctival vs subciliary
There are two routes for operating on the lower eyelid, and the choice depends mainly on whether there is excess skin or not:
- Transconjunctival technique: the incision is made on the inside of the eyelid, through the conjunctiva, so it leaves no visible external scar. It is ideal when the main problem is fat bags and the skin still has good tone. The fat can be removed or, when there is a hollow between the bag and the cheek, repositioned to smooth the transition rather than simply taken away.
- Subciliary technique: the incision runs just below the lash line and allows the excess skin to be removed too, not only the fat. The scar stays very discreet in that fold. It is chosen when, in addition to bags, there is clearly excess skin that needs to be trimmed.
In many modern cases, repositioning the fat is preferred over removing it entirely, because over-emptying the lower eyelid can, over the years, lead to a hollow, aged appearance. Once again, conservative judgment rules. You will find more information on the lower blepharoplasty in Miraflores page.
Can upper and lower be combined?
Yes. When both eyelids show signs of aging, it is common to perform upper and lower blepharoplasty in the same surgical session. Doing them together has clear advantages: a single preparation, a single recovery, and a more harmonious result, because the whole gaze is balanced rather than treating only half of it. The decision to combine them, or to treat one first and the other later, is made during the consultation according to what each face needs. There is no single answer: it depends on the examination, your goals, and a plan designed so the result looks natural.
What recovery is like
Blepharoplasty is usually performed under local anesthesia, with or without sedation, which makes it a well-tolerated and, in most cases, outpatient procedure: the patient goes home the same day. Recovery, however, requires patience with the area, because the eyelids swell and can bruise easily.
- First few days: swelling and bruising around the eyes are to be expected. Cold compresses and keeping the head elevated while sleeping help control them.
- First to second week: most of the swelling and bruising resolves during this period, which usually ranges from several days up to roughly one to two weeks. Many people feel comfortable returning to social life once the bruising is easy to conceal.
- Aftercare: avoid intense physical effort, direct sun and makeup on the area until the team clears it. Precise instructions are given and follow-up visits are scheduled to monitor healing.
Everyone heals at their own pace, so these timelines are indicative and not a promise. The consultation explains what to expect for your particular case.
Results: when they show and how they last
The change begins to be visible as soon as the initial swelling subsides, but the final result settles over weeks and even months, as the tissues settle and the scars mature and fade. A well-performed blepharoplasty gives the eyes a more rested, open look without changing the identity of the face: the goal is not to transform the face, but to make it look the way one feels.
It is worth holding realistic expectations. Surgery does not stop aging, so the skin will continue its natural process over the years; even so, the results of a blepharoplasty tend to be long-lasting and very satisfying when the indication was correct. Results vary from one person to another, and no specific figures or outcomes are guaranteed.
Price of blepharoplasty in Lima
At Elyzea, both upper and lower blepharoplasty have a referential price from S/3,500 (~US$1,000) each. This is a starting price: the final cost depends on each case —on whether both are combined, on the chosen technique, and on what the examination indicates— and is always confirmed at the free consultation, which can be in person or online. Surgery is not booked online; the assessment is done first, and the procedure is scheduled from there.
We recommend being wary of prices that seem too low for eyelid surgery: in such a delicate area, what defines the result and safety is the surgeon's experience, the quality of the surgical environment and the follow-up, not saving a few soles.
Safety and why Elyzea
Blepharoplasty, like any surgery, carries risks —prolonged swelling, asymmetries, a transient dry-eye sensation or, infrequently, temporary difficulty closing the lid fully— which decrease significantly when it is performed by a surgeon with good judgment, in a prepared environment and with a conservative plan. That is why being honest about what surgery can and cannot achieve is part of how we work.
At Elyzea, the procedure is performed by Dr. Geldres, plastic surgeon, on an own, certified operating floor inside the same Miraflores building. This integration —consultation, surgery and follow-up in one place, with aesthetic medicine available for cases that do not require surgery— allows us to care for each gaze with medical precision and attentive service. If you want to take the first step, the plastic surgery consultation is where your case is assessed, your questions are answered and a tailored plan is drawn up, with no obligation.
Frequently asked questions
Is the blepharoplasty scar noticeable?
In upper blepharoplasty the incision is designed hidden within the natural crease of the eyelid, so once healed it stays tucked inside that fold and is virtually imperceptible when the eye is open. In the lower lid, the transconjunctival technique leaves no external scar because it operates from the inside of the eyelid; the subciliary technique leaves a very discreet line just below the lashes. Everyone heals at their own pace.
What is the difference between upper and lower blepharoplasty?
The upper one removes excess skin (and sometimes fat) from the top eyelid, which feels heavy or forms a hanging fold. The lower one corrects the area beneath the eye: fat bags and, depending on the case, excess skin. They solve different problems and, when both are present, can be performed in the same surgery.
Does lower blepharoplasty remove dark circles?
Only sometimes. If the dark circle is caused by the shadow cast by the fat bag, removing or repositioning it improves its appearance. But when the dark circle is due to skin pigmentation or to a hollow that casts a shadow, surgery does not eliminate it; in those cases a non-surgical approach, such as hyaluronic acid to restore volume or treatments for pigmentation, is usually more appropriate.
How long is recovery?
Swelling and bruising are to be expected in the first few days. Most of it resolves over a period ranging from several days up to roughly one to two weeks, at which point many people return to social life with the bruising already concealed. The final result settles over weeks and even months. These are indicative timelines: everyone heals at their own pace.
Can both eyelids be operated on at the same time?
Yes. When the upper and lower eyelids show signs of aging, it is common to combine them in a single session: one preparation, one recovery and a more harmonious result for the whole gaze. The decision is made during the consultation according to what each face needs.
Will the result look natural?
That is precisely the goal. The surgery is performed with conservative judgment —removing just enough and, when appropriate, repositioning the fat rather than over-emptying— so the eyes look rested and open without changing the identity of the face. Results vary from one person to another, and no specific outcomes are guaranteed.
How much does blepharoplasty cost in Lima?
At Elyzea, both upper and lower blepharoplasty have a referential price from S/3,500 (~US$1,000) each. It is a starting price; the final cost depends on each case —whether they are combined, the technique and what the examination indicates— and is confirmed at the free consultation. Surgery is not booked online.