What Is Upper Blepharoplasty?
Upper blepharoplasty treats excess upper eyelid skin, upper eyelid hooding, heavy eyelids, and hooded eyelids through an incision placed in the natural eyelid crease. OFA-Bleph™ upper eyelid surgery is Dr. Gill's tissue-preserving approach: the plan is not only to decide what should be reduced, but what should be released, preserved, supported, or repositioned.
In selected patients, deep-plane ligament release and orbital fat transposition can support the upper eyelid-brow junction. Orbital fat is the eye's own cushioning fat within the bony socket; when carefully mobilized, it can act like an autologous natural filler, adding soft volume, projection, and better light reflection to the upper eyelid-brow complex.
This matters because many patients worry about looking hollow, over-resected, or unnatural after eyelid surgery. A strong upper eyelid result should make the eye look more open and rested while preserving the person's natural eye shape.
For a deeper patient guide to this concept, read why orbital fat preservation matters in blepharoplasty.
Dr. Gill is ASOPRS fellowship-trained, with focused training in eyelid, orbital, and periorbital surgery. His approach to upper blepharoplasty is anatomy-led: place the crease where it belongs, preserve the structures that maintain eyelid function, and avoid the hollow or operated look that can follow over-reduction.
Who Is a Candidate?
Upper blepharoplasty may be appropriate for healthy adults who want to see more comfortably, look less heavy or tired, or understand whether both concerns are present. Common reasons include:
- ✓Excess upper eyelid skin resting on the lashes or obstructing the visual field
- ✓Upper eyelid heaviness or fatigue by end of day
- ✓Difficulty applying eye makeup due to excess skin
- ✓A persistently tired or aged appearance despite adequate rest
- ✓Asymmetric upper eyelid folds or creases
If the eyelid margin itself droops — not just the skin — ptosis repair may be needed in addition to or instead of blepharoplasty. This is diagnosed at consultation.
The Procedure
The incision is marked in the natural upper eyelid crease. Excess skin is measured conservatively, but the deeper plan is individualized: ligament release, crease formation, ptosis assessment, fat preservation, and selective orbital fat transposition may all be considered depending on the patient's anatomy.
When fat is prominent, deficient, or malpositioned, the question is not automatically how much to remove. In OFA-Bleph planning, Dr. Gill evaluates whether the eyelid needs reduction, repositioning, or volume support so the final contour looks more open, rested, and naturally supported rather than hollowed or over-resected.
The incision is closed with fine sutures. A functional upper blepharoplasty can often be performed under local anesthesia with oral sedation and usually takes about 45-60 minutes. Cosmetic OFA-Bleph™ plans may take longer when crease refinement, ptosis assessment, fat preservation, or additional support is part of the plan.
Sutures are removed at 5–7 days. The crease is visible immediately; final scar maturation takes 3–6 months.
OHIP Coverage
Upper blepharoplasty may be insured by OHIP only when Ministry criteria are met. Ontario's Schedule of Benefits describes insured blepharoplasty as requiring a vertical visual field defect crossing the fixation point caused by redundant eyelid skin, with Ministry prior authorization.
The OHIP pathway is vision-first and can take weeks to months. It requires a computer-generated visual field report and interpretive report. It is not the pathway for patients primarily seeking optimized symmetry, eyelid folds, crease refinement, shadow improvement, or fat-pad sculpting.
Dr. Gill does not routinely perform OHIP upper blepharoplasty. When functional surgery is appropriate, EyeFACE associate oculoplastic surgeons can provide upper eyelid surgery through the medical pathway.
Full OHIP guide — eligibility criteria, testing, and process →Recovery
Cool compresses, head elevation. Swelling and bruising present — most significant on day 2–3.
Suture removal. Return to desk work. Bruising yellowing. Most patients are comfortable at home.
Presentable in public, especially with sunglasses. Most bruising resolved.
Progressive return to exercise and normal activity.
Final result as scar fully matures and residual firmness resolves.
Frequently Asked Questions
What does upper blepharoplasty correct?+
Upper blepharoplasty corrects excess upper eyelid skin, hooding, crease imbalance, and selected soft-tissue fullness or hollowing. In OFA-Bleph planning, the goal is not only to decide what should be reduced; it is to restore the eyelid platform while preserving natural eye shape and soft upper eyelid-brow support.
Is upper blepharoplasty covered by OHIP?+
Sometimes. OHIP may cover functional upper blepharoplasty only when Ministry criteria and prior authorization requirements are met, including visual field documentation showing a vertical visual field defect crossing the fixation point caused by redundant eyelid skin. Cosmetic goals such as symmetry, fold or crease refinement, shadow improvement, and fat-pad sculpting are separate from OHIP coverage.
What is the difference between blepharoplasty and ptosis repair?+
Blepharoplasty addresses the eyelid skin, crease, and surrounding soft tissue. Ptosis repair addresses a drooping eyelid margin caused by a weakened levator muscle — the muscle that lifts the eyelid. Both may be present simultaneously and can be addressed in the same procedure. Accurate diagnosis before surgery is essential.
Will there be a visible scar?+
The incision is placed precisely within the natural upper eyelid crease, which conceals it when the eye is open. When the eye is closed, a very fine scar may be visible initially and usually fades significantly over 3–6 months, though scars vary by patient.
What is recovery like?+
Swelling and bruising for 7–14 days. Most patients return to desk work within 5–7 days. Sutures are removed at 5–7 days. Strenuous activity resumes at 3–4 weeks. Final results emerge over 3–6 months as residual swelling resolves.
Can upper and lower blepharoplasty be done together?+
Yes — four-eyelid blepharoplasty (upper and lower together) is a common combination. Performing both under a single anaesthetic can reduce duplicate recovery time and may simplify planning. Dr. Gill will advise on whether a combined approach is appropriate for your anatomy.