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TOP - MENU - Eye (Blephaloplasty) - Upper Eyelid Skin Excision

Upper eyelid sagging excision

Do you ever feel like your “upper eyelids are heavy,” your “double eyelid crease has narrowed,” or your “eyes look tired”?

Upper eyelid blepharoplasty is a procedure that removes excess skin to create a more defined eye area. It makes the double eyelid crease more visible and can also improve vision if the skin is obstructing your field of vision.

However, sagging eyelids are not always caused solely by loose skin. Conditions such as ptosis may also be a factor, so it is important to identify the cause and select the appropriate treatment.

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Table of Contents

  1. 01Do you have any of these concerns?
  2. 02(medical) case
  3. 03Why We're the Top Choice
  4. 04About Upper Eyelid Skin Excision
  5. 05Recommended for
  6. 06Differences from Eyelid Ptosis Surgery
  7. 07Treatment Process, Post-Treatment Recovery, and Fees
  8. 08What You Should Know Before Your Treatment
  9. 09Frequently Asked Questions
  10. 10References
  11. 11Medical Advisor
R.O.clinic院長 呂秀彦医師

Hidehiko Lu

Director, R.O. Clinic

Doctor of Medicine
Board Certified Plastic Surgeon, Japan Medical Association
Adjunct Lecturer, Department of Plastic and Reconstructive Surgery, Showa University

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Explanation from Director Lu

In upper eyelid ptosis surgery, it is important to carefully assess not only the amount of excess skin but also the double eyelid crease, the thickness of the eyelid, and any asymmetry between the left and right sides. At R.O. Clinic, we take into account both the appearance of the eyes when open and when closed, aiming for a natural result that harmonizes with the patient’s entire face.

Do you have any of these concerns regarding sagging upper eyelids?

  • My upper eyelids feel heavy, and my vision isn't clear.
  • The double eyelid line has become narrower or is starting to fade
  • People have been telling me more often, “Are you tired?” or “You look sleepy.”
  • My eyeliner and eyeshadow don't show up well
  • The eyelashes are touching the skin of the upper eyelid.
  • I feel like the appearance of my eyes has changed as I've gotten older.

These concerns may be caused by sagging of the upper eyelids due to aging.

However, heavy eyelids or difficulty opening your eyes can also be caused by other conditions, such as ptosis. Do not make a self-diagnosis; instead, have the cause properly identified and then choose the treatment that is right for you.

[R.O. Clinic] Case Study: Upper Eyelid Skin Excision

At R.O. Clinic, we tailor our designs to each patient’s individual eyelid condition and preferences. Here, we present case studies that demonstrate how we correct sagging upper eyelids to achieve a natural, youthful eye area that reflects each patient’s unique features.

  • 呂院長による上まぶたたるみ切除の症例1:上は術前、下は術後3ヶ月
    Top: Preoperative / Bottom: 3 months postoperative
    Treatment Name
    Bifid shaping / Bifid incision (excision of sagging upper eyelid)
    Attending Physician
    Director Lu
    Charge
    407,000 yen (including tax)
    anesthesia
    local anesthesia
    Downtime
    Swelling and bruising: About 1 to 2 weeks
    Removal of Stitches
    1 week later
    Risks and Side Effects
    Swelling, bruising, redness of the scar, asymmetry, etc.

    Results and progress may vary from person to person.

  • 黒田副院長による上まぶたたるみ切除の症例2:上は術前、下は術後3ヶ月
    Top: Preoperative / Bottom: 3 months postoperative
    Treatment Name
    Bifid shaping / Bifid incision (excision of sagging upper eyelid)
    Attending Physician
    Deputy Director Kuroda
    Charge
    407,000 yen (including tax)
    anesthesia
    local anesthesia
    Downtime
    Swelling and bruising: About 1 to 2 weeks
    Removal of Stitches
    1 week later
    Risks and Side Effects
    Swelling, bruising, redness of the scar, asymmetry, etc.

    Results and progress may vary from person to person.

  • 呂院長による上まぶたたるみ切除の症例3:上は術前、下は術後3ヶ月
    Top: Preoperative / Bottom: 3 months postoperative
    Treatment Name
    Bifid shaping / Bifid incision (excision of sagging upper eyelid)
    Attending Physician
    Director Lu
    Charge
    407,000 yen (including tax)
    anesthesia
    local anesthesia
    Downtime
    Swelling and bruising: About 1 to 2 weeks
    Removal of Stitches
    1 week later
    Risks and Side Effects
    Swelling, bruising, redness around the scar, and slight asymmetry in the final result

    Results and progress may vary from person to person.

Reasons Why R.O. Clinic's Upper Eyelid Skin Excision Is the Top Choice

Upper eyelid ptosis correction is a procedure in which the final result varies significantly depending on the amount of tissue removed and the design chosen. At R.O. Clinic, we tailor the design to each patient’s individual eye area and preferences, aiming for a natural and beautiful result.

Japanese Society of Plastic and Reconstructive Surgery: Thorough Examinations and Surgeries Performed by Board-Certified Plastic Surgeons

Upper eyelid ptosis correction is a procedure in which the final result varies significantly depending on the amount of tissue removed and the surgical design. At R.O. Clinic, a board-certified plastic surgeon from the Japanese Society of Plastic and Reconstructive Surgery personally oversees every step of the process—from the initial consultation through surgery. After carefully assessing the structure and function of the eyelids, as well as any asymmetry between the left and right sides, the surgeon performs the procedure with the goal of achieving a natural result that prioritizes both aesthetics and function.

Comprehensive examinations that cover not only aesthetic aspects but also eyelid function

The symptom of “heavy upper eyelids” can be caused not only by sagging skin but also by ptosis, excess fat, or the position of the eyebrows.

At R.O. Clinic, we conduct consultations after identifying the cause of your symptoms and recommend the most appropriate treatment, including upper eyelid lift surgery, subbrow incisions, and ptosis surgery.

A Customized Resection Plan Tailored to Each Individual

The thickness of the upper eyelid, the amount of fat, the degree of skin sagging, and the position of the eyebrows vary from person to person. Therefore, the amount of skin to be removed and the surgical design also differ for each patient.

At R.O.clinic, we take into account the current condition of your eyelids, your preferences, and future changes, and tailor the design to meet your specific requests—whether you want to “maintain the width of your double eyelids” or achieve “as natural a look as possible.”

We strive for a beautiful finish not only when it's open, but also when it's closed.

The eye area is visible to others not only when your eyes are open, but also when you blink or close your eyes.

At R.O. Clinic, we aim for a natural-looking result that enhances your unique features by taking into account not only the double eyelid crease but also scars when your eyes are closed, asymmetry, and the way your skin stretches.

Precise suturing using a high-magnification 3.0x loupe

The skin on the upper eyelid is thin, making scars more noticeable in this area.

At R.O. Clinic, we use a high-magnification 3.0x surgical loupe to perform delicate suturing while carefully examining every detail. By performing each procedure with meticulous care, stitch by stitch, we aim to achieve a natural-looking result that takes into account the appearance of scars and suture lines.

Upper Eyelid Skin Excision at R.O. Clinic

R.O.clinicの上まぶたたるみ切除

Upper eyelid blepharoplasty is a procedure designed to remove excess skin from the upper eyelids caused by aging or other factors, with the goal of improving the heavy appearance around the eyes.

Removing excess skin can help reveal double eyelid creases that were previously hidden by sagging skin and improve the appearance of heavy-looking eyes. If the skin is obstructing your vision, this procedure may also help improve your vision.

At R.O. Clinic, rather than simply removing excess skin, we create a design tailored to each individual, taking into account the appearance of the eyes when they are open and closed, as well as any asymmetry between the left and right eyes. We also incorporate fat adjustment as needed to achieve a natural, youthful look around the eyes.

R.O.clinicの上まぶたたるみ切除
Illustration of an Upper Eyelid Skin Excision Procedure (Excision / Suturing)

Furthermore, since even a slight difference in the amount of tissue removed around the eyes can drastically change one’s appearance, at R.O. Clinic, we perform procedures while taking into account not only the appearance but also eyelid movement and balance between the left and right sides.

Another characteristic of this procedure is that, because it involves removing the skin itself, the improvement in sagging tends to last relatively longer.

R.O.clinicの上まぶたたるみ切除
Before-and-After Images of Upper Eyelid Skin Excision Surgery

Expected Benefits

The following results can be expected from upper eyelid blepharoplasty.

  • Improves sagging of the upper eyelids and makes the eye area look more defined
  • Make the double eyelid line more visible
  • Softens the heavy, aged appearance
  • If skin is obstructing your vision, you can expect an improvement in your vision.

Since this procedure involves removing skin, the results last relatively long; however, because the effects of aging continue, sagging may occur again in the future.

Risks and Side Effects

The main risks and side effects are as follows.

  • Swelling
  • Bruising
  • Redness of a Scar
  • Difference between the left and right sides
  • It becomes difficult to close my eyes

Swelling and bruising usually subside within about 1 to 2 weeks, but it may take about 3 months for the final results to become apparent. Additionally, the redness of the scars will gradually fade over a period of about 3 to 6 months.

Since removing too much skin can lead to risks such as difficulty closing the eyes, it is important to determine the appropriate amount of skin to remove. To achieve a natural-looking result, a consultation with an experienced surgeon and proper planning are essential.

Who Should Consider Upper Eyelid Lift Surgery?

If you have any of the following concerns, upper eyelid blepharoplasty may be right for you.

  • My upper eyelids feel heavy
  • I'm concerned about sagging and wrinkles on my upper eyelids
  • The double eyelid line is hidden by sagging skin
  • I'm concerned about how the appearance of my eyes is changing with age

If sagging skin is making the area around your eyes look heavy, removing the excess skin can help create a natural, refreshed appearance. However, since there may be other underlying causes, such as ptosis, it’s important to first have a doctor examine the current condition of your eyelids.

Differences from Eyelid Ptosis Surgery

Even if you feel that your “eyelids are heavy” or “it’s hard to open your eyes,” the cause isn’t necessarily sagging skin. It may also be related to ptosis, a condition in which the muscles and tendons that lift the eyelids lose their function.

[The Difference Between Upper Eyelid Skin Removal and Ptosis]

ItemUpper eyelid sagging excisionBlepharoplasty
Main CausesSkin Sagging Due to AgingDeterioration in the function of the muscles and tendons that open the eyelids
Treatment ObjectivesRemove excess skinImprove the ability to open the eyelids
Main TreatmentsSkin excision and fat adjustment as neededThe levator muscle anterior rotation method, etc.
Who This Is ForFor those concerned about sagging skinPeople who have difficulty opening their eyes or have a narrow field of vision

In some cases, sagging skin and ptosis may occur simultaneously; in such cases, treatments may be combined depending on the symptoms.

Since it is difficult to make a diagnosis based on symptoms alone, at R.O. Clinic, we conduct examinations that assess not only skin laxity but also the ability to open the eyelids, and then recommend the most appropriate treatment method.

The Procedure for Upper Eyelid Skin Excision

上まぶたたるみ切除の施術の流れ

At R.O. Clinic, we provide attentive care from the initial consultation through post-treatment follow-up to ensure our patients can undergo their procedures with peace of mind.

Counseling and Medical Examinations

First, we will listen carefully to your concerns and preferences. We will examine not only the degree of sagging in your upper eyelids but also the thickness of your skin, the amount of fat, the position of your eyebrows, and your ability to open your eyes, to determine whether an upper eyelid lift is appropriate for you.

We’ll explain the treatment details, expected results, downtime, and risks, so please feel free to ask us if you have any concerns or questions.

Design and Treatment

We design with more than just the width of the double eyelid in mind—we also take into account how the eyes look when open and closed, any asymmetry between the left and right eyes, and even how the eyelashes appear.

The procedure is an outpatient surgery (*) performed under local anesthesia. Excess skin is removed along the pre-determined design, fat is adjusted as needed, and the incision is carefully sutured. The procedure takes approximately 40 to 50 minutes.

*Preoperative testing and postoperative follow-up are required.

Postoperative Recovery and Downtime

Swelling and bruising may occur after the procedure, but in most cases, noticeable swelling subsides within about 1 to 2 weeks. Scars and swelling will gradually fade over the course of about 3 months, resulting in a more natural appearance.

Sutures are typically removed about one week after surgery. You may apply eye makeup after the sutures are removed, but since this may vary depending on the condition of the incision, please follow your doctor’s instructions. You may take a shower on the day of surgery and wash your face starting the next day. Please be careful not to get the incision site wet on the day of surgery.

Follow-up

To ensure your peace of mind after surgery, we’ll monitor the progress of any swelling or scarring during regular follow-up visits. If you have any symptoms that concern you or any worries, please feel free to contact us at any time.

At R.O. Clinic, we provide comprehensive support not only during your treatment but also throughout your post-treatment recovery, ensuring you can undergo treatment with peace of mind.

Estimated Treatment Duration and Number of Sessions

As an example of a follow-up schedule, if you undergo one surgery, followed by suture removal one week after surgery and follow-up visits at 1, 3, and 6 months post-surgery, you will have a total of 4 post-surgery visits—5 visits in total, including the day of surgery. Separate visits are required for the initial consultation, counseling, and preoperative examinations.

In this example, the period from surgery to the final follow-up visit is approximately 6 months. The actual treatment duration and number of clinic visits will vary depending on the condition of your eyelids, your postoperative progress, and the doctor’s judgment. We will provide you with a specific schedule for your clinic visits during your consultation.

Postoperative course and follow-up

ItemDetails
Treatment Time40-50 minutes
Postoperative hospital visitRequired 1 week after surgery
The stitches will be removed in one week.
Postoperative swellingNoticeable swelling for 1 to 2 weeks
Approximately 3 months to settle down (individual differences)
Treatment on the day of counselingpossible
anesthesiaCream anesthesia, combined with local anesthesia
Laughing anesthesia is available upon request.
showerYou can start using it on the day of application; starting the next day, it's okay to get the patch wet.
makeEye makeup 1 week after surgery
face-washingAvailable from the next day

Cost of Upper Eyelid Skin Removal Surgery

Treatment DetailsPrices (including tax)
Upper eyelid sagging excision407,000 yen
Upper eyelid sagging excision + ROOF excision462,000 yen
Eyelift (incision under the eyebrow)440,000 yen
blowlift440,000 yen
ROOF excision option (not available as a stand-alone procedure)+55,000 yen

*Prices include tax; upper eyelid skin excision is a self-pay procedure.

Related Videos

R.O. Clinic has released videos explaining everything from the basics of double eyelid surgery to advanced techniques. We also cover topics of interest to those considering upper eyelid ptosis correction—such as the differences between incision-based and non-incision (buried suture) methods—so please be sure to check them out.

  • 関連動画1
  • 関連動画2
  • 関連動画3

What You Need to Know to Avoid Regrets After Upper Eyelid Skin Removal Surgery

上まぶたたるみ切除で後悔しないために知っておきたいこと

Upper eyelid skin removal is not a procedure suitable for everyone. If the cause of heavy-looking eyelids is not sagging skin but rather ptosis or a change in the position of the eyebrows, a different treatment may be more appropriate.

In addition, since scarring and the final results vary from person to person depending on the extent of the excision and skin type, it is important to thoroughly discuss your desired double eyelid width and the overall look of your eyes during the consultation.

Instead of basing your decision solely on treatment methods and costs, choose a clinic that accurately assesses the condition of your eyes and recommends a treatment plan tailored to your individual needs.

At R.O. Clinic, we assess not only the degree of sagging but also the ability to open the eyelids and any asymmetry between the eyes, and we propose treatments that take both appearance and function into account. It is important to undergo the procedure only after fully understanding not only the expected results but also the risks and downtime.

Frequently Asked Questions

How long is the downtime?
Swelling and bruising typically last about 1 to 2 weeks. While significant swelling will gradually subside, it may take about 3 months for the final results to become apparent.
Will the scar be noticeable?
Since the incision lines are designed to follow the double eyelid crease or the line beneath the eyebrows, they generally become less noticeable over time. Any redness will gradually subside in about 3 to 6 months.
How long do the effects last?
Since excess skin is removed, the results are expected to last for a long time. However, because the effects of aging continue, sagging may occur again in the future.
Can I receive treatment on the same day as my consultation?
Depending on our schedule and your health status, we may be able to provide treatment on the same day. Please discuss this with us during your consultation for more details.
Can I have upper eyelid skin removal and ptosis surgery at the same time?
Depending on the condition of your eyelids, we may combine different treatments. We will determine your eligibility following a consultation.

References

Ptosis | Japanese Ophthalmological Society

Double Eyelid Surgery / Double Eyelid Incision (Upper Eyelid Skin Removal) | R.O. Clinic

Medical Advisor

Information on the Medical Consultant for This Page

R.O.clinic院長 呂秀彦医師

We take our responsibilities in cosmetic medicine seriously and with integrity, offering treatment plans tailored to each individual patient. We respond with sincerity and dedication to your desire to look more beautiful and youthful.

Director, R.O. Clinic

Hidehiko Lu HIDEHIKO RO, M.D., Ph.D.

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Position
Director, R.O. Clinic
Qualifications
  • Doctor of Medicine
  • Board Certified Plastic Surgeon, Japan Medical Association
  • Adjunct Lecturer, Department of Plastic and Reconstructive Surgery, Showa University
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We are committed to responsible cosmetic medicine and strive to recommend treatments tailored to each patient with sincerity and dedication.
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    • Bifid surgery / Bifid incision (upper eyelid sagging excision)
    • Bifocal Surgery / Blepharoplasty
    • Bifidus surgery/revision of other hospital's treatment
    • Correction after mongolian fold formation and craniotomy
    • Brow lift (upper brow incision) and eyelift (lower brow incision)
    • craniotomy
    • Eye incision and suspension eye correction
    • glamorous line formation
    • Lower eyelid sagging excision (hamula method)
    • Lower eyelid blepharoplasty
    • Upper eyelid hollow
    • Lower eyelid inverted eyelash surgery
    • Tear pouch formation
    • Under-eye dark circles treatment

    - nose

    • rhinoplasty
    • rhinoplasty
    • rhinoplasty
    • auricular cartilage graft
    • rhinoplasty
    • Nasal bone osteotomy widening
    • nasal septum extension
    • hump osteotomy
    • osteotomy for correcting an oblique nose
    • rhinoplasty
    • rhinotomy
    • Nasal wing base (laugh lines)
    • foreign-body removal
    • reduction left ventriculoplasty

    - ear

    • standing ear
    • Judo ear
    • Eustachian cleft/piercing hole
    • reduction of an earlobe

    - mouth (of a bottle)

    • lip reduction
    • lip enlargement
    • raising one's tone of voice (in response to a request for help)
    • Gummy smile surgery (auricular cartilage graft)
  • - all

    • Mastoid augmentation (chin augmentation)
    • Mastoid augmentation (chin augmentation)
    • mandibular mussel osteotomy
    • Mandible gill osteotomy
    • Zygomatic osteotomy
    • liposuction
    • Facial Fat Injection
    • Bacal Fat Removal
    • facelift
    • frontal lift
    • thread-lift
  • - all

    • breast augmentation
    • breast augmentation
    • breast augmentation
    • breast augmentation
    • sunken nipple
    • nipple reduction
    • areola reduction
    • Breast Lifting / Breast Reduction
    • side line
    • gynecomastia
  • - all

    - Liposuction / Laxity resection

    • liposuction
    • Abdominal Reduction
    • hip enhancement surgery

    - female genitalia

    • Labia minora and labia majora reduction
    • vaginal reduction
  • - all

    • lipolytic injection
    • rejuran
    • hyaluronic acid injection
    • Baby Collagen
    • pink glow
    • Wrinkle removal injection (botulinum toxin injection)
    • Japan unique process
  • - all

    • medicine taken internally
    • potenza
    • XERF
    • HIFU Therapy
    • R.O. Facial
    • R.O. Facial Spot⁺
    • photofacial
    • ruby fractional
    • picographic fractional
    • picogenesis
    • picot
    • picotoning
    • Tattoo Removal
    • Peeling treatment
    • medical hair removal
    • hydra-gentle
    • ein
    • Dermapen4
    • TrifilPro
    • CO2 Vampire
    • Dermapen4
    • Water light injections (Bella Vita)
    • Water light injection (MP gun)
    • Electroporation (Delmacio)
    • MiraDry (Japanese hair dryer)
    • indiva
    • PRP injection
    • beauty drip
    • Laser treatment of moles, warts, and birthmarks
    • piercing (hole) drilling
  • - all

    • Excision and suture of moles, warts, and birthmarks
    • Treatment for armpit cancer (pruning method)
  • - all

    • Injection of dermal fibroblasts
    • Combination of adipose stem cells and fat injections
    • intravenous drip infusion therapy
  • - all

    • XERF
    • POTENZA
    • Trifill PRO
    • Dermapen4
    • ULTRAFORMERIII
    • DISCOVERY PICO
    • EIEN
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face

eye

  • Upper eyelid sagging excision
  • Bifocal Augmentation / Embedding Method
  • Bifocal incision / Double incision (total incision)
  • Bifid surgery / Bifid incision (upper eyelid sagging excision)
  • Bifocal Surgery / Blepharoplasty
  • Bifidus surgery/revision of other hospital's treatment
  • Correction after mongolian fold formation and craniotomy
  • Brow lift (upper brow incision) and eyelift (lower brow incision)
  • craniotomy
  • Eye incision and suspension eye correction
  • glamorous line formation
  • Lower eyelid sagging excision (hamula method)
  • Lower eyelid blepharoplasty
  • Upper eyelid hollow
  • Lower eyelid inverted eyelash surgery
  • Tear pouch formation
  • Under-eye dark circles treatment

nose

  • rhinoplasty
  • rhinoplasty
  • rhinoplasty
  • auricular cartilage graft
  • rhinoplasty
  • Nasal bone osteotomy widening
  • nasal septum extension
  • hump osteotomy
  • osteotomy for correcting an oblique nose
  • rhinoplasty
  • rhinotomy
  • Nasal wing base (laugh lines)
  • foreign-body removal
  • reduction left ventriculoplasty

ear

  • standing ear
  • Judo ear
  • Eustachian cleft/piercing hole
  • reduction of an earlobe

mouth

  • lip reduction
  • lip enlargement
  • raising one's tone of voice (in response to a request for help)
  • Gummy smile surgery (auricular cartilage graft)
face line / contour
  • Mastoid augmentation (chin augmentation)
  • Mastoid augmentation (chin augmentation)
  • mandibular mussel osteotomy
  • Mandible gill osteotomy
  • Zygomatic osteotomy
  • liposuction
  • Facial Fat Injection
  • Bacal Fat Removal
  • facelift
  • frontal lift
  • thread-lift
breast
  • breast augmentation
  • breast augmentation
  • breast augmentation
  • breast augmentation
  • sunken nipple
  • nipple reduction
  • areola reduction
  • Breast Lifting / Breast Reduction
  • side line
  • gynecomastia
body / Body & Others

Liposuction and sagging excision

  • liposuction
  • Abdominal Reduction
  • hip enhancement surgery

female genitalia

  • Labia minora and labia majora reduction
  • vaginal reduction
Injection / Injection Therapy
  • lipolytic injection
  • rejuran
  • hyaluronic acid injection
  • Baby Collagen
  • pink glow
  • Wrinkle removal injection (botulinum toxin injection)
  • Japan unique process
skin care / cosmetic dermatology
  • medicine taken internally
  • potenza
  • XERF
  • HIFU Therapy
  • R.O. Facial
  • R.O. Facial Spot⁺
  • photofacial
  • ruby fractional
  • picographic fractional
  • picogenesis
  • picot
  • picotoning
  • Tattoo Removal
  • Peeling treatment
  • medical hair removal
  • hydra-gentle
  • ein
  • Dermapen4
  • TrifilPro
  • CO2 Vampire
  • Dermapen4
  • Water light injections (Bella Vita)
  • Water light injection (MP gun)
  • Electroporation (Delmacio)
  • MiraDry (Japanese hair dryer)
  • indiva
  • PRP injection
  • beauty drip
  • Laser treatment of moles, warts, and birthmarks
  • piercing (hole) drilling
plastic surgery
  • Excision and suture of moles, warts, and birthmarks
  • Treatment for armpit cancer (pruning method)
regenerative medicine
  • Injection of dermal fibroblasts
  • Combination of adipose stem cells and fat injections
  • intravenous drip infusion therapy
machine / medical equipment
  • XERF
  • POTENZA
  • Trifill PRO
  • Dermapen4
  • ULTRAFORMERIII
  • DISCOVERY PICO
  • EIEN
  • BellaVita
  • HydraGentle
  • Thunder -Thunder MT
  • miraDry
  • DERMATION -DERMACIO
  • StellaM22
  • MP GUN
  • INDIBA
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