Blepharoplasty Isn’t Just Eyelid Surgery Anymore—It’s the Most Popular Cosmetic Procedure Today

If you’ve ever zoomed in on your under-eyes and thought, do I need something done?, Breaking Beauty just handed you the most useful blepharoplasty breakdown on the internet. Hosts Jill Dunn and Carlene Higgins invite oculoplastic surgeon Dr. Babak Maleki—the man behind Higgins’ “newly lifted eyes”—to explain why eyelid surgery has officially overtaken lipo and why it’s a lot more technical than people may think.

From the “hollow eye” effect to Higgins’ own revision surgery, this episode turns a trendy procedure into a realistic guide—what it costs, what can go wrong, and how to choose a surgeon who won’t steal your smolder.

It quietly became the number one cosmetic surgery

A blepharoplasty is a surgery that reshapes the eyelids by removing or repositioning skin and fat—or even adding fat back in. As Dr. Maleki puts it, having one “is going to alter the appearance of the eyelids, and it may involve removal of skin. It may involve removal of fat. It may involve repositioning of fat or adding fat.” Because the eyes are the first place most of us see aging, small changes here create an outsized payoff.

That payoff is exactly why the procedure has skyrocketed. “I feel like this is the poor man’s facelift…I’d love to get a facelift, but I can’t afford one,” Higgins notes. Blepharoplasty typically costs “anywhere from $5000 to $10,000,” while facelifts, Dr. Maleki says, range anywhere from $15 to $150 thousand.

And then there’s the impact. When the skin is lifted and the eyes look more open, people often look dramatically younger without the “I did something” vibe. “You really can look 10 years younger just by having your eyes more open,” Dr. Maleki states. Add in a quick recovery time, and it makes sense why more than 2.1 million eyelid surgeries were done last year.

Those ‘tired eyes’ are actually something else entirely

A lot of people assume their lids look heavy because they’re aging, not sleeping well, or just “don’t look like they used to.” Higgins learned the hard way that sometimes the culprit isn’t extra skin at all—it’s ptosis, a medical issue where the eyelid muscle starts to droop. “Ptosis in the general population between the ages of 18 to about 65 is about 11 percent.…If you look at people over the age of 65, about 30 percent of them have ptosis.” 

Higgins remembers spotting it in photos, then having friends and her mom point it out. After scans and specialist visits, she finally heard the word “ptosis” and learned that long-term contact lens use can trigger it. Dr. Maleki confirms it’s one of the big causes, along with dry eyes or allergies. 

Avoiding the hollow-eye outcome

One of the biggest concerns people have about eyelid surgery is looking “too done” or losing the character in their eyes. Dr. Maleki explains that this hollow, over-opened look usually traces back to older surgical techniques that removed too much fat. “Modern upper blepharoplasty techniques are all about preservation of tissue and not removing excess, too much excess tissue,” he says.

Fat isn’t the enemy—it’s actually what gives the eye its youthful structure. When too much is taken out, the upper lid can look empty, the eye shape can subtly shift, and the results can feel less like an upgrade and more like a departure from your natural expression. 

If someone does end up hollow, there is a path back. “I would probably recommend doing some fat grafting to the upper eyelid…then reshape the eyelids,” Dr. Maleki explains. It’s a complex revision, but it’s possible when the surgeon specializes in this anatomy.

The revision question you should always ask your surgeon

While Higgins’ surgery corrected both the excess skin and most of the ptosis, once the swelling fully settled, her “sleepy” eye still sat a touch lower. Not dramatically—just enough that she kept noticing it.

Dr. Maleki walked her through the reality of ptosis repair. “There may be some variability in terms of how people heal and the outcome varies.” When the lid position didn’t land exactly where they hoped, they didn’t rush into anything. They waited, measured, talked it through, and eventually agreed a small secondary adjustment would give her the symmetry she wanted. She’s thrilled she did it.

But here’s the part everyone should pay attention to. Dr. Maleki says, “If you’re going to undergo any type of cosmetic or plastic surgery, one of the questions that you should ask your surgeon is that should things not go as planned, are you able to do your own revision surgery?”

A surgeon who can handle their own revisions is a surgeon who truly knows the anatomy, understands the range of healing outcomes, and stays accountable for their work. That’s the person you want operating on your eyes.

For the full conversation, listen to Breaking Beauty wherever you get your podcasts.

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