Our eyes are the first and most important tool we use daily to express ourselves. However, due to aging and/or heredity, our eyes can sometimes deceive those around us. Extra eyelid skin, bags under our eyes, and even puffiness around the eyes can prompt others to think we are sad, angry, or tired, when in fact, we feel quite the opposite! Eyelid surgery can do wonders for restoring the youthful, rested look to your entire face.

There are two basic types of eyelid surgery: upper lid blepharoplasty and lower lid blepharoplasty. An upper blepharoplasty is used to correct drooping upper eyelids that may be affecting a patient’s vision and/or facial expressions, while a lower lid blepharoplasty is primarily used to address undereye bags and pockets of fat beneath the eyes. These can be performed combined or as singular procedures.

Upper Lid Blepharoplasty

This procedure is used to remove fat deposits, as well as loose and drooping skin that may form around the upper eyelids with age. Heredity, smoking, swelling from allergies, and sun damage can accelerate these changes. Younger people may also elect to have this procedure done to eliminate puffiness of the eyes from congenital excess fatty tissue.

Upper lid blepharoplasty can improve two common areas:

  1. Excess skin on the upper eyelid (often referred to as “hooding of the upper lid”)
  2. Puffiness in the inner corner and middle of the upper eyelid caused by herniation (pushing forward) of fat

This procedure is frequently done at the same time as other procedures, such as a lower eyelid blepharoplasty, facelift, or forehead lift. When drooping of the upper lids interferes with your vision, the procedure may sometimes be partially or fully covered by insurance.

Lower Lid Blepharoplasty

Eye bags under our eyes or puffy eyes occur to almost everyone at some point in their lives, but when they become a chronic problem, they can be more than just a temporary annoyance.

When skin loses elasticity, and fat starts to press against the thinning skin of the lower lids, it may be a good time to consider a lower lid blepharoplasty consult.


Ptosis is another type of droopy eyelid in which the upper eyelid falls to a position that is lower than normal to the extent that it covers the pupil. It can affect one or both eyes and affects all races as well as men and women equally. Ptosis may be present at birth, or acquired later in life. As we age, the muscles that hold up our eyelids weaken or loosen and can cause our eyelids to droop. This can result in a tired, sleepy appearance and can reduce peripheral vision. Some individuals experience brow or forehead aches and fatigue at the end of the day from constantly raising their brows to see.

Surgical repair of ptosis helps improve vision and provides a more vibrant appearance. There are various surgical approaches to address ptosis including external approach and an internal approach. Ptosis surgery is very delicate and requires a thorough understanding of the anatomy and function of the muscle.

Cosmetic Wrinkle Prevention

Our office also offers Botox and Dysport with Dr. Sean Paul of Austin Oculoplastics. Botox and Dysport are neurotoxins used to treat muscle stiffness, muscle spasms, prevent chronic migraine headaches, and most commonly to improve the appearance of wrinkles on the face. Medical uses for Botox include treatment of migraine headaches, excessive sweating, muscle spasms, eyelid twitching, and Bell’s Palsy patients, among others. Dr. Paul also offers fillers such as Restylane, Juvederm, and Belotero as another option to help reduce the appearance of wrinkles.

If you feel it’s time to consider any of the above, call our office to learn how we can help!

Schedule an Eye Evaluation

New Braunfels Vision Clinic is your local solution for oculoplastics. Schedule an eye examination today.