Blepharoplasty Eyelid Surgery vs. Injectable Fillers

Blepharoplasty, commonly referred to as eyelid surgery or “upper blepharoplasty”, is a traditional approach to fix eyelid problems such as droopy eyelids, puffy eyes, and bags under the eyes. 

Blepharoplasty has been on the rise due to patients wanting a way to improve their appearance. This is a surgical approach rather than using an injectable filler to fix under eye bags. It provides a long term solution for a patient looking to improve or rejuvenate the appearance of their eyelids. 

Surgical Blepharoplasty Techniques for Optimal Results 

Surgical blepharoplasty is where a surgical incision is made around the natural structure of the eyelids to fix any problems that the patient may have with their eyes. 

This type of treatment is ideal for a patient who has dealt with under eye bags for a longer period of time because the problem will return for a second time if they get filled.

Fillers are great, but eventually the cost becomes a factor, and as we age, there comes a time where you simply have to consider a surgical solution. Consider these things:

1. Longevity of Results: Blepharoplasty has the advantage of achieving long-lasting or permanent results. 

While injectable fillers typically last several months to a few years, this type of eye surgery delivers corrective benefits to droopy eyelids and under eye bags for many years to come.

By removing excess skin and fatty tissue, it corrects the root causes of these problems– something topical creams and serums can’t achieve. By correcting the fundamental tissue, bleph is less of a “quick fix” than an enduring natural improvement.

2. Comprehensive Correction: At times injectable fillers are an effective option in helping with lack of volume on the lower eyelids, dark circles under the eyes, hollow areas or some wrinkling. Makeup will smooth over all of those areas. Injectable fillers will not however improve the deep wrinkles directly under the eyelashes or the jowl look we get as our skin sags. A blepharoplasty procedure will correct all of these concerns naturally (if well done). 

When performed by Dr. Ben Cilento, at Cilento Facial Plastics in Spring, Texas, this procedure also usually includes lifting of the cheek complex in a mid-face lift, which creates a more youthful appearance.

3. Achieving Natural Looking Results: In the hands of a skilled facial plastic surgeon like Dr. Ben Cilento, a blepharoplasty can provide natural looking results by enhancing the eyes in a way that looks younger but not overdone. By custom tailoring a surgical plan to the unique anatomy of each patient and the aesthetic goals of each individual, this procedure can create a more youthful and refreshed look that blends with the rest of the patient’s facial features.

4. Increased Confidence: The psychological improvements a person can experience from eyelid surgery can go far beyond the physical changes. If you had eyelid surgery in order to correct any issues you’ve had with your older eyes you may find yourself not only looking a lot younger, but also feeling a lot younger. Most people find such level of satisfaction in this because they tend to look as young as they possibly can leading to a better self esteem and an overall better level of confidence in their daily life.

There are also functional (non-cosmetic) benefits to blepharoplasty. Some people have heavy upper lids that cause them to lose their peripheral (outside) vision. These people sometimes lift their foreheads or eyebrows to lift the lid to regain their peripheral vision.

By lifting the lid surgically, blepharoplasty can better your peripheral vision, ‘eye strain’ and make your eyes more comfortable. Eye fatigue is a big complaint we hear from our patients and it can be greatly improved or cured with blepharoplasty.

While dermal fillers have advantages of their own, blepharoplasty is clearly the best answer for most signs of aging when it comes to the eyes. Fillers can help early on but eventually the volume loss and structural aging become too great to compensate with just filler.


blonde woman smiling at the camera after receiving blepharoplasty eyelid surgery.
Cafe owner smiling at the camera at the cafe

Injectable Fillers

Filler advantages can be done without surgery, it’s good for low-hanging bags and fine, crinkling lines. Most fillers are made of a substance your body already makes, hyaluronic acid. It’s a sugar molecule, already in your skin, that holds in water. If it is put in the right place, it looks natural and can hold in water for several months. It will cost a few hundred dollars and you’ll need touch-ups.

Injectable soft-tissue fillers such as Restylane, Juvederm and Radiesse can be used for treating volume loss in the lower eyelid area. These fillers have a temporary effect, can in most cases be dissolved if the patient desires or may be trying the effect before committing to a more permanent surgical solution.

You have many choices of products and providers with injectable fillers, and many ways they can be used to address various areas and issues you may be experiencing. Some fillers are intended to be used in the spaces between the muscles of facial expression, and others are intended to be used in deeper facial muscles that are always there and constantly working.

The injectable fillers commonly used today consist of hyaluronic acid that has been modified to last longer. Respira Medical can help you in selecting the right filler for you, but there are many that will work just fine.

We are primarily using fillers with hyaluronic acid in them due to their safety, but this is not important to all providers. We will use only one filler, Sculptra, to help define and enlarge the chin. There are many options available, and Dr. Whaley can discuss the limitations and benefits of different fillers and their cost with you.

Minimal Risk and Recovery

Only a series of injections as opposed to surgery means less risk and less recovery period involved. However, it is possible to get an allergic reaction from receiving lip injections or have a negative reaction to the filler itself. Like fillers, only a few cases you will need to remain indoors for a week before going out. Most people carry on with their daily routines as soon as the procedure is completed. So this procedure attracts those with busy or limited downtime lifestyles.

Surgical Correction With Blepharoplasty

There are certain indications that may signal the need for surgical correction with blepharoplasty. Although fillers can be a great solution to temporarily improve the under-eye area, they will not be the long-term result that you are wanting to achieve.

  1. Loose, sagging or hanging skin: Some patients have too much loose upper and or lower eyelid skin, that may need to be removed surgically. The same as with fillers, surgery of this type should only be performed by an experienced eyelid surgeon, who can advise on which technique if needed, is more applicable. This treatment would be the most long lasting of all treatment modalities.
  2. Fat Prolapse: Fat repositioning or removal may be necessary in individuals with prominent fat pads or under-eye bags due to the herniation of orbital fat. Blepharoplasty can reshape the lower eyelids and correct the under-eye hallows to produce a smooth contour across the lower eyelid and cheek junction for a more youthful look.
  3. Drooping of the Eyelids, eyelid ptosis: weakened muscles of the eyes may cause the eyelids to droop and may require surgery to reposition and function the eyelid correctly. Blepharoplasty may be combined with ptosis repair to correct both medical problems and cosmetic concerns associated with eyelids droopiness.
  4. Results That Are Long-Lasting: For the person looking to get rid of their aging eyelids and under-eye bags, blepharoplasty is more likely to be a better option compared the injectable fillers. Filler syringes for the eyelids are good quick-fix solution; but ultimately the results are temporary. Blepharoplasty offers permanent results that does not require frequent maintenance or touch-up treatments.

Eyelid surgery is extremely effective and easy to recover from. If you have concerns about eye aging and you’re using fillers already, come see Dr. Ben Cilento for a consultation. Call us at: 346-413-9313