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In many cases, the first signs of aging will appear around the eyes. As the skin around the eyes is extremely thin and fragile compared to other parts of the body, it’s more susceptible to developing wrinkles, becoming loose and sagging and sometimes puffy, which can make individuals appear tired or older than their actual age.

Eyelid surgery is an excellent way to address droopy or tired eyes, leading to a more youthful and rested appearance. Dr. Leo Lapuerta performs various eyelid surgery techniques and will use the one that best meets each patient’s aesthetic goals. With over 20 years of experience, Dr. Lapuerta has performed multiple eyelid surgeries in his facilities throughout the greater Houston area, including Houston, Pearland, and Katy, TX.

  • Review from M. B.
  • Source: Google
  • May 13, 2019
Dr. Lapuerta and his incredible staff always make me feel as if I'm the only patient in the world every time I step through their door. The care I've received is second to none, and I'm thrilled to recommend them.


Eyelid surgery (blepharoplasty) improves the appearance of the eyes by addressing the skin around the eye. During eyelid surgery, excess tissue around the eye region is removed. Although some patients may decide to have the procedure done on only the upper or lower eyelids, most patients prefer having the procedure performed on both eyelids at the same time. Incisions are made below the eyelashes for the lower eyelids, and in the crease for the upper eyelids. Regardless of whether lower or upper eyelid surgery is performed, the incision will be strategically made to minimize scarring.


People who have drooping or heavy eyelids, and puffy bags under their eyes, are generally the best candidates for this procedure. Potential patients must also be in good overall health and have realistic expectations for the expected outcome of the procedure. During a consultation, Dr. Lapuerta will fully describe what to expect before, during, and after surgery. This will help patients go into the procedure with an informed and complete understanding of exactly what the procedure will consist of, as well as crucial details regarding the recovery process.


The surgical technique will vary depending on whether the patient opts for upper eyelid surgery, lower eyelid surgery, or double eyelid surgery.


During upper eyelid surgery, an incision is made within the natural fold of the lid and extended outward. The incision will go out as wide as can be so that additional skin folds on the outside of the upper eye can also be addressed. Once the incision is made, excess skin, tissue and, in some cases, a small portion of the orbicularis oculi muscle (the muscle responsible for closing your eyelids) are removed. The incision is closed and generally heals well and is well hidden because of where it resides in the natural crease of the upper lid.


During lower eyelid surgery, an incision is made along the bottom of the lash line. This allows the surgeon to remove excess fat and tissue. In patients who have puffy lower eyelids but good skin tone, an approach known as a transconjunctival blepharoplasty can be performed. This technique puts the incision inside the lower eyelid rather than outside. Patients who have dark circles under their eyes will sometimes have a deficiency of fat in these areas. Injectables can be used to help fill these soft-tissue deficiencies and can improve the appearance of these circles.


Double eyelid surgery, also known as East Asian blepharoplasty, is the best option for patients who want to give their eyes a larger appearance. Double eyelid surgery creates an additional fold of skin above the upper eyelashes, reshaping the eyes to make them appear larger in size.


Eyelid surgery can be performed under sedation with local anesthesia, deep sedation with local anesthesia or performed under general anesthesia with local anesthesia.  The choice of anesthesia technique depends primarily on the patient’s medical history and patient preference. When given the option, most patients elect to have a deep sedation or general anesthesia.  Regardless of the method, patient’s will be kept comfortable and safe. Deeper sedation allows for the possibility that patients may hear or sense things that are going on during the surgery whereas with general anesthesia, patients will be completely asleep and unaware. 

The surgery is an outpatient procedure that must take place in an accredited surgical facility. Patients usually elect to have eyelid surgery performed at Dr. Lapuerta’s on-site AAAASF accredited outpatient surgical facility. For upper or lower eyelid surgery only, it generally takes about 60-90 minutes.  If patient’s elect to have both upper and lower eyelids addressed, surgery typically lasts about 2 hours. Many patients also elect to have Botox, facial fillers or fat injections done at the same time as eyelid surgery.


Recovery from surgery is generally a quick process with very little discomfort. Immediately following surgery, the area around the eyes will be bruised and swollen. Dr. Lapuerta provides special cooling masks for patients to wear in recovery and during the post-operative period at home. Patients generally only experience mild discomfort following eyelid surgery. Sometimes patients initially complain of a stingy sensation in their eyes due to the local anesthesia. This is easily resolved by flushing the eyes with sterile saline eye wash available from a drug store.  Patients may also experience difficulty opening their eyes and complain of blurry vision for the first 23-36 hours due to swelling. To treat this bruising and swelling, patients should apply the special cool eye masks Dr. Lapuerta provides around the clock. Patients are also encouraged to keep their head elevated including while sleeping in a recliner or on several pillows. Patients are usually able to return to work within a few days and can resume exercising around two weeks after the procedure.

Patients comment on the fact that friends and family tell them they look great, but often can’t put a finger on what is different. These subtle, yet dramatic results restore a softer, more youthful appearance.  The effect of eyelid surgery is dramatic in terms of restoring a youthful, rested appearance and yet patients will still look like themselves!


Blepharoplasty cost varies for each patient and will fluctuate depending on whether both the upper and lower eyelids were addressed.  An upper and lower eyelid surgery will range between $4700 and $6800. In some patients where the upper eyelid skin obstructs the view, a portion of the surgery may be covered by medical insurance. We also offer several different financing options for patients.

In order to get an accurate and customized estimate for the cost of surgery, patients need to visit Dr. Lapuerta for an eyelid consultation. During the consultation, Dr. Lapuerta will partner with the patient to determine their eyelid surgery goals and how to best achieve those goals. After a thorough examination and a review of the patient’s medical records, Dr. Lapuerta will decide on a customized eyelid treatment plan and present an updated eyelid surgery cost estimate. To learn more, contact Dr. Lapuerta to request a consultation today.


  • Recovery Time
  • 1-2 Weeks
  • Average Procedure Time
  • 2 Hours
  • Post-op Follow-up
  • 1 Week
  • Procedure Recovery Location
  • Outpatient


After surgery, scarring will not be visible because of where the incisions are placed. In the upper eyelid, the incision follows the natural crease of the eye. The lower eyelid incision will run just under the eyelashes or inside the eyelid. Scarring will be inconspicuous.
Eyelid surgery will reduce puffy bags and excess skin and may help contribute to some minimization of crow’s feet. However, to truly treat crow’s feet, one will need a different approach. BOTOX® injections and procedures such as a browlift, are better options to help eliminate crow’s feet.
Some patients will experience dryness and minimal irritation following surgery. If these occur, we can recommend ointments and eye drops to assist during the healing phase. Patients should protect their eyes against wind and sun irritation for the first several months by wearing dark sunglasses.
If anything, eyelid surgery actually helps improve the vision for many patients. Not only does it restore a fresh, younger look from a cosmetic standpoint, it eliminates the excess skin that may have been impairing vision. It is important to select a skilled surgeon who has expertise with eyelid surgery. We take great care during this surgery so that the eyes themselves are left untouched and unharmed.
Leo Lapuerta Plastic Surgery