Blepharoplasty (Eyelid Surgery) in Paris
In short: Blepharoplasty, or eyelid surgery, removes excess skin and fat from the upper lids, the lower lids or all four. On the upper lids, Dr David Ganon also treats the hollow above the lid, usually with fat grafting. The operation lasts 30 minutes to 2 hours, usually as an outpatient. Fees: €2,500 upper, €2,800 lower, €4,000 for all four lids.
WHAT EYELID SURGERY CORRECTS
Blepharoplasty, also called eyelid surgery or an eyelid lift, is surgery of the eyelids. It aims to replace a tired look with a more rested one, while preserving the essential functions of the lids. It can involve the two upper lids, the two lower lids or all four, alone or combined with another facial procedure, in men as well as women.
It corrects three frequent problems:
• Heavy, drooping upper lids, with a fold of excess skin.
• Sagging lower lids, with fine horizontal wrinkles caused by stretched skin.
• Fat herniation, responsible for bags under the eyes or puffy upper lids.
A heavy upper lid is not always excess skin. A brow that has descended, or ptosis — a drooping of the lid margin itself, because the muscle that lifts it has weakened — gives the same impression but calls for a different treatment. Telling these situations apart is the first purpose of the consultation, and Dr Ganon may advise against surgery when another approach is better suited.
Blepharoplasty is often performed from the age of 40 to 50, but can be done much earlier when the problem is constitutional rather than age-related, as with some hereditary fat bags. There is no upper age limit: general health and the eye examination decide.
UPPER BLEPHAROPLASTY: SKIN, FAT AND VOLUME
For the upper lids, Dr David Ganon takes three elements into account:
• The excess skin (dermatochalasis), removed as a fine ellipse.
• The inner fat pad, at the inner corner of the eye, which is removed.
• The hollow above the lid, usually filled with facial fat grafting.
The reason is simple: an aging look is not just a loosened lid, it is also a loss of volume. That is why he takes into account all the elements that age the eyes, not the skin alone.
The incision lies in the natural crease, halfway up the lid, between its mobile and fixed parts. With the eye open, it disappears into the fold; with the eye closed, it blends into it.
LOWER BLEPHAROPLASTY: TWO APPROACHES
On the lower lids, the approach depends on what the examination finds:
• Fat bags without excess skin: transconjunctival approach, through an incision inside the eyelid, with no incision on the skin.
• Marked excess skin: subciliary approach, through an incision 1 to 2 mm below the lashes, sometimes extended slightly outward, where it is concealed.
If the lower lid itself is lax, the outer corner of the eye can be refixed (canthopexy). When a bag and a hollow coexist, the bag is usually treated first, and fat grafting is often added in the same operation to fill the hollow.
Conversely, an isolated hollow under the eye, with no bag and no excess skin, is not a case for surgery but for injections. No cream or injection removes a true fat bag: hyaluronic acid fills a hollow, and injected under a large bag it would make it more visible.
ANESTHESIA, DURATION AND RECOVERY DAY BY DAY
Three types of anesthesia are possible: local anesthesia alone, local anesthesia deepened with intravenous sedation, or general anesthesia, mainly when another procedure is combined. The choice is made with you. The operation lasts 30 minutes to 2 hours, depending on the number of lids and any combined procedure, at Clinique Alphand (Paris 16th) or Clinique Monceau (Paris 17th).
You usually go home the same day; a night in the clinic remains possible if you prefer, or if another procedure is combined. The usual course is as follows:
• Days 1 to 4: swelling, bruising and watery eyes, with no real pain, rather a feeling of tightness, mild irritation or temporarily blurred vision. Rest as much as possible and avoid any strenuous effort.
• Day 5: removal of the very fine, non-absorbable stitches.
• Day 7: makeup on the scars is usually allowed; the exact timing is confirmed at the follow-up visit.
• Days 6 to 20: return to social and professional life, depending on the residual swelling and your activity.
• Months 3 to 6: the result can truly be assessed, once the tissues have regained their suppleness.
Before surgery, avoid aspirin, anti-inflammatory and anticoagulant medication for five days, and fast for six hours if you have general anesthesia or sedation. Smoking, e-cigarettes included, must stop at least one month before surgery and until one month after healing, which is reached around the second week.
SCARS, RESULTS AND RISKS
The scars lie in natural folds. They stay pink for a few weeks, then fade. Small white cysts called milia may appear along them; they are harmless and removed during a follow-up visit with a simple puncture. What really matters for their quality is stopping smoking, protecting them from the sun and following the post-operative instructions.
The result of blepharoplasty is among the most durable in aesthetic surgery. Once removed, fat bags usually do not recur, and a new operation on the upper lids is rarely considered within about twenty years. The goal is a real improvement, based on realistic expectations.
Complications are rare but must be known: hematoma; infection, which is exceptional; dry eye; incomplete closure of the upper lid in the first days, which resolves on its own; or a slight downward pull of the lower lid, the “round eye”, which usually settles after a few weeks of massage. Exceptional cases of double vision, glaucoma and loss of vision have been reported in the international literature.
A minor flaw that persists, such as a slight asymmetry, can be revised from the sixth month, usually under local anesthesia.
FEES, INSURANCE AND THE COOLING-OFF PERIOD
At Dr Ganon's practice in Paris 8th:
• Upper blepharoplasty (both upper lids): €2,500.
• Lower blepharoplasty (both lower lids): €2,800.
• Blepharoplasty of all four lids: €4,000.
These fees are all-inclusive: the surgeon's fees, the clinic fees and the anesthesiologist's fees when one is needed, which is always the case under general anesthesia. Operating on all four lids in one session costs less than two separate operations, because anesthesia, operating room time and recovery are shared. When another procedure is combined, the detailed quote covers the whole. The first consultation costs €100; follow-up visits are not charged.
Blepharoplasty performed for aesthetic reasons is not covered by French health insurance. It can be covered when it corrects a demonstrated functional problem, such as upper-lid skin that reduces the upper field of vision, or ptosis, after prior approval from the insurer based on a visual field test by an ophthalmologist and photographs (conditions explained in French). Lower-lid surgery is covered in exceptional cases, as bags do not impair vision.
As for any aesthetic surgery in France, the detailed quote is followed by a cooling-off period of at least 15 days before the operation, during which no deposit may be requested. If you are coming from abroad, see planning your stay in Paris.
FURTHER READING
In English: English-speaking plastic surgeon in Paris (consultations, fees and travel planning), facial fat grafting, facelift and neck lift: the G-Lift, which can be combined with eyelid surgery, and Quantum radiofrequency neck lift.
French version: Blépharoplastie à Paris 8e. To book a consultation in English, use the appointment page or call +33 7 83 79 83 71.
FREQUENTLY ASKED QUESTIONS ABOUT BLEPHAROPLASTY
How much does eyelid surgery cost in Paris?
At Dr David Ganon's practice in Paris 8th, upper blepharoplasty costs €2,500, lower blepharoplasty €2,800 and all four lids €4,000. These all-inclusive fees cover the surgeon, the clinic and, when one is needed, the anesthesiologist; the exact amount appears on the detailed quote.
Is blepharoplasty painful?
There is no real pain afterward. The first days bring swelling, bruising and watery eyes, with a feeling of tightness, mild irritation or temporarily blurred vision; these effects settle in about ten days.
How long is the recovery after eyelid surgery?
Most people return to social and professional life within 6 to 20 days, depending on the number of lids operated, individual swelling and the type of work. Stitches come out on day 5, and makeup on the scars is usually allowed from day 7.
Will the scars be visible?
They are placed in natural folds: the crease of the upper lid, and 1 to 2 mm below the lashes when lower-lid skin must be removed. When a lower-lid bag comes without excess skin, the transconjunctival approach avoids any skin incision. The scars stay pink for a few weeks, then fade between the third and sixth month.
Can under-eye bags be removed without surgery?
Not when they are true fat bags: no cream or injection removes herniated fat. Hyaluronic acid can fill a hollow under the eye, but it does not remove a bag.
Is blepharoplasty covered by insurance in France?
Not when it is done for aesthetic reasons. It can be covered when it corrects a demonstrated functional problem, such as upper-lid skin that reduces the field of vision, or ptosis, after prior approval from the French health insurance.
How long do the results of blepharoplasty last?
They are among the most durable in aesthetic surgery. Removed fat bags usually do not recur, and a new upper-lid operation is rarely considered within about twenty years.
Can I have eyelid surgery during a short stay in Paris?
French law requires at least 15 days between the written quote and the operation, so plan an in-person consultation well ahead. After surgery, plan your stay around the first follow-up visits, including the removal of stitches on day 5.