Facelift or Blepharoplasty: Which Surgery Matches the Changes You See in the Mirror?

A face can appear more tired or older for very different reasons. In some people, the change is concentrated around the eyes: heavier upper eyelids, bags beneath the eyes or an expression that seems persistently tired. In others, the main changes involve the facial contour, jowls and laxity through the lower face.

These situations do not necessarily call for the same operation.

Blepharoplasty targets the eyelids. A facelift acts more on tissues that have become lax in the lower face and, depending on the approach, certain components of the neck.

Understanding this difference helps prevent someone from choosing a procedure simply because it is associated with “facial rejuvenation.”

When the change comes mainly from the eyelids

Over time, upper-eyelid skin may become looser and form a larger fold. In some people, this change is primarily cosmetic. In others, pronounced excess skin can also become a functional concern.

The lower eyelids age differently. Bags may become more visible as orbital fat projects farther forward, while the skin and supporting structures also change.

Blepharoplasty is intended to address these localized changes.

It does not, however, lift jowls or directly redefine a jawline that has become less distinct.

When the concern is lower in the face

A facelift addresses a different type of change.

Over the years, facial tissues can gradually descend. The transition between the cheeks and jaw becomes less distinct, jowls may develop and the facial contour can lose some of its definition.

In this situation, removing skin around the eyes does not address the main cause of the ageing appearance.

A facelift instead seeks to reposition facial tissues and improve contours affected by laxity.

Why does one procedure not necessarily correct everything?

Facial ageing does not occur uniformly.

One person may have relatively youthful eyelids together with pronounced lower-face laxity. Another may retain a well-defined jawline while under-eye bags create a persistently tired appearance.

Some people have both concerns.

In the latter situation, combining procedures may sometimes be discussed, but this does not mean combined treatment is routinely necessary.

Surgery should correspond to the structures that are actually creating the change.

A tired appearance: avoid drawing conclusions too quickly

“I always look tired” is a common statement among people considering eyelid surgery.

Several features can contribute to this impression, including brow position, hollows beneath the eyes, prominent fat pads, skin quality and the face’s natural anatomy.

Blepharoplasty may be relevant when the eyelids are an important part of the concern, but it does not correct every possible cause of a tired appearance.

This nuance is important for establishing realistic expectations.

What if the neck is also loose?

A changing jawline is sometimes accompanied by changes in the neck.

The skin, submental fat and platysma muscle can all contribute to the neck contour. Treatment therefore depends on what is actually causing the loss of definition.

In some patients, the lower face and neck need to be considered together rather than as two independent regions.

Choosing surgery based on anatomy, not age

There is no universal age for blepharoplasty or facelift surgery.

Genetics play an important role. Under-eye bags can be present relatively early, while another person may not develop lower-face laxity until much later.

The objective is to identify the structure responsible for the change rather than choose an operation because it is associated with a particular age group.

Facial surgery in Longueuil and on Montréal’s South Shore

Dr Alain Gagnon sees patients from Longueuil, Brossard, Saint-Lambert, Boucherville, Saint-Bruno-de-Montarville and communities across Montréal’s South Shore who wish to discuss eyelid surgery or facelift surgery.

An assessment of the eyes, eyelids, facial contour, jawline and neck can determine which region is contributing most to the changes observed.