Upper blepharoplasty costs an average of $3,359 in surgeon fees, while lower blepharoplasty averages $3,876, according to the American Society of Plastic Surgeons. Those figures cover only the surgeon’s fee. Once you add anesthesia, the operating facility, and other expenses, the total out-of-pocket cost for both procedures together typically falls between $10,000 and $15,000 or more depending on where you live and who performs the surgery.
What the Average Fees Actually Include
The national averages of $3,359 (upper) and $3,876 (lower) reflect what the surgeon charges for the procedure itself. They don’t include several other line items that show up on your final bill:
- Anesthesia fees: Usually $500 to $1,500 depending on whether you receive local sedation or general anesthesia. Upper-only procedures often use local anesthesia with sedation, which costs less.
- Operating room or facility fees: Ranges from $500 to $2,000+, depending on whether the surgery takes place in an office-based suite, an ambulatory surgery center, or a hospital.
- Pre-surgical testing: Lab work, medical clearance, and (if you’re seeking insurance coverage) visual field testing.
- Post-operative costs: Prescription medications, follow-up appointments, and occasionally special eye drops or cold compresses.
When you combine upper and lower eyelid surgery into a single session, you pay one anesthesia fee and one facility fee instead of two. That shared overhead is where most of the savings come from. Surgeons may also reduce their combined fee slightly, though this varies by practice. A reasonable expectation for a combined procedure is a total cost somewhere between $10,000 and $15,000, with significant variation based on geography and surgeon experience.
Why Costs Vary So Much by Location
A plastic surgeon in Manhattan or Beverly Hills may charge double what a surgeon in a mid-sized Southern city charges for the same procedure. This isn’t purely a prestige markup. Office rent, staff salaries, malpractice insurance, and facility costs all scale with local cost of living. Metropolitan areas on the coasts consistently sit at the high end of the range, while practices in the Midwest and Southeast tend to fall below the national average.
Surgeon experience also plays a role. Oculoplastic surgeons, who specialize exclusively in procedures around the eyes, often charge more than general plastic surgeons. The tradeoff is a narrower specialty focus, which some patients prefer for a delicate area like the eyelids.
When Insurance Might Cover Part of the Cost
Cosmetic blepharoplasty is never covered by insurance, but upper eyelid surgery sometimes qualifies as medically necessary. The key distinction is whether drooping skin on your upper lids blocks your vision enough to interfere with daily activities like reading or driving.
To qualify, you’ll need a visual field test performed by an optometrist or ophthalmologist. The test measures your peripheral vision with and without the excess skin taped up out of the way. If your visual field improves meaningfully when the skin is lifted, that documents a functional impairment, and most insurers will consider coverage. You’ll still likely owe a copay, deductible, and any portion your plan doesn’t cover, but the out-of-pocket cost drops substantially compared to paying the full price yourself.
Lower blepharoplasty is almost always considered cosmetic, so insurance coverage for the lower lids is rare. If you’re having a medically necessary upper procedure and adding a cosmetic lower procedure at the same time, the insurer typically covers only the upper portion. You’d pay for the lower lid work, the cosmetic share of anesthesia, and any additional facility time out of pocket.
Upper vs. Lower: Why the Price Differs
Lower blepharoplasty costs more because it’s a more complex procedure. Upper eyelid surgery primarily involves removing or repositioning excess skin, which is relatively straightforward. Lower eyelid surgery often requires addressing fat pads that cause under-eye bags, and the surgeon may need to reposition or redistribute that fat rather than simply remove it. Some lower lid techniques also involve tightening the lower lid to prevent it from pulling downward after surgery, adding time and technical difficulty.
The recovery timeline reflects this complexity. Upper blepharoplasty patients typically see bruising and swelling resolve within 7 to 10 days, while lower blepharoplasty recovery often takes closer to two weeks before the area looks presentable, and subtle swelling can linger for several months.
Revision Surgery Costs More
If results from a first procedure are unsatisfactory, or if aging eventually creates new drooping years later, revision blepharoplasty is an option. Revision surgery generally costs more than a primary procedure because the surgeon is working with scar tissue and altered anatomy, which demands more precision and operating time. Not all surgeons perform revisions, so you may need to consult an oculoplastic specialist, which can also increase the fee.
Some surgeons offer a reduced revision fee if they performed the original surgery, particularly if the revision is needed within the first year. This is worth asking about during your initial consultation.
How to Compare Quotes
When you request pricing from a surgeon’s office, ask for an “all-in” estimate that includes the surgeon fee, anesthesia, facility costs, and any anticipated follow-up visits. Some practices quote only the surgeon fee upfront, which makes their number look lower but doesn’t reflect what you’ll actually pay. Getting itemized quotes from two or three board-certified surgeons in your area gives you the clearest picture of local market rates.
Most practices offer financing through third-party medical credit companies, with plans ranging from zero-interest promotional periods to longer-term loans. If you’re combining upper and lower procedures to save on shared costs, financing can spread out the larger single payment. Just be sure to read the terms carefully, since deferred-interest plans can charge retroactive interest if you don’t pay the balance before the promotional period ends.