Upper Blepharoplasty vs. Lower Blepharoplasty: How to Know Which Eyelid Surgery You Need in Nashville
Posted June 17, 2026 in Blepharoplasty (Eyelid Surgery)
If you have been researching upper blepharoplasty in Nashville or weighing lower blepharoplasty vs upper eyelid surgery, you already know the eyes are one of the first areas where aging becomes visible. Choosing the right eyelid surgery option begins with understanding what each procedure addresses and which one aligns with your specific concerns. At Gilpin Facial Plastics and Aesthetics, Dr. David Gilpin brings dual board certification and subspecialty-focused expertise to every consultation, helping patients arrive at decisions grounded in anatomy, not guesswork. Request a consultation to begin the conversation.
What Is Upper Blepharoplasty?
Upper blepharoplasty addresses the upper eyelid, where excess skin, redundant tissue, and weakened muscle can accumulate with age. For patients dealing with hooded eyelid surgery concerns, the upper lid is typically the primary focus. When the upper lid skin folds down over the lash line, it can create a heavy or tired appearance and, in more pronounced cases, may affect peripheral vision.
During upper blepharoplasty, Dr. Gilpin removes carefully measured amounts of skin and, when indicated, a small portion of the orbicularis muscle and herniated fat. Incisions are placed within the natural eyelid crease, making them well-concealed once healed. The result is a more open, refreshed appearance that still looks entirely natural. Patients frequently describe looking more alert and rested without appearing as though they have had work done. Results vary by individual, and Dr. Gilpin tailors each plan to the patient’s unique anatomy. Learn more about eyelid surgery in Nashville through the practice’s dedicated service page.
What Is Lower Blepharoplasty?
Lower blepharoplasty targets the under-eye area, addressing concerns such as persistent puffiness, under-eye bags, hollowing, and fine crepey skin. These concerns are largely structural, rooted in fat prolapse, loss of volume, or skin laxity beneath the eye rather than excess upper-lid skin.
Dr. Gilpin approaches lower blepharoplasty with equal precision. Depending on the patient’s anatomy, the procedure may be performed through a transconjunctival incision placed inside the lower lid, leaving no visible external scar, or through a subciliary incision just below the lash line when skin removal is also indicated. Fat may be repositioned rather than removed outright to preserve natural contour and avoid a hollowed result. Some patients benefit from combining lower blepharoplasty with complementary treatments such as cheek filler to restore mid-face volume that supports the lower lid. Individual results vary, and a thorough in-person evaluation determines the most appropriate approach.
Which Eyelid Surgery Is Right for You?
Choosing between upper blepharoplasty and lower blepharoplasty in Nashville begins with identifying the primary source of your concern. If you see heavy skin folding over your upper lashes, difficulty applying eyeliner, or a consistently tired or stern expression that does not reflect how you feel, hooded eyelid surgery targeting the upper lid is likely the more relevant option. Patients who notice persistent puffiness or under-eye bags despite adequate sleep, a shadowed or hollow appearance beneath the eyes, or fine crepey texture on the lower lid are better served by a lower blepharoplasty approach.
Many patients are candidates for both procedures performed together, which can deliver a more balanced and comprehensive rejuvenation of the entire eye area. Additionally, some patients seeking upper-lid improvement may also benefit from an endoscopic brow lift if brow descent is contributing to the appearance of upper-lid heaviness.
Dr. Gilpin evaluates each patient’s full facial anatomy during consultation, considering brow position, skin quality, fat distribution, and overall facial proportions before recommending any eyelid surgery option. His dual board certification and exclusive subspecialty focus on the face mean that every recommendation is grounded in deep, discipline-specific expertise rather than a generalist’s perspective. Individual results vary, and a personalized consultation is the most reliable way to determine which procedure or combination is appropriate for you.
Why Choose Dr. David Gilpin for Eyelid Surgery in Nashville?
Dr. Gilpin is the only facial plastic surgeon in Nashville who holds dual board certification from both the American Board of Otolaryngology Head and Neck Surgery and the American Board of Facial Plastic and Reconstructive Surgery. His practice is subspecialty-exclusive: every procedure he performs involves the face, which means his skill, judgment, and aesthetic eye are refined through thousands of procedures in a single anatomical region.
Recognized as a Castle Connolly Top Doctor for six consecutive years and a RealSelf Hall of Fame honoree, Dr. Gilpin brings a level of credentialed expertise to upper blepharoplasty Nashville patients that is difficult to find anywhere in the region. His fellowship training under one of the world’s leading facial plastic surgeons informs every surgical decision. Procedures are performed in a fully accredited, private in-house surgical suite, and Dr. Gilpin personally contacts patients after surgery to ensure every step of the recovery experience reflects the same level of care as the procedure itself. View patient gallery results to see the quality of outcomes he consistently delivers.
Frequently Asked Questions About Upper and Lower Blepharoplasty in Nashville
Can upper and lower blepharoplasty be performed at the same time?
Yes, combining upper and lower blepharoplasty in a single surgical session is a common and efficient approach for patients with concerns in both areas. Performing both procedures together reduces overall recovery time compared to staging them separately, and the results are often more harmonious because the entire eye area is addressed simultaneously. Dr. Gilpin evaluates combined candidacy during a thorough in-person consultation. Individual results vary.
How do costs compare between upper and lower blepharoplasty?
Upper blepharoplasty is generally less complex than lower blepharoplasty and may reflect a different price point, though total cost depends on factors including the extent of correction needed, whether procedures are combined, anesthesia, and surgical facility fees. A personalized quote is provided following consultation, where Dr. Gilpin has assessed your anatomy and outlined the appropriate surgical plan. Financing options are available for qualified patients.
How should I choose a surgeon for eyelid surgery in Nashville?
Look for a surgeon whose training and practice are focused on the face rather than a broad range of body procedures. Dual board certification, subspecialty focus, and a verifiable track record of peer-recognized excellence are meaningful differentiators. Reviewing a surgeon’s before-and-after gallery, reading patient accounts, and evaluating whether the surgeon personally guides you through the consultation and recovery process are all important factors before committing to care.
What is recovery like for each procedure?
Upper blepharoplasty typically involves bruising and swelling that resolve for most patients within 10 to 14 days, with many returning to desk work within one week. Lower blepharoplasty may involve a slightly longer swelling cycle, with full results becoming visible around three to four months post-procedure. Dr. Gilpin personally follows up with patients after surgery, and detailed recovery guidance is provided at consultation and throughout aftercare. Individual recovery timelines vary.
Is hooded eyelid surgery the same as upper blepharoplasty?
In most contexts, yes. Hooded eyelid surgery refers to the correction of excess upper-lid skin that folds over the lash line, which is precisely what upper blepharoplasty addresses. However, if brow descent is contributing to the hooded appearance, a brow lift may also be recommended alongside or instead of upper blepharoplasty. An accurate assessment requires in-person evaluation of your brow position and lid anatomy together.
Take the Next Step Toward Clearer, More Refreshed Eyes
Whether upper blepharoplasty in Nashville is the right fit or your concerns point toward lower eyelid surgery, the most important step is a consultation with a surgeon who has the credentials, focus, and genuine investment in your outcome to guide you accurately. Dr. David Gilpin and the team at Gilpin Facial Plastics and Aesthetics are ready to help. Request your consultation online or contact the practice to get started today.
Dr. David Gilpin is Nashville’s most accomplished dual board-certified facial plastic surgeon and the founder of Gilpin Facial Plastics, the city’s largest facial plastic surgery and medspa practice. With advanced fellowship training under one of the world’s leading experts in facial plastic surgery, Dr. Gilpin brings extensive knowledge, skill, and experience to every procedure he performs. He is particularly recognized for his expertise in facelift plastic surgery, delivering natural-looking facelifts that enhance facial harmony while preserving each patient’s unique features. Committed to continual learning and innovation, Dr. Gilpin stays at the forefront of facial rejuvenation techniques to provide patients with the most advanced and cutting-edge facelift procedures available.
Renowned for his personalized approach to both surgical and non-surgical facial procedures, Dr. Gilpin is known for achieving refined, long-lasting, and natural results. He has been featured in Nashville Lifestyles, recognized as a RealSelf Top Doctor, and regularly serves as a national speaker, sharing his expert knowledge with peers across the country. Handpicked by his peers as a Castle Connolly Top Doctor for the past six years and selected by Allergan to host the official Allergan Botox Day celebration two years in a row, Dr. Gilpin is trusted by A-list clients and respected colleagues alike. His leadership, experience, and compassionate care firmly establish him as one of the most sought-after facial plastic surgeons in Nashville, TN, and the eastern United States.Dr. David Gilpin is Nashville’s most accomplished
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