Eyelid Surgery

At our Idaho Falls practice, eyelid surgery is one of the most commonly performed plastic surgery procedures. According to statistics, more people have eyelid surgery every year than facelifts or rhinoplasty. The reason is that a small correction in the appearance of the eyelids, called blepharoplasty, can make a monumental difference in the way you look and feel with minimal downtime. When the eyes are bright and alert, the effects of aging on the rest of the face are less apparent.

Come in and see what sets Dr. Freeman apart from other surgeons in the Northwest. Request an appointment online with Dr. Freeman, who is happy to help you explore your cosmetic options. He serves Twin Falls, Boise, and Pocatello, Idaho, and other surrounding communities.

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Blepharoplasty Explained

Blepharoplasty is designed to removed excess skin or fatty tissue in order to re-contour the eyelid and create a more rested or youthful expression. Eyelid procedures can be broken down into 2 main types: upper and lower lid surgery. Both procedures have various methods that can be tailored to fit your specific situation to enhance your eyelid appearance. The key with either surgery is to remember that the goal of quality plastic surgery is the restoration of your own natural look without changing the overall shape of the eye and risking looking “different.”

Meet Our Surgeons

Mark E. Freeman, MD Board-Certified Plastic Surgeon

Mark E. Freeman, MD Meet Dr. Freeman

Matthew Hagan, MD Board-Certified Plastic Surgeon

Matthew Hagan, MD Meet Dr. Hagan

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Dr. Freeman's and Dr. Hagan's credentials Dr. Freeman's and Dr. Hagan's credentials

Upper Eyelids

The two most common issues that affect aging of face as it relates to the upper eyelid are excess skin, which can weigh down and obscure the lash line, or excessive soft tissue and fat that gives the eyes a puffy appearance.

Sagging Skin

Extra skin that has stretched or become lax over time will begin to droop down and cover the natural upper eyelid crease. This loss of a natural landmark leads to a more aged or even stern look. On the other hand, the natural crisp line that forms above the lashes with the eyes open gives a more alert and youthful countenance. This extra skin may become so heavy that it actually weighs down the lid and can begin to obstruct your peripheral visual fields.


The eyeball itself lies in the orbital socket insulated by fatty tissue allowing it to move with ease. However, as we age, the small ligaments that contain this fatty tissue begin to weaken and the fat may begin to herniate or bulge out through the lids leading to a more “puffy” appearance. This herniation causes the upper eyelid to lose its youthful contour and become more blurred. Puffy upper eyelids are often associated with a more tired or run-down expression.

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Surgery of the upper eyelid must be tailored to the exact problem that is affecting the look of the eye. Some see this surgery as a “one size fits all” procedure while a quality plastic surgeon knows that the best result is one that addresses the specific needs of the patient. Dr. Freeman prides himself in his ability to work with you to find out your specific concerns and to return the youthful look of the upper lid crease in the most conservative manner possible.

Lower Eyelids

The three most common issues affecting the lower eyelid are remarkably different from the upper eyelid. The herniation of fat in the lower eyelid forms an enlarged pouch or “bag” beneath the eye and a corresponding indentation beneath it called a “tear trough.” The skin in this area can also stretch over time but tends to show more fine lines than actual drooping skin. The last and more important issue is the laxity of the lid itself.


Herniated fat often pushes forward, stretching the orbital retaining ligament leading to a defined diagonal crease, beneath the eye. This indentation is called a tear trough while the bulge above it is often simply called a “bag.” The skin in this area which is often stretched and stressed with edema can become darkened or discolored forming dark circles that are associated with a tired look.

Crepey Skin

The loose skin beneath the lower eyelids may sag but more often it forms multiple fine lines that begin to resemble crepe paper. This fine, loose skin overlies important muscles needed to support the lower lid and prevent it from becoming loose. A quality result depends on removing these fine lines while maintaining support.

Lower Lid Laxity

If the lower lid tone weakens, it is possible for the lid to begin to droop downward similar to a clothesline weighed down with too many clothes. This drooping can cause the lower lash line to drift downward showing more of the sclera or white of the eye.

The lower eyelid must be approached with a great deal of care as there are multiple issues to be addressed or avoided in each specific situation. The lower eyelid can be corrected with amazing results often with the most minimal procedures. From an isolated peel to tone the fine lines, to a small amount of fat grafting to the tear trough, less is often more. During a detailed exam, Dr. Freeman will determine if your situation requires a more minimalistic approach or if we need to address deeper structures that would require a small incision beneath the lower eyelash line.

Customized Eyelid Surgery

Eyelid surgery can be a relatively minor procedure but should be performed by those experienced in the nuances of the eyelids, and their effect on the entire facial appearance. A “one size fits all” mentality can lead to results that are just the opposite of what you had in mind. Choosing the right plastic surgeon is paramount, as a less than ideal result can often leave the whole face appearing older and unnatural.

When Dr. Freeman performs eyelid surgery in Idaho Falls, the procedure is planned out thoroughly with careful attention to your goals. This procedure can create a youthful and rested appearance by relying more on restoration and less on removing tissues. The goal is to look like a younger more rested version of yourself, not a different person.

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