Simone Biles is getting candid about her plastic surgery experiences. The 11-time Olympic medalist casually shared in a recent TikTok that she’s had three plastic surgeries, including two that people wouldn’t notice.
While the 28-year-old was coy in the video about what she’s had done, she later told People that she’s had breast augmentation, surgery to fix a tear in her ear, and a blepharoplasty (aka “bleph”), which is a surgical procedure done on the eyelids.
"I got a lower bleph because me and my family have, I call it the 'Biles eye bags,' " she said. "We've just always had them, hereditary, and so that was just a big flaw. Every time I would go to a shoot, they're like, 'Oh, can we put some strips on her?' " Biles joked that she would get comments about her eyes, even when she had 12 hours of sleep the night before. “These are just hereditary, so it's something that I wanted to fix,” she said.
While most people are familiar with breast augmentation, blepharoplasty isn’t a term everyone knows. What’s the deal with this surgery? We tapped three doctors who perform it for details.
While the name for this surgery isn’t well-known in pop culture, it was the most common facial plastic surgery procedure in 2024, according to data shared by the American Society of Plastic Surgeons.
Commonly referred to as “bleph” surgery, this can be done on the upper eyelids or lower eyelids, Linda N. Lee, MD, facial plastic and reconstructive surgeon at the Mass Eye and Ear Facial and Cosmetic Surgery Center and assistant professor at Harvard Medical School, tells SELF. But Dr. Lee says that an upper blepharoplasty is the most common.
“It’s a small surgery that takes the excess skin from the eyelid,” she says. “You just remove it.”
The surgery helps address the looseness skin can develop over time, as well as eye bags, Anthony Brissett, MD, a facial plastic surgeon at Houston Methodist and president of the American Academy of Facial Plastic and Reconstructive Surgery, tells SELF. “You’re removing skin and muscle and sometimes removing or repositioning fat in the upper and lower eyelids for a ‘youthful’ look,” he says.
There are different variations of this, Sachin M. Shridharani, MD, a board-certified plastic surgeon in New York City, tells SELF. “You can have an upper blepharoplasty, a lower blepharoplasty, or a quad blepharoplasty, which addresses all four eyelids,” he says.
Dr. Brissett says this is a very common procedure, noting that it’s getting even more popular with people in their 20s and 30s.
It depends. A lot of the time, it’s for aesthetics, Dr. Lee says. “The skin around the eyes just becomes so excessive that the eye hoods and causes the eyelid to droop,” she says. Removing excess eyelid skin can help to open up the eyes, get rid of eye bags, and make someone look less tired, Dr. Brissett says.
While many people get this procedure for cosmetic reasons, Dr. Brissett points out that there can be a visual need, too. “The eyelid tissue can sometimes overlap the eyelashes and eyelids, creating a blinder effect that obstructs the visual field,” he says.
That can be a safety hazard, according to Dr. Lee. “You may not see cars coming from the side when you’re driving or someone who is walking next to you,” she says. “Sometimes people start accidentally hitting their head because they don’t see what’s above them as well.”
“It’s a pretty quick procedure,” Dr. Lee says. “It can be done awake with just local anesthesia, but some people prefer a little twilight.” She estimates that blepharoplasty typically takes about 30 minutes for each eye.
“A lot of the procedure is in the design,” she says. “You sit up and we really precisely draw each eye with calibers, before we lay you down and do the surgery. The actual surgery part is quick, but the crucial element is the design.”
Dr. Lee stresses the importance of doctors getting the look right. “It has the potential to change your eyelid shape, which is so critical to your look,” she says. “You don’t want to go for broke, overdo it, and change someone’s natural eyelid shape. That can change the look of your face.”
Most people will have swelling and bruising for seven days or more, according to Dr. Brissett. “After that, you’re beginning to heal,” he says. (Doctors will usually recommend that you avoid exercise or strain for two weeks after your surgery, according to Dr. Lee.)
Dr. Shridharani calls the recovery “very manageable,” noting that most people usually do just fine with NSAIDs (non-steroidal anti-inflammatory drugs) and acetaminophen for pain management in the immediate aftermath. “We also recommend that patients use lubricating eye drops to keep the eyes moist, especially if they have a history of contact lens use,” he says.
But Dr. Shridharani says that most people are “socially presentable” after about 10 to 14 days.
Some people will wear fashion glasses frames to cover what can look like purple eyeliner as the eyes heal, Dr. Lee says. “You can also put on sunglasses to go out and do things,” she says. But while most people start to look like themselves after two weeks, Dr. Lee points out that you’ll still have swelling for up to three months. “It looks like you have allergies or like you cried last night—you may be a little pink and swollen,” she says. “You’re not usually red carpet-ready until three to six months later, and full healing takes a year.”
Some plastic surgeries need maintenance updates after a while, but Dr. Shridharani says that’s not typically the case with a blepharoplasty. “Usually, this is a ‘one-and-done’ procedure,” he says. “For my patients who wait until their 40s, 50s, or 60s, I can’t recall the last time someone needed a revision, except in cases where they were genetically prone to very lax skin.”
While Biles didn’t dive into details of her blepharoplasty, she seems happy with the outcome. Biles also stressed that she wanted to be upfront about her experiences. “It shows young girls that they have the right to their own choices, whatever they are, and that's no shame added as well," she said.
