Lifting the Lid on Upper Blepharoplasty, Judgment, and Aging Beautifully with Karen Karlsen

As we navigate the journey of midlife, many of us find ourselves confronting new questions about beauty, aging, and authenticity. The mirror reflects changes we didn’t expect to see so soon, and suddenly, we’re faced with choices our mothers’ generation very rarely discussed openly. 

Recently, I had the pleasure of sitting down with my friend Karen Karlsen for an open, honest conversation about our experiences with eye rejuvenation procedures. As a 53-year-old woman speaking with Karen, who’s in her 60s, we explored the deeply personal journey of aesthetic choices in midlife. I wanted to share some insights from our discussion that might resonate with many of you navigating similar decisions. 

As Karen beautifully expressed, by our 50s and 60s, we should be “solid enough to make our own decisions like a big girl and not look around for approval.” Yet, oftentimes, we can be scared of judgement for the decisions we make. The truth is, you can be judged whichever route you take: criticizing women who choose interventions as “cheating” or “using hacks,” while simultaneously judging women who don’t use available treatments as “letting themselves go.”

Here’s my truth: choosing procedures doesn’t mean I hate myself. Quite the opposite—I love myself enough to align my appearance with how I feel inside. As I told Karen, “I actually don’t hate myself at all. I love myself, and I want to feel good, and I want to look good.”

There’s No Single “Right Way” to Age

One of the first things Karen and I agreed on is something I deeply believe: there is absolutely no single “right way” to age. Some women choose to embrace every line and change naturally, while others prefer interventions to help their appearance align with how they feel inside.

I have immense respect for women on both paths. Those who go completely natural deserve admiration, but so do those who choose procedures to maintain or enhance their appearance. What matters isn’t which path you choose, but that it’s truly your choice, made with confidence and without apology.

When Your Mirror Doesn’t Match Your Energy

What initially prompted my interest in eye rejuvenation was noticing a disconnect between how I felt and what I saw in the mirror. I’d catch glimpses of myself and think, “Why am I looking at my mom all of a sudden?” (My mom is amazing at 79 and looks amazing, by the way, but you get it!) It was jarring to feel vibrant and youthful inside while my eyes looked perpetually tired.

Karen shared a similar experience, describing how after having filler removed from her under-eye area, she found herself thinking, “I’m not freaking tired, but I look like I haven’t slept in days.” This mismatch affected her confidence and even made her feel a bit depressed.

I firmly believe that when our appearance aligns with our internal energy, we’re more likely to maintain healthy habits, stay social, and engage fully with life. It’s not about vanity—it’s about harmony.

My Experience with Upper Eyelid Surgery

For those curious about what I experienced with my eye procedure, I opted for both upper and lower eyelid blepharoplasty. The upper procedure addressed the drooping skin that was making my eyes look smaller and was beginning to interfere with applying makeup. The surgeon made a small incision in my eyelid crease (where it’s virtually invisible once healed).

For my lower eyes, I chose a “scarless” approach where the surgeon went inside my lower eyelid to remove a small pocket that was creating shadows. He also performed a fat transfer, taking a tiny amount of fat from my thigh and strategically placing it to restore volume where needed. Finally, a CO2 laser treatment helped improve skin texture.

What surprised me most? I was completely healed in just six days! The procedure that had intimidated me for so long turned out to be remarkably straightforward in recovery.

Choosing the Right Surgeon Makes All the Difference

If there’s one piece of advice I would emphasize above all else, it’s this: research your surgeon meticulously. For facial procedures, especially around the eyes, I recommend seeking specialists who focus exclusively on faces or, even better, ocular plastic surgeons who work on eyes all day, every day.

I personally chose to go with a surgeon who does my particular procedure all day long—I wanted somebody where that’s their whole focus. The millimeters matter enormously around your eyes, and expertise specifically in this area isn’t optional—it’s essential.

What I Wish I’d Known Earlier in Life

If I could take it back and talk to my younger self, I would have prioritized the following things 

• Sun protection is non-negotiable (and not just your face—protect your neck, chest, and hands too)
• Consistent skincare matters more than expensive products
• While I love the sun for health benefits, I regret excessive tanning earlier in life

Karen shared that she’s been using retinoids since age 23 and believes this has saved years on her skin. She’s also incorporated peptides, vitamin C, and various targeted treatments throughout different decades of her life. 

Where’s Your Line?

One question Karen and I explored was about personal boundaries—where do each of us draw the line with aesthetic interventions? I shared a story about seeing an elderly woman on a plane whose body clearly showed her age, but whose face had been so dramatically altered it created a jarring disconnect.

For me, that visual reinforced the importance of maintaining harmony and proportion. Whatever choices we make should enhance, not disguise, who we are. The goal isn’t to look 25 again—it’s to look like our best selves at the age we actually are.

If you’re considering any cosmetic procedure, remember there’s no shame in either choice—moving forward or deciding it’s not for you. The greatest freedom of midlife might just be defining beauty on our own terms, unapologetically and without explanation.

The contents of the Midlife Conversations podcast is for educational and informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always consult with a qualified healthcare provider. Some episodes of Midlife Conversations may be sponsored by products or services discussed during the show. The host may receive compensation for such advertisements or if you purchase products through affiliate links mentioned on this podcast.