Cosmetic Eyelid Surgery (Blepharoplasty)

Before and After for Patient #254

Cosmetic eyelid surgery or blepharoplasty is a procedure to remove fat, and usually excess skin from the upper and lower eyelids. Blepharoplasty can be done alone or in conjunction with other facial plastic surgery procedures such as a facelift or browlift. Excessive upper eyelid skin can often obstruct vision, so an eyelid lift can often improve functional as well as esthetics.

Cosmetic Eyelid Surgery Before & After Photographs

Select a patient below to view more detailed pictures and information about the cosmetic eyelid surgery procedures performed by Dr. Joseph.

Why have a Blepharoplasty?

Our eyes are often called the windows of the soul. They express our deepest feelings and emotions. However, our eyes are often one of the first facial features to show signs of aging and can give the wrong impression to others.

Why do the Eyelids Sag?

The skin and muscles of the eyelids are half as thick as the rest of the face. As a result, eyelid skin is more prone to sagging and stretching. This is made worse by sun exposure, squinting and eye rubbing. Fat and supporting muscles cushion our eyeball. As we age, the eyelid skin and supporting muscles become weak. The fat can then protrude forming “bags” under the lower eyelids making us look old, sad or tired.

Aging changes of the eyelids can begin in the third decade and it is not uncommon to perform cosmetic eyelid surgery on patients in their 30’s or 40’s. Many young people often look much older than they feel due to droopy and baggy eyelids. By rejuvenating the eyelids, patients look more alert, less tired and refreshed.

Blepharoplasty Procedure

Blepharoplasty surgery is usually performed in our office surgery suite with local anesthesia and light IV anesthesia. The surgery takes about 30 minutes per eyelid and the recovery time is usually about a week. During this period, you must avoid strenuous activity and lifting. The eyes may bruise for several days after surgery and are easily covered with dark sunglasses.

Dr. Joseph uses Laser and Radiowave for eyelid surgery. There is less bleeding and tissue damage, which means less bruising, faster healing and less pain. The incisions for the upper eyelids are made along natural creases and are closed with very fine sutures leaving them barely visible after healing.

For lower eyelids, Dr. Joseph uses the transconjunctival approach placing the incision inside the lower eyelid so there is no visible scar. This method is less likely to pull down or retract the lower eyelid that is often seen with external incisions. Dr. Joseph frequently treats the excess lower eyelid skin with laser resurfacing. This gives dramatic skin tightening without cutting away skin. No incision is required. When performing laser resurfacing of the eyelid skin the patient will be red for a week and then pink for another week. Makeup can be used to cover the pinkness until it resolves. Dr. Joseph also utilizes a technique called “skin pinch” for patients that do not desire laser skin tightening.

The newest application for fillers is the “tear trough” area under the eyes. Fillers can also be used to fill in the lines that are underneath the lower eyelids called the tear troughs. This area makes patients look hollow and by injecting fillers, it plumps out the depression and improves the “dark circle” look.

When considering cosmetic eyelid surgery it is important to inform your surgeon of any abnormalities of your eyes, vision, or general eye health. You should schedule your surgery when you can relax for a week. Patients often return to work in a week with transconjunctival surgery and slightly longer after upper and lower lid surgery. Eyelid surgery is very safe but complications can occur when patients over exert themselves. It is very important to avoid strenuous activities that require bending or lifting for a week after surgery. In addition, any drugs that increase bleeding such as aspirin, some vitamins and herbs and other over the counter medications need to be discontinued 2 weeks before surgery.

If excess upper eyelid skin obscures the vision, insurance companies may sometimes cover part of the surgery. Beware, that functional surgery, covered by insurance is not as comprehensive as cosmetic eyelid surgery. Just because a procedure is covered by insurance does not mean it is the correct cosmetic procedure. For instance, many patients actually need a brow lift procedure but insurance will only cover upper eyelid surgery. If too much skin is removed from the upper lids, future brow lift will be impossible.

Removing too much skin or fat can make one look worse than no surgery at all. It can also make male eyelids appear "feminized" and female eyelids more hollow. By using the latest techniques, Dr. Joseph leaves his patients with a natural look. Modern trends in upper blepharoplasty are designed to avoid creating a hollow upper eyelid.

Brow Lift

Sometimes what appears to be sagging of the upper eyelids is actually from drooping of the brow, and is better addressed by a brow lift. Dr. Joseph can determine which procedure is right for you. We often review photos from your 20’s or 30’s to determine how best to rejuvenate your upper face. Endoscopic and mini open brow lifting are newer procedures that address this problem.