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Blepharoplasty

Blepharoplasty (Eyelid Surgery) – San Diego

Blepharoplasty is the medical term for a plastic surgery procedure on the eyelid(s). Sometimes (erroneously) called an “eyelid lift,” treatment can have a very rejuvenating and youth-restoring effect on the eyes and the upper third of the face. Blepharoplasty may be performed on the upper eyelids, lower eyelids, or all 4 lids depending on the patient’s goals and needs. This procedure is often combined with endoscopic browlifting and/or facelifting to create a more thorough cosmetic enhancement. This facial procedure can also be performed to create certain effects on the lid like the creation of a more defined upper eyelid fold in Asian patients (the so-called “Asian eyelid surgery,” quite popular in countries like South Korea, Vietnam, China and in the American Asian community). Dr. Sayed is quite experienced in eye lifts and considers it a key component of facial restoration.

Cosmetic eyelid surgery usually includes one or more of these elements:

  • Removing excess skin from the upper and/or lower eyelids to improve hooding and bagginess of the lids
  • Removing or repositioning fat in certain areas to reduce bulging of the eyelids
  • Fat grafting to the eye socket hollows in selected areas to create a more youthful eyelid
  • Tightening or supporting the eyelid muscle system to reduce the risk of problems with eyelid position
  • Blending the eyelid-cheek junction to make the lower eyelid look less sunken in

Blepharoplasty is usually performed by first creating small incisions along the upper eyelid crease and just below the lower eyelid lash line. Sometimes an incision may be placed on the inside of the lower eyelid (transconjunctival blepharoplasty) in order to remove or reposition fat in the lower lid. We may place supporting sutures to keep the lower eyelid from having a strange shape or being poorly positioned. We have all seen photos of celebrities whose eyes seem so different from their well-known public appearance after suspected plastic surgery, and in some cases, these changes make the individual almost unrecognizable! Imagine if your livelihood depended on your appearance (maybe yours does!), and your plastic surgery left you with strange-looking eyelids…This is one of the main issues Dr. Sayed strives to avoid with blepharoplasty, and he’s often called on to correct botched surgeries performed elsewhere. Aesthetics Done Right™ means paying attention to details! We treat every patient like a celebrity in the public eye!

PHOTO GALLERY

View real patient before & after results in our photo gallery.

Face Procedures before and after photos

Blepharoplasty 101

The procedure starts with understanding and analyzing the patient’s eyelid anatomy. Dr. Sayed evaluates the position and extent of fat (and whether there’s excess or loss), the amount of loose skin, the elasticity of the eyelid tissue, supporting structures, eyelid musculature, and any other findings in the skin. During your treatment, Dr. Sayed may remove, add, or reposition fat depending on your eyelid anatomy.

The blepharoplasty incisions are well camouflaged along the upper eyelid crease and below the lower lid’s lash line. Sometimes the lower lid incision extends slightly out to the corner of the eyelid in a skin crease that hides it.

Frequently Asked Questions About Blepharoplasty

Some of our selection criteria for cosmetic eyelid surgery include:

  • Upper eyelid hooding, bulging or hollow eye sockets, loose lower eyelid skin, malar bags (bunched up skin near the bottom of the lower eyelid), dark circles around the eyes, eyelid malposition, cosmetic dissatisfaction with the eyelid appearance, desire for a “western” eyelid in an Asian patient, and other indications
  • General good health, meaning you do not have major uncorrected cardiovascular, respiratory, kidney or other major organ conditions, and you are able to get medically cleared by your primary care doctor or a designated internal medicine physician who will perform a comprehensive physical examination and review preoperative laboratory studies. We also recommend an ophthalmology evaluation for all patients undergoing surgery in order to have a reliable baseline documented eye exam. Your test should include checking your visual fields, tear duct function, and general visual acuity (do you need glasses, are you nearsighted or farsighted, etc.)
  • Nonsmoker or willing to commit to NO NICOTINE IN ANY FORM for at least 3 weeks preop and for the duration of your recovery
  • Available support system of friends, family, caregivers or others who can help you to keep your appointments, complete your preop and postop tasks, and emotionally bolster you through this exciting journey
  • Reasonable expectations of how much youthful restoration is possible with specific blepharoplasty techniques

Our blepharoplasty surgeries can be done in an hour or less when done as a single procedure in most patients. Obviously, when combined with browlifting, facelifting, laser resurfacing, and/or fat grafting, the combined procedure will take longer – closer to 3 to 6 hours depending on the extent. The eyelid lift component of the combined facial rejuvenation process is usually about a 45 to 60 minute portion. When done alone, an upper eyelid lift can take about 20 minutes total, and a lower blepharoplasty takes about 40. In selected patients, an upper lid lift can be done under local anesthesia, but Dr. Sayed prefers sedation (“twilight anesthesia”) or general anesthesia for combination procedures and lower eyelids.

Our blepharoplasty surgeries are performed on an outpatient basis in an AAAASF-certified operating room, meaning the facility is up to very high standards of accreditation. After their procedure, patients usually spend up to a couple hours in the postoperative suite before being discharged in the care of a companion, family member or friend. Dr. Sayed gives a 24-hour phone number to all patients who want to reach him for urgent questions about their recovery, and we also issue access to a patient engagement application that allows the patient or companion/caregiver to send SMS messages, photos, video and other content to our team in a secure, private digital format. This keeps us mutually informed on your recovery and allows us to update your recovery instructions while requiring a respectful number of face-to-face visits in the office.

Early postop recovery findings for the blepharoplasty can include eyelid bruising and swelling, mild discomfort, slight eye irritation, drainage, dryness, sensitivity to light, and some mental adjustment to the process of healing which most patients undergo after surgery. Usually, the swelling subsides within a couple of days and bruising is either resolved or easily concealed within 7-10 days. Most patients are advised to take 10-14 days out of social circulation and to give a good 3 weeks of recovery from their procedure before expecting to be really in the public eye. Stitches in the upper lid and corner of the eyelid are removed at 7 to 10 days depending on the patient’s rate of healing. Sutures under the lower eyelid are dissolvable. Topical antibiotics should be applied to incisions and the eyes should be kept lubricated with drops and ointments for the first week or so.

We ask that you abstain from exercise for 2 weeks after the blepharoplasty and then return to light fitness routines after that. During your recovery, Dr. Sayed and his team provide close postop care in the office and with our remote engagement tools. You will be asked to take some supplemental medications to aid in your recovery, which may include medications for pain, bruising, swelling, and dietary optimization.

Any scarring from will eventually fade away, but depending on the technique, Dr. Sayed will place the incisions in the natural contours of the eye or inside the eyelid, where they won’t be visible to anyone.

When your incisions begin to heal, they’ll look slightly red or pinkish. After 1-2 weeks, you’ll be able to cover the scarring with makeup. Over the next six months, the scars will mature, meaning they’ll soften in texture and fade in color. For some patients, it might take a year or so until the scars fully heal.

While blepharoplasty does not stop the aging process (sadly, nothing does), it can have a very meaningful and lasting effect on the appearance of the eyes. Our patients can expect a more well rested, youthful, and vigorous appearance after their treatment. This can be maintained for 5 to 10 years depending on your aging process and genes. Smokers, sun-worshippers, and certain other patients may be more prone to problems with the skin and eyelid tissues occurring in the future. On the whole, most patients are highly satisfied with their results for many years.

  • Have a reasonable expectation of what treatment can accomplish
  • Look at before and after photos and understand what kinds techniques you are interested in
  • Don’t smoke or take nicotine in any form for at least 3 weeks and ideally longer before (and after) your blepharoplasty
  • Stay well rested and well hydrated and eat a nutritious diet balanced with plenty of protein
  • If your diet is lacking in vitamins, take vitamin C and zinc supplementation but ask Dr. Sayed about other supplements. We have a list of ingredients we ask you to avoid in the immediate preop phase to optimize healing and minimize bleeding risk.
  • Designate a caretaker who can help you through the first 5 to 7 days after your procedure.
  • Have your vision and tear duct function checked by a qualified ophthalmologist (a physician, not an optometrist or optician – we need a medical report before your surgery so we are aware of any issues with your vision, tear ducts or other eye functions that might come up during your recovery)

Sometimes, the degree of volume loss and loss of elasticity happens at different rates for each eye, leading to left and right eyelids that are asymmetric. If you’re seeking a way to restore symmetry, Dr. Sayed’s precise work with blepharoplasty allows him to restore symmetry to your eyelids.

A blepharoplasty’s main goal is to restore tightness to sagging, puffy eyelids that make you look too tired and exhausted. Because it’s localized to the eyelids, an eyelid lift won’t soften the appearance of crow’s feet, and may only partially correct under-eye troughs (which may require fat grafting or fillers to fully improve). During your consultation, Dr. Sayed will help determine the causes of your concerns so you can know exactly what to address. If the drooping skin on the upper area of your face is more concentrated around the forehead or the eyebrows, an eyebrow lift might be more appropriate.

As your eyelids begin to heal and the swelling decreases, you should begin to see your final results. While you should be presentable at around 10 days after the blepharoplasty, it might take up to a month before a majority of the swelling and bruising dissipates. For some patients, it can be 6 months to a year before they see their final results, but most patients have obvious improvement noticeable within several weeks of surgery.

This will all depend on what kind of coverage you have. Of course, to qualify for insurance coverage for a blepharoplasty in San Diego, your drooping eyelids should impair your visual field substantially. You will need an examination from an ophthalmologist to test the amount of visual impairment. Dr. Sayed’s office will submit information, including photos and medical records, to your insurance to seek authorization for coverage of upper eyelid lifts if you are seeing him for an insurance consultation. The insurance company then evaluates if you meet criteria for insurance coverage according to your policy. Even for a patient who is a candidate for upper blepharoplasty through insurance, the lower eyelid procedure is not covered (since lower eyelids can’t block the vision).

Our pricing for a blepharoplasty in San Diego is subject to market changes and dependent on the types of procedures you consider. Review our Pricing page to build a “wishlist” and get estimated pricing on an eyelid lift or a combination of procedures. We also have a fee schedule available in the office after your consultation. Feel free to contact our San Diego office for a pre-consultation and we are happy to provide more information. There is some discounting applied if you undergo multiple procedures – for example, having all four eyelids done in one procedure will cost less than doing the upper lids now and the lower lids in a future procedure.

Contact us today!

If you’re in the San Diego or Newport Beach areas and have any questions about eyelid surgery or wish to schedule a consultation with Dr. Sayed, please contact our office.