Blepharoplasty (Eyelid Surgery)


Blepharoplasty (Eyelid Surgery) Newport Beach

Blepharoplasty is the medical term for a plastic surgery procedure on the eyelid(s). Sometimes (erroneously) called an “eyelid lift,” a blepharoplasty can have a very rejuvenating and youth-restoring effect on the appearance of 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. Blepharoplasty 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 experienced in blepharoplasty and considers it a key component of facial restoration.

Blepharoplasty 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 through 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. Supporting sutures may be placed to keep the lower eyelid, in particular, 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 a strange look to your eyelids…. This is one of the main issues Dr. Sayed strives to avoid and is often called on to correct after surgery performed elsewhere. Aesthetics Done Right™ means paying attention to details! We treat every patient like a celebrity in the public eye!

Blepharoplasty 101

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

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

Blepharoplasty FAQ’s

1. How do I know if I am a candidate for blepharoplasty surgery?

Some of our selection criteria to include you as a blepharoplasty candidate 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 blepharoplasty surgery in order to have a reliable baseline documented eye exam including 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 techniques

2. How long does blepharoplasty surgery usually take?

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

3. What is recovery from blepharoplasty surgery like?

Most blepharoplasties are performed on an outpatient basis in a AAAASF-certified operating room, meaning the facility is up to very high standards of accreditation. 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 can reach him for urgent questions, 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 instructions while requiring a respectful number of face-to-face visits in the office.

Early postop recovery findings 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. 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 from surgery 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 healing. Sutures under the lower eyelid are dissolvable. Incisions require application of topical antibiotics and the eyes are kept lubricated with drops and ointments for the first week or so.

We ask that you abstain from exercise for 2 weeks and then return to light fitness routines after that. 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 supplement medications to aid in your recovery, which may include medications fo pain, bruising, swelling, and dietary optimization.

4. How long do blepharoplasty results usually last?

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. A more well rested, youthful, vigorous appearance would be expected soon after the surgery in most patients. This may 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 for many years.

5. How can I prepare for my blepharoplasty surgery?

  • Have a reasonable expectation of what surgery can accomplish
  • Look at before and after photos and understand what kinds of 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) surgery
  • 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 blepharoplasty.
  • 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)

6. How much does a blepharoplasty cost in Southern California?

We don’t like to publish pricing as it is subject to market changes and dependent on the types of procedures you consider. We do have a fee schedule available in the office after your consultation, and we can give you an estimate through virtual consultation tools available on this site like our Zwivel® page. Feel free to contact us 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.