Cosmetic Upper and Lower Lid Blepharoplasty
Eyelid Surgery

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Eyelid Surgery


When excess tissue in the eyelids makes the eyes appear aged and tired, a technique known as blepharoplasty can often be used make the eyelids appear more youthful.  With blepharoplasty surgery, sagging tissues are removed or repositioned to create a bright, more youthful look.

Upper and Lower Blepharoplasty

Upper blepharoplasty is performed through a fine incision hidden in the eyelid’s natural fold, while much of the work in lower blepharoplasty is often carried out through the inside of the eyelid, thus avoiding visible scars or telltale signs of surgery. When there is a significant amount of excess lower eyelid skin, the redundant tissue is generally removed via an incision made beneath the lower eyelashes. The lashes themselves are not threatened by this procedure. In many patients rather than removing the bulging lower eyelid fat, the excess tissue is spread into the depressions that develop beneath the lower eyelid. This prevents an excessively hollow appearance after surgery

Where the Surgery Is Performed

Whether performing blepharoplasty in an outpatient surgery center or the office, Dr. Biesman often uses a laser, thus reducing both the surgical time and the recovery period of the treatment. The outcomes are identical in either location. Here are the main differences between the two options:

  • Outpatient Surgery Center: The patient is typically in a state of twilight sleep, during which he or she is unaware of surroundings. There are additional costs associated with procedures performed in a surgery center.
  • In-Office Treatment: Instead of being in twilight sleep, for an in-office treatment, the patient remains awake during the procedure. When undergoing in office blepharoplasty, most patients choose to take something to help them relax.

Blepharoplasty surgery typically takes from less than 1 hour to as much as 1.5 hours, , depending on the exact nature of the procedure performed.

What to Expect Before and After the Procedure

Patients undergoing blepharoplasty surgery should avoid taking aspirin or blood thinners for two weeks prior to surgery, as this will reduce the risk of bleeding and bruising. After treatment, most patients experience very little discomfort and find that Extra Strength Tylenol provides suitable relief of any discomfort. Likewise, cold compresses applied for the first day or two after surgery help reduce swelling and bruising, as does sleeping on an extra pillow at night.

For approximately two weeks after surgery, heavy bending and lifting should be avoided,but routine activities such as driving, walking, bathing, etc. may be resumed on the first postoperative day. In general, approximately 80% of bruising and swelling is resolved within the first two weeks. Contact lens wear may be resumed one week after eyelid surgery, but care should be taken to avoid rubbing the eyelids vigorously for several weeks. If removable sutures (stitches) are used, these will be removed at the first post-operative visit (approximately one week) after surgery.

Internal Brow Lifting or Browpexy

For those patients who have both heavy upper eyelids and mild drooping of the eyebrows who are not candidates for a full endoscopic forehead and brow lift surgery, the eyebrows may be stabilized through the eyelid incision used to perform the upper blepharoplasty. This is known as internal brow lifting or “browpexy”. The internal brow lift does not provide as much elevation as a standard brow lift and does not address the frown muscles, but does provide nice stabilization of the eyebrows without inducing a dramatic change in one’s appearance, elevating the forehead or creating incisions in areas that may be visible in patients with a receding hairline. During your consultation session with Dr. Biesman, it will be determined which of these procedures would best suit your specific needs.

Undergoing Treatment from Dr. Biesman

As a specialist in Ophthalmic Plastic Surgery, Dr. Biesman has an in-depth understanding of the complex relationship between the eye, the eyelids and the underlying facial structures. This helps make him particularly qualified amongst cosmetic surgeons to design an operation that will not only produce the best aesthetic result, but also preserve your eye’s safety and health.