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Upper lid Blepharoplasty

Blepharoplasty is eyelid surgery which involves the removal of excess skin and fat pockets in the upper and lower eyelids. In the upper eyelids, excess skin can result in a tired appearance to some, while in others, it can actually result in difficulty seeing in the top gaze of your vision (also referred to as limitations in super visual field). Dr. Zoumalan will meet with you during your consultation and perform a comprehensive oculoplastic examination.

The Upper Eyelid Surgery Procedure

Both you and Dr. Zoumalan will go over the plan and what to expect from the surgery. An upper lid blepharoplasty can often be performed in the office using only local anesthesia if only skin is planning to be removed. Both excess skin and excess fat can pockets can be removed at the same time under local anesthesia. It is a painless procedure that we do in our very own procedure room in the office.  However, in cases where additional surgery is performed, Dr. Zoumalan will perform the procedure under sedation within an operating room. An upper lid blepharoplasty is often combined with lower lid blepharoplasty where the lower lid excess skin and fat pockets are removed. In cases where the brows are also low set, Dr. Zoumalan may recommend a brow lift. Upper eyelid surgery will not help with the fine wrinkles on the sides of your eyelids though. Botox can be injected to help improve these wrinkles and Botox can be used in combination with eyelid surgery. 

Why Choose Dr. Zoumalan

Dr. Zoumalan is a board-certified Oculoplastic surgeon that specializes in eyelid surgery. He regularly speaks at conferences providing the latest regarding advanced techniques and his research publications. He has authored numerous book chapters and publications in major medical journals within the field of Oculoplastic Surgery. Dr. Zoumalan also volunteers as an instructor to young doctors at the Keck School of Medicine of USC teaching them the skills necessary to perform Oculoplastic Surgery.

Special Considerations

Other important things to consider are a history of dry eyes and prior eyelid surgery, both of which need to be evaluated carefully prior to any eyelid surgery by Dr. Zoumalan. Dry eyes must be managed properly by your eye doctor prior to surgery since dry eye symptoms can worsen after eyelid surgery. Dr. Zoumalan will generally not operate on a patient with active dry eye symptoms. Patients with prior eyelid surgery may also be at risk for dry eye symptoms and difficulty closing eyelids after surgery. Having prior eyelid surgery does not exclude you from further surgery, but it is important to see an eyelid specialist such as Dr. Zoumalan for a proper examination to make sure you will be a safe and appropriate candidate.

Combination Procedures

Brow Lift

In cases of low set brows with excess eyelid skin, patients may need to have a combined brow lift in addition to upper eyelid blepharoplasty. There are several types of brow lifting procedures that Dr. Zoumalan performs, and each one is specific to the patient’s desired results, examination findings, age, and gender. They all provide excellent results when done on the appropriately selected patients. The incisions for the brow lift can either incorporate the existing blepharoplasty incisions (such as brow pexy) or well-hidden small in incisions in the hair-baring scalp areas (such as in temporal brow lift or endoscopic brow lift surgeries). The benefit of combining a brow lift with a blepharoplasty is that the brows are repositioned to a more natural and youthful position. By doing so, less skin is required to be removed in the upper eyelids. Dr. Zoumalan’s goal in performing brow lift surgery is to achieve natural looking brows without creating an overcorrected or undesirable look.

Ptosis Surgery (Droopy eyelid surgery)

In other instances, patients may have some droopiness to the upper lids (also termed as upper lid ptosis) along with excess upper lid skin. Performing upper lid blepharoplasty alone without addressing the ptosis will result in the patient looking even more tired appearing and lacking a rejuvenated look.  Thankfully, the low set position of the upper lids  (ptosis) can be addressed at the same time as a blepharoplasty.  Dr. Zoumalan will perform a careful evaluation and determine if you will need a ptosis repair and a blepharoplasty surgery at the same setting.  Both are commonly performed at the same setting to achieve the desired look of a rejuvenated eyelid.  Dr. Zoumalan performs minimally advanced ptosis surgery techniques to help allow you to heal well and quickly as possible.

Lower lid blepharoplasty

Dr. Zoumalan routinely performs upper and lower lid blepharoplasty at the same time. Patients who often have upper lid aging signs may also have lower lid aging signs which include prominent lower lid fat pockets (lower lid eye bags), volume loss and hollowing, and even excess lower lid skin. A lower lid blepharoplasty can help improve the look of the lower lid. Dr. Zoumalan employs the latest advanced techniques to help allow you to look as natural looking as possible while having a result that leaves you looking refreshed and youthful again. When you meet with Dr. Zoumalan, ask if you would benefit from a lower lid blepharoplasty at the same time as an upper lid surgery.

Other cosmetic surgeries (i.e. facelift, necklift, rhinoplasty, breast augmentation, liposuction, and body work)

If you desire to undergo multiple cosmetic procedures at the same time as your blepharoplasty surgery, we can help accommodate that for you. We’ll have you meet with our other specialists so that you get the best and most specialized care possible. Although Dr. Zoumalan is an eyelid specialist and exclusively performs eyelid plastic surgery, he works with a team of specialized and board-certified plastic surgeons. Working closely with these surgeons, Dr. Zoumalan and his team will strive to address your cosmetic needs.

Recovery After Upper Eyelid Surgery

Depending on the complexity of the case, the surgery typically lasts 1-2 hours and you can expect to go home the same day of surgery. Bruising is minimized by Dr. Zoumalan’s rapid recovery techniques but patients should expect to have some degree of swelling and bruising for at least 2 weeks.

  • Before Photo-Upper Lid Blepharoplasty Patient 164
    After Photo-Upper Lid Blepharoplasty Patient 164

    upper eyelid blepharoplasty

    This female desired to undergo an upper eyelid surgery to improve her appearance and to allow her peripheral vision to improve. An upper eyelid blepharoplasty surgery was performed to allow her to achieve her desires. The procedure was performed in the office under local anesthesia.

    Preoperative Diagnosis: Upper lid excess skin

    Procedure performed: Upper eyelid blepharoplasty

  • Before Photo-Upper Lid Blepharoplasty Patient 1
    After Photo-Upper Lid Blepharoplasty Patient 1

    This 44 year old male had excess skin and droopy upper lids which we wished to have corrected. He underwent a blepharoplasty surgery to remove his excess skin. Ptosis surgery was also performed at the same time to lift up his droopy lids, right more so than his left. His appears more rested and able to see better after having eyelid surgery.

    Preoperative diagnosis: Bilateral upper lid ptosis and excess skin.

    Procedure performed: Bilateral upper lid ptosis repair, upper lid blepharoplasty.

  • Before Photo-Upper Lid Blepharoplasty Patient 157
    After Photo-Upper Lid Blepharoplasty Patient 157

    Upper lid blepharoplasty

    Excess upper eyelid skin was bothering this patient and she wished to have her eyes more improved and rested. A minimally invasive upper eyelid blepharoplasty was performed to improve the patient’s appearance, while still enhancing her natural appearance.

    Preoperative Diagnosis: Upper lid excess skin

    Procedure performed: Upper lid blepharoplasty

  • Before Photo-Upper Lid Blepharoplasty Patient 120
    After Photo-Upper Lid Blepharoplasty Patient 120

    She had excess skin in upper lids which was making her look more tired. She was also having difficulty seeing well due to the excess skin.  An upper lid blepharoplasty was performed to improve her appearance and ability to see better.

    Preoperative Diagnosis: Excess upper lid skin

    Procedure performed: Bilateral upper lid blepharoplasty

  • Before Photo-Upper Lid Blepharoplasty Patient 119
    After Photo-Upper Lid Blepharoplasty Patient 119

    A Natural Looking Blepharoplasty TM technique was used to carefully remove some the patient’s excess skin from her upper lids. The patient did not have a visible fat pocket, but she did not like her fine lines and wrinkles on her lower lids, so a chemical peel was done at the same time.

    Preoperative Diagnosis: Upper lid excess skin

    Procedure performed: Upper lid blepharoplasty

  • Before Photo-Upper Lid Blepharoplasty Patient 2
    After Photo-Upper Lid Blepharoplasty Patient 2

    This 78 year-old male had excess skinand excess fat pockets in his upper and lower lids. He wished to undergo upper and lower lid cosmetic eyelid surgery. He underwent upper lid blepharoplasty to remove the excess skin. A ptosis repair was also done to help lift up his droopy lids to a higher position. The lower lid fat pockets were repositioned to fill in some of the hollows. His left brow was also slightly droopy so a minimally invasive external browpexy was performed to stabilize and lift his brow. He has healed well and appears more rested and youthful after having surgery.

    Preoperative diagnosis: Bilateral upper lid ptosis and brow ptosis, lower lid excess fat pockets

    Procedure performed: Bilateral upper lid ptosis repair, upper and lower lid blepharoplasty with fat repositioning to lower lids, and left external browpexy

  • Before Photo-Upper Lid Blepharoplasty Patient 46
    After Photo-Upper Lid Blepharoplasty Patient 46

    This patient desired to undergo upper lid surgery to remove her excess skin.  She was unhappy about her tired appearance and the excess skin was resulting in her inability to see well in her peripheral vision.  A minimally-invasive, skin only upper lid blepharoplasty was performed to improve her appearance.  Note the improved appearance and more youthful and refreshed look to her eyes.

    Preoperative Diagnosis: Excess skin (dermatochalasia), upper lids.

    Procedure performed: Upper lid blepharoplasty

  • Before Photo-Upper Lid Blepharoplasty Patient 44
    After Photo-Upper Lid Blepharoplasty Patient 44

    The patient underwent cosmetic eyelid and brow surgery to help improve her appearance.  She had mild brow ptosis with excess skin n her upper lids.  An upper lid blepharoplasty was performed to remove the excess skin. A minimally-invasive, skin only blepharoplasty was performed in the upper lids.  A lower lid blepharoplasty with fat repositioning and chemical peel was also performed.  Fat grafting was performed to help augment her midface and cheek volume.

    Preoperative Diagnosis: Brow ptosis, upper and lower lid aging changes.

    Procedure performed: Endoscopic brow lift, upper and lower lid blepharoplasty with fat repositioning, lower lid chemical peel, fat grafting to midface

  • Before Photo-Upper Lid Blepharoplasty Patient 15
    After Photo-Upper Lid Blepharoplasty Patient 15

    Preoperative Diagnosis: Right upper lid ptosis and bilateral upper lid excess skin (dermatochalasia).

    Procedure performed: Right upper lid ptosis repair and bilateral upper lid blepharoplasty.

Disclaimer:

*Individual results may vary

All before and after pictures displayed are real patients who have consented to having their pictures published on our site. Individual results will vary with each patient and Dr. Christopher Zoumalan does not guarantee any outcomes of procedures shown. All pictures are meant for reference and illustrative purposes only.

Upper lid blepharoplasty Recovery

Immediately After

Swelling and some bruising usually start to occur immediately after surgery, and icing can be very helpful. It is normal to have some dry eye sensation during the first week of surgery.

1 Week

Your stitches from your upper lids are removed one week after surgery. You should be able to start reading, watching TV, and doing small activities around the house for longer periods of time.

2 to 3 Weeks

Most of your swelling and bruising improves by the second week.
It is still normal to have some asymmetry between the two lids. You should be able to resume most if not all your routine day to day activities.

1 Month to 6 Weeks

Some minor amounts of swelling may still persist, which should improve over the next several months after surgery. The incisions in the upper lids usually heal well but can take time, sometimes up to several months. The doctor may inject steroid injections or provide a scar cream to help improve your scars.

Where is the incision made in the upper lids for an upper eyelid blepharoplasty?

Dr. Zoumalan will identify your natural crease carefully and make a hairline incision over the natural crease. Most of us are born with a natural crease; if the crease is too high or non-existent (such as in some Asian eyelids), Dr. Zoumalan will discuss with you options to change the lid crease. Dr. Zoumalan uses a modified technique to remove lateral excess hooding of the skin by curving the lateral markings upward which help in removing the lateral hooding but also opening up the eyelid while keep the brow elevated. The hairline incision heals well within the crows feet wrinkles. Curving downward can often result in more visible incision and can leave residual skin and also bring the eyebrow down. Dr. Zoumalan pays careful attention to the wound closure using very fine, non absorbable sutures which are removed usually in 5-6 days.