310.278.4000

fb

twitter

you-tube

google-plus

instagram

Select Your Language
  • English
  • Español

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. However, in cases where excess fat pockets have to be removed or when 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 and is only a handful of surgeons that exclusively performs 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 expert 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.

  • image

    Preoperative Diagnosis: Bilateral upper lid ptosis, upper and lower lid dermatochalasia (excess skin) and fat prolapse.

    Procedure performed:Bilateral upper lid ptosis repair, upper and lower lid blepharoplasty, lower lid chemical peel (TCA 30%).

  • right_eyelid_surgery_blepharoplasty_chemical_peel

    Preoperative Diagnosis: Bilateral upper lid ptosis, upper and lower lid dermatochalasia (excess skin) and fat prolapse.

    Procedure performed: Bilateral upper lid ptosis repair, upper and lower lid blepharoplasty, lower lid chemical peel (TCA 30%).

  • image

    Preoperative Diagnosis: Bilateral upper lid ptosis and left upper lid brow ptosis.

    Procedure performed: Bilateral upper lid ptosis repair and left upper lid brow ptosis repair through an internal browpexy technique.

  • image

    Preoperative Diagnosis: Bilateral upper lid mild ptosis, upper and lower lid dermatochalasia (excess skin) and fat prolapse.

    Procedure performed: Bilateral upper lid ptosis repair, upper and lower lid blepharoplasty, periorbital and lower lid fat grafting.

  • image

    Preoperative Diagnosis:Upper lid dermatochalasia (extra skin) resulting in lid hooding and ptosis.

    Procedure performed:Bilateral upper lid blepharoplasty.

  • image

    Preoperative Diagnosis: Upper lid excess skin and lid ptosis (droopy lid) resulting in difficulty seeing well and a tired appearance, lower lid bags and excess skin.

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

  • image

    Preoperative Diagnosis:Upper lid and brow ptosis resulting in difficulty seeing well and a tired appearance.

    Procedure performed:Bilateral upper lid blepharoplasty, upper lid ptosis repair, and upper lid external browpexy (brow ptosis repair).

  • image

    Preoperative Diagnosis:Upper lid and brow ptosis resulting in difficulty seeing well and a tired appearance.

    Procedure performed:Bilateral upper lid blepharoplasty, upper lid ptosis repair, and upper lid external browpexy (upper lid brow ptosis repair).

  • image

    Preoperative Diagnosis Above:Upper lid ptosis and upper and lower lid dermatochalasia.

    Procedure performed:Upper lid ptosis repair, upper lid blepharoplasty and lower lid blepharoplasty using a lower lid orbicularis suspension flap (skin-muscle flap) technique. Note how well the scars have healed. They are virtually undetectable even four months out from surgery.

  • image

    Preoperative Diagnosis:Upper lid and brow ptosis resulting in difficulty seeing well and a tired appearance.

    Procedure performed: Bilateral upper lid blepharoplasty, upper lid ptosis repair, and upper lid internal browpexy (upper lid brow ptosis repair done through an internal suture technique).

  • image

    Preoperative Diagnosis:Upper lid and brow ptosis resulting in difficulty seeing well and a tired appearance.

    Procedure performed: Bilateral upper lid blepharoplasty, upper lid ptosis repair, and upper lid external browpexy (upper lid brow ptosis repair).

  • image

    Preoperative Diagnosis:Bilateral upper lid ptosis and dermatochalasia.

    Procedure performed: Bilateral upper eyelid ptosis repair and upper lid blepharoplasty (The eyelid position was lifted and excess skin was also removed). This photo was taken 3 months after undergoing the surgery.

  • image

    Preoperative Diagnosis:Bilateral upper lid dermatochalasia, eyelid ptosis, upper brow ptosis, and lower eyelid laxity.

    Procedure performed: Bilateral upper eyelid blepharoplasty, ptosis repair, endoscopic brow lift, and lower eyelid canthoplasty.

  • image

    Preoperative Diagnosis:Bilateral upper lid and brow ptosis, upper and lower lid dermatochalasia (excess skin) and fat prolapse.

    Procedure performed: Bilateral upper lid ptosis repair, upper and lower lid blepharoplasty, and upper lid external browpexy.

  • image

    Preoperative Diagnosis:Right upper lid dermatochalasia (extra skin) resulting in difficulty seeing well and asymmetry.

    Procedure performed: Right upper lid blepharoplasty.

  • image

    Preoperative Diagnosis: Significant upper lid ptosis.

    Procedure performed: Bilateral upper lid ptosis repair. Excess nasal skin and protruding fat pads were removed through small incisions near the medial (nasal side) of the lid crease.

  • image

    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.

  • image

    Preoperative Diagnosis: Upper and lower lid dermatochalasia and lower lid fat prolapse.

    Procedure performed: Upper and lower lid blepharoplasty and periorbital fat grafting. Deep plane face lift (facialplasty) and periorbital fat and facial fat grafting performed by Dr. Richard Zoumalan.

  • image

    Preoperative Diagnosis: Bilateral upper lid ptosis, upper and lower lid dermatochalasia (excess skin) and fat prolapse.

    Procedure performed: Bilateral upper lid ptosis repair, upper and lower lid blepharoplasty, lower lid chemical peel (TCA 30%).

  • side_profile_eyelid_surgery_blepharoplasty_chemical_peel

    Preoperative Diagnosis: Bilateral upper lid ptosis, upper and lower lid dermatochalasia (excess skin) and fat prolapse.

    Procedure performed:Bilateral upper lid ptosis repair, upper and lower lid blepharoplasty, lower lid chemical peel (TCA 30%).

  • pre-brow-lift-face-lift-blepharoplasty

    Preoperative Diagnosis: Upper and lower lid dermatochalasia, upper lid mild ptosis, mild upper lid ptosis, facial aging, and lower lid fat prolapse.

    Procedure performed:Upper and lower lid blepharoplasty and periorbital fat grafting, ptosis repair. Deep plane face lift (facialplasty), brow lift, and periorbital fat and facial fat grafting performed by Dr. Richard Zoumalan.

    Surgeon: Christopher Zoumalan, MD. Oculoplastic Surgeon; Richard Zoumalan, MD. Facial Plastic Surgeon, Beverly Hills, California.

  • image

    Preoperative Diagnosis: Excess upper lid skin

    Procedure performed: Bilateral upper lid blepharoplasty and external browpexy

  • image

    Preoperative Diagnosis: Excess upper lid skin

    Procedure performed: Bilateral upper lid blepharoplasty and external browpexy

  • image

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

    Procedure performed:Bilateral upper lid ptosis repair (blepharoplasty) and external browpexy, lower lid blepharoplasty.

  • image

    Preoperative diagnosis: Bilateral upper and lower lid excess skin, lower lid aging changes with excess fat pockets.

    Procedure performed: Bilateral upper lid ptosis repair (blepharoplasty), lower lid blepharoplasty with fat repositioning, chemical peel to lower lids

  • image

    Preoperative diagnosis: Bilateral upper and lower lid aging changes

    Procedure performed: Bilateral upper and lower lid blepharoplasty, chemical peel to lower lids.

  • image

    Preoperative diagnosis: Bilateral upper lid ptosis, lower lid infraorbital hollowing

    Procedure performed: Bilateral upper lid blepharoplasty, hyaluronic acid fillers to her lower lid infraorbital area using Restylane.

  • image

    Preoperative diagnosis: Bilateral upper lid ptosis and excess skin

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

  • image

    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

  • image

    Preoperative diagnosis: Bilateral upper lid ptosis and excess skin.

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

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.

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.