Am I a candidate for Blepharoplasty?

Blepharoplasty is a procedure usually performed on otherwise healthy patients who may have excess skin, muscle, and fat around the eyelids that they feel makes them look older than they are.

Most patients undergo eyelid surgery later in life when the effects of aging cause undesirable cosmetic changes. Younger patients may consider blepharoplasty if they have issues such as mono lids, downturned eyes, or naturally hooded eyes.

A blepharoplasty operation may be suitable for you if you are bothered by:

Mono eyelids
Excess skin on the upper lid that sags interferes/could interfere with your vision
Excess skin on the upper lid that hides the eyelid skin above the lashes
Excessive wrinkling on the upper lid
Puffiness or bags under the lower lid
Excess skin and wrinkles on the lower lids

Blepharoplasty may be suitable for you as long as you:

Do not smoke
Are not pregnant or nursing
Are in good health physically and emotionally
Have realistic expectations about what eyelid surgery can and cannot achieve for you

However, there are some reasons why some people are not good candidates for blepharoplasty, even if they fulfill some of the criteria above. Some medical conditions that may increase the risk of complications from eyelid surgery include:

Hyperthyroidism
High blood pressure (hypertension)
"Dry Eye" or problems with your tear ducts.
Graves' disease
Glaucoma
Detached retina
Cardiovascular disease
Diabetes

To increase your rate of recovery and lessen your risk of complications arising from blepharoplasty surgery, it is important to discuss your medical history, use of medications, supplements, recreational substances, and other psychological and physical health concerns with your surgeon before having blepharoplasty.

Consultation and Preparation

If you are considering eyelid surgery, you will have an initial consultation with Dr. Williams.

They will ask about your general medical history and any previous eyelid surgery. They will also ask about any possible thyroid or kidney disease as these can produce swelling of the eyelids and any history of eyelid conditions and dryness of the eyes. Your surgeon will also discuss with you the results you can expect from your eyelid operation, the inherent limitations, and the positioning of the scars.

Your blepharoplasty surgeon will give you specific instructions on preparing for eyelid surgery, including guidelines on eating and drinking, smoking, and taking or avoiding certain vitamins and medications. Listening to this advice and following these instructions will help your surgery to go more smoothly and will help to reduce the risk of possible blepharoplasty side effects and complications.

Smokers will need to quit four weeks in advance and remain nicotine-free for a minimum of four weeks after the procedure. Please arrange a ride to and from the surgical center ahead of time.

Your Blepharoplasty Procedure

The procedure typically takes place under general anesthesia, although local anesthetic may be used in some cases. The average length of the operation is one to two hours.

STEP 1 – ANESTHESIA

Your face will be swabbed with disinfectant and draped in sterile sheets. The blepharoplasty surgeon will measure the exact amount of skin to be removed and mark this on the skin on your eyelids and around your eyes. The surgeon will then administer local anesthesia starting at the outer aspect of the eyelids and continuing towards the inner eyelids.

STEP 2 - THE INCISIONS

1. Your blepharoplasty surgeon will make incisions along the marks made on your skin, and the marks are made in such a way as to hide the scars in the natural creases of the skin. If your upper eyelids are being worked on, once the incisions are made, the excess skin and then excess muscle is carefully removed. Two pockets of fat underneath the muscle will be exposed and the fat is removed using a series of surgical instruments. You will probably have bruising or swelling from your eyelid surgery that will last up to a week or more.

Additional Reading

2. If your lower eyelid is being worked on, you may have an incision inside the eyelid (normally this will be if you only need excess fatty tissue removed, not skin. The tissues are separated to obtain access to the fat pockets in the lower eyelid. The pockets of fat are exposed and a series of surgical instruments are used to remove the fat. Again, you will experience bruising and swelling following your blepharoplasty operation.

3. Alternatively, the surgeon may operate on your lower eyelid by making an incision outside the eyelid. An incision is made just underneath the lid margin and the skin is gently pulled back to allow the blepharoplasty surgeon to dissect the underlying fat pockets. The surgeon will gently press on the eye to better expose the fat that will be removed, then remove the fat and the excess skin. You will have swelling and bruising after this blepharoplasty procedure.

STEP 3 – THE SUTURES

1. Upper eyelids - The incision will be closed with small sutures that are usually underneath the skin, and may be absorbable. These sutures will normally be left in for three to five days.

Additional Reading

2. Lower eyelid, incision inside the eyelid - sutures may or may not be used, depending on your blepharoplasty surgeon’s preference.

3. Lower eyelid, incision outside the eyelid - the wounds are closed with fine sutures which will be removed after three to five days.

4. Small adhesive strips are placed over the sutures, and the blepharoplasty surgeon will probably lubricate your eyes with ointment and may apply a compression bandage after your blepharoplasty operation. Your eyelids may feel tight and sore as the anesthesia wears off after your eyelid surgery, and your doctor will prescribe pain medication. If you feel severe pain, call your surgeon immediately.

STEP 4 – THE RESULTS

1. You will need to keep your head elevated for several days after your blepharoplasty procedure and use cold compresses to reduce swelling and bruising. The extent and severity of bruising varies from patient to patient. It is worst during the first week, but should clear after two to four weeks.

Additional Reading

2. Before you leave the hospital or clinic after your eyelid surgery, you will be shown how to clean your eyes, which may be sticky for a week or so. Your doctor may recommend eye drops, as your eyelids will probably feel dry at first and may itch or burn.

3. In the first few weeks after your blepharoplasty operation, your eyes may feel “teary”, you may feel sensitive to light, and you may also experience blurring or double vision. The stitches will be removed about a week after eyelid surgery. Once they're removed, the swelling and bruising around your eyes will subside, and your new look will begin to emerge.

Types of Blepharoplasty Procedures

There are many different surgical and non-surgical options for patients who are unsatisfied with the appearance of their eyes.

Some of the procedures that we offer are:

Upper Lid Blepharoplasty
Lower Lid Blepharoplasty
Fat Grafting to the Tear Trough (Tear Trough Augmentation)
Canthopexy
Asian Blepharoplasty

Upper Blepharoplasty

This procedure lifts the eyelids and may improve peripheral vision in patients with extensive eyelid ptosis or prominent hooding. When performed on the upper eyelid, blepharoplasty is performed via an incision along the eyelid crease. Excess skin, fat, and muscle will be removed from this area, and the incision will be closed. Following blepharoplasty Oakland patients may experience bruising and swelling, but these should resolve within two to four weeks.

Lower Blepharoplasty

Puffy lower eyelids, dark circles, and wrinkles can give the eyes a tired, stressed, or aged appearance. Dr. Williams offers lower-lid surgery to address these issues. The approach they almost always use is a transconjunctival (inside the eyelid) blepharoplasty, followed by making a separate incision for skin removal on the outside.

Additional Reading

In transconjunctival lower lid blepharoplasty, the incision is placed on the inside of the lower eyelid. The tissues are separated to access the fat pockets in the lower lid. The pockets of fat are then exposed and teased out with fine surgical instruments. This technique is also known as scarless blepharoplasty or scarless eye bag removal. The advantage is that there is no visible scar.

Your surgeon will then make an incision outside the eyelid. The incision is placed just underneath the lid lash line, and the skin is gently pulled back to allow your blepharoplasty surgeon to dissect the underlying fat pockets. The surgeon will gently press on the eye to better expose the fat that will be removed, then remove the fat and the excess skin. You will have swelling and bruising after this blepharoplasty procedure.

Canthopexy

Canthopexy is a procedure that tightens and lifts the outer corner of the eyes. It also restores an almond shape to eyes that have become rounded due to aging. Canthopexy involves the reinforcement of the existing tendon and requires the removal of a minimal amount of fat to achieve a good result. Cathopexy may also prevent future hollowing of the lower eyelid. Bruising and swelling are to be expected following canthopexy, though these conditions should subside within 7 to 10 days. Canthopexy is less involved than blepharoplasty, though it also does not offer as dramatic or long-lasting results. Canthopexy may be performed under local anesthesia, and patients can expect to resume regular activity within just a few days.

Ethnic Blepharoplasty or Double Blepharoplasty

Asian blepharoplasty is used to create a natural-looking double eyelid, remove excess skin which may obstruct the visual field, smooth under-eye bags, or reduce other signs of aging. It is important to note that the goal of Asian eye procedures is to enhance the natural beauty of the Asian eye structure and not to detract from it.

Asian Blepharoplasty and Canthopexy

Asian blepharoplasty and canthopexy can be used to create a natural-looking double eyelid, remove excess skin which may obstruct the visual field, smooth under-eye bags, or reduce other signs of aging. It is important to note that the goal of Asian eye procedures is to enhance the natural beauty of the Asian eye structure, and not to detract from it.

Fat Grafting or Repositioning

Fat grafting or repositioning are often included in blepharoplasty as well as canthopexy to increase volume and create volume where needed. It is often used to treat conditions such as tear trough deformity, lower eyelid fat herniation, or periorbital hollowing.

Tear Trough Augmentation

Hollows often form under the eyes as we get older. Thanks to genetics, some individuals are also naturally predisposed to under-eye hollows and dark circles. Tear trough fillers can correct these issues by placing tiny droplets of hyaluronic acid-based fillers beneath the eye to restore volume.

Combining Blepharoplasty with Other Cosmetic Procedures

Eyelid surgery is often combined with other procedures such as facelift, browlift, or filler injections. Combining procedures into a single surgery benefits patients in that they will only have one recovery period. They may also save money on anesthesia-related costs and enjoy a fresher, more harmonious appearance overall. All available options can be discussed with Dr. Williams during your Oakland or Bay Area blepharoplasty consultation.

Non-Surgical Alternatives to Blepharoplasty

There are many non-surgical procedures that can be done to achieve your goals. For example, Botox and Dysport are great for preventing or slowing down the formation of wrinkles. Dermal fillers are great for plumping wrinkles around the eye or cheek area close to the eye to reduce under-eye hollows.

Results, Recovery, and Aftercare

You will probably have bruising or swelling from your eyelid surgery that will last up to a week or more.

You will need to keep your head elevated for several days after your blepharoplasty procedure and use cold compresses to reduce swelling and bruising. The extent and severity of bruising varies from patient to patient. It is worst during the first week but should clear after two to four weeks.

Before you leave the hospital or clinic after your eyelid surgery, you will be shown how to clean your eyes, which may be sticky for a week or so. Your doctor may recommend eye drops, as your eyelids will probably feel dry at first and may itch or burn.

In the first few weeks after your blepharoplasty operation, your eyes may feel “teary”, you may feel sensitive to light, and you may also experience blurring or double vision.

The stitches will be removed about a week after eyelid surgery. Once they are removed, the swelling and bruising around your eyes will subside, and your new look will begin to emerge.

You will be able to wear makeup again after about two weeks and return to sports and physical activities after four to six weeks. Avoiding strong sunlight during eyelid surgery recovery time is crucial, as the skin around the eyes will be even more sensitive than usual. Wear sun cream with a very high SPF, sunglasses, and hats for six to eight weeks after a blepharoplasty procedure.

Temporary Side Effects of Blepharoplasty

Side effects as a result of blepharoplasty are inevitable though they will vary from patient to patient, as with any surgical procedure. Blepharoplasty side effects can include:

Soreness, swelling, and bruising around the eyes
Sticky, dry, and itchy eyes
Watery eyes
Sensitivity to light
Double or blurred vision
Scarring

Longevity of Results

The beauty of eyelid surgery is that in some cases, the results can last a lifetime. Other individuals may re-experience sagging in future years as the tissues will continue to age, but the signs of aging may be less pronounced.

Dr. Steven Williams - Oakland Plastic Surgeon

Why Dr. Williams?

Dr. Williams is board-certified plastic surgeons and premier Oakland providers of facial sculpting procedures, including those which address conditions around the eyes.

Blepharoplasty procedures should be performed by a qualified and experienced plastic surgeon. Dr. Steven Williams is board-certified plastic surgeon and premier provider of facial rejuvenation procedures, including those that address the eyes. Dr. Williams and his experienced team of medical and aesthetic professionals at Tri Valley Plastic Surgery in Dublin, CA, provide the Bay Area with exceptional patient care and beautiful results.

The American Society for Aesthetic Plastic Surgery, Inc

Schedule your Oakland, CA, Blepharoplasty Consultation at Tri Valley Plastic Surgery Today

If you would like to learn more about improving your quality of life with any of the eye procedures or related treatments available at Tri Valley Plastic Surgery, please contact our Dublin, CA, office (serving residents in the Oakland and Bay area) during regular business hours to schedule your consultation. Call (925) 875-0700 or fill out the online booking form.

FAQs

Is Blepharoplasty common?

According to data from the International Society of Aesthetic Plastic Surgery (ISAPS), eyelid surgery is the world's third most popular elective surgery. Nearly 997,000 women and 263,000 men had the procedure in 2019 alone. At Tri Valley Plastic Surgery, Dr. Williams frequently performs blepharoplasty to help their patients refresh their eyes.

Can I have Blepharoplasty while I am awake?

Dr. Williams specializes in awake blepharoplasty with patients in the Oakland and Bay areas. Blepharoplasty surgery is usually a day procedure. You may go under local anesthesia, which numbs the area around your eyes. You'll be awake during the surgery but relaxed and not be sensitive to pain. Some patients may prefer general anesthetic, meaning you would be asleep during the operation.

How long does the Blepharoplasty operation take?

Whether you have an upper blepharoplasty, a lower blepharoplasty, or both upper and lower lids, the surgery will last between one and three hours. If you are having other cosmetic surgery procedures done at the same time, you may be in surgery even longer.

Is an overnight hospital stay required after Blepharoplasty?

Eyelid surgery may be performed in a clinic or in the hospital. It's usually done outpatient and rarely requires an inpatient stay.

Is the recovery after Blepharoplasty painful?

Your eyelids may feel tight and sore as the anesthesia wears off after your eyelid surgery. Dr. Williams will prescribe pain medication and eye drops. In the unlikely event you feel severe pain, call your surgeon immediately.

What can I expect as I heal from Blepharoplasty?

Eyelid swelling and bruising under the eyes are common post-operative blepharoplasty side effects in the first few days after eyelid surgery, though these can last up to two weeks. A rest regimen, sleeping with your head elevated, and using ice compresses can all speed the healing process.

What are the risks associated with Blepharoplasty?

Blepharoplasty complications are infrequent and usually minor. As with any surgery, the outcome is not predictable. Blepharoplasty risks and complications may include an unexpected reaction to the anesthetic, excessive bleeding, infection, or developing a blood clot, usually in a vein in the leg (deep vein thrombosis, DVT). Antibiotics may be needed to help prevent infection.

Complications that can occur specifically after blepharoplasty include:

Hematoma (a collection of blood under the skin that may require surgery to stop the bleeding and to drain the area)
Sensation disturbances (usually temporary)
Damage to the surface of the eyeball
Sunken or uneven appearance
Infection
Pigmentation changes
Poor healing of the skin – most likely to affect smokers
Allergic reactions to the anesthesia

Is Blepharoplasty permanent?

Most patients enjoy more youthful-looking eyes for an average of five to seven years. Technically, no cosmetic surgical procedure is considered permanent. The skin and tissues around your eyes will continue to age after blepharoplasty.

Can Blepharoplasty treat hooded eyes?

Upper blepharoplasty is the preeminent way to treat naturally hooded eyelids caused by genetics. If you have acquired blepharoplasty, or hooded lids resulting from aging, prescription eye drops such as Upneeq can offer a temporary solution, although the eye-opening effect pales in comparison to what upper eyelid surgery can achieve.

Can Blepharoplasty improve my vision?

Patients with heavy upper eyelids that droop onto the lash line may see improvements in peripheral vision after upper blepharoplasty.

Can I combine Upper and Lower Blepharoplasty?

Absolutely. Upper and lower eyelid surgery is a combined procedure that can be safely done on the same day. Treating the upper and lower eyelids simultaneously can correct a host of issues, from puffy eyes to under-eye bags and drooping, tired, or angry-looking eyes.

What is a good age to get Blepharoplasty?

The majority of patients who seek out eye procedures such as blepharoplasty or canthopexy are in their 40s and 50s. However, patients with naturally hooded eyes may choose to undergo such a procedure in their 20s or 30s.

What is the downtime after Blepharoplasty?

Most patients feel comfortable going out in public within seven to 14 days after blepharoplasty. High-impact exercise and heavy lifting are best avoided for four to six weeks.

What other factors can affect healing after Blepharoplasty?

Blepharoplasty recovery times will vary patient by patient and by the extent of the eyelid surgery performed. Healing time after eyelid surgery depends on a patient's physical and emotional health and response to surgery. Patients with a history of medical problems such as scarring or circulation problems and patients who smoke may experience a longer or more arduous healing time after blepharoplasty. The recovery rate also depends on the quality of a patient's aftercare and whether or not they experience complications.

Will I need a ride home from the surgical center?

Someone must be present to drive you home after your procedure. While you will most likely be awake during blepharoplasty, your vision may be blurry temporarily. Driving after three to four days may be possible if you have minimal work done. However, most patients should plan to wait at least five days before getting behind the wheel.

Is Blepharoplasty covered by my insurance?

Insurance coverage is not typically applicable to cosmetic procedures. However, coverage is possible if one of these procedures is performed to address an obstructed field of vision. As the lower lid does not usually contribute to a loss of peripheral vision, lower lid blepharoplasty is generally not covered by insurance.

Are payment plans available?

The cost of blepharoplasty can vary widely based on the extent of surgery, the type of anesthesia, and the surgeon’s expertise. Patients in need of financial assistance may apply to CareCredit or PatientFi.

Is there considerable scarring after Blepharoplasty?

Reputable blepharoplasty surgeons will take care to hide the incision lines in the natural skin folds above and below the eye. This helps to minimize scars. After the incisions heal, they should ultimately fade to a fine line that is not obvious from a conversational distance.

What are some tips for a successful Blepharoplasty recovery?

Important things to remember for a faster blepharoplasty recovery:

Keep your head propped up on pillows when you are lying down to reduce swelling and bruising.
Avoid bending forward for a few days.
Carefully cleanse your eyes and use the ointment prescribed by your surgeon.
Don't wear contact lenses for at least two weeks.
Don't drive until your eyes have stopped watering and your vision has returned to normal.

Length of Surgery	1-2 Hours, Varies
Inpatient / Outpatient	Usually Outpatient
Anesthesia	Usually general, sometimes local
Duration of Results	Long lasting. Weight loss/gain, pregnancy, and age may reduce surgical results over time.

Blepharoplasty Serving Oakland, Walnut Creek, and the greater San Francisco Bay Areaat our Dublin, CA location

Blepharoplasty at Tri Valley Plastic Surgery

What is Blepharoplasty?

What to Expect from Tri Valley Plastic Surgery

Eye procedures

Benefits of Blepharoplasty

Am I a candidate for Blepharoplasty?

Consultation and Preparation

Your Blepharoplasty Procedure

STEP 1 – ANESTHESIA

STEP 2 - THE INCISIONS

Additional Reading

STEP 3 – THE SUTURES

Additional Reading

STEP 4 – THE RESULTS

Additional Reading

Types of Blepharoplasty Procedures

Upper Blepharoplasty

Lower Blepharoplasty

Additional Reading

Canthopexy

Ethnic Blepharoplasty or Double Blepharoplasty

Asian Blepharoplasty and Canthopexy

Fat Grafting or Repositioning

Tear Trough Augmentation

Combining Blepharoplasty with Other Cosmetic Procedures

Non-Surgical Alternatives to Blepharoplasty

Results, Recovery, and Aftercare

Temporary Side Effects of Blepharoplasty

Longevity of Results

Why Dr. Williams?

Schedule your Oakland, CA, Blepharoplasty Consultation at Tri Valley Plastic Surgery Today

FAQs

Your Journey to Renewal Goes Through Tri Valley

Blepharoplasty Serving Oakland, Walnut Creek, and the greater San Francisco Bay Area
at our Dublin, CA location