UPPER EYELID SURGERY (UPPER BLEPHAROPLASTY)

Aesthetic upper blepharoplasty is ideal for patients with excessive upper eyelid skin that gives patients a “tired” look or can hang down and impair vision. For some patients, it can get so severe that the skin rests on their eyelashes, making it hard to open their eyes and obstructing their visual field. Excess eyelid skin is removed during the procedure, and the underlying tissue can be re-positioned to improve the overall appearance. Whether the upper blepharoplasty is done for aesthetic or functional purposes, the goal is to create fresher-appearing and rejuvenated eyes.
 

Good candidates for this procedure:

  • Patients with excess skin obscuring the natural fold of the upper eyelids

  • Patients with loose upper eyelid skin that impairs vision

  • Patients with upper eyelid puffiness which makes eyes look tired and sad

  • Patients whose small or rough upper eye surface makes it difficult to apply makeup

 

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What to expect: Consultation

All cosmetic consultations are complimentary and serve as a great opportunity to gain further insight by voicing your concerns and having questions answered. During the initial consultation, Dr. Hsu will ask some questions to get to know you and determine if you are a good candidate for upper eyelid surgery.

Dr. Hsu will first ask you about your specific goals for the upper eyelid surgery. He will also ask you about your general health history, including any existing medical problems, prior surgery, daily medications, allergies, and any smoking habits.

Dr. Hsu will then give you his assessment on whether you would be a good candidate for the procedure, and if so, how the surgical plan should be individualized for your anatomy. Since each patient's anatomy and surgical goals are different, you and Dr. Hsu will work together to reach optimal aesthetic results.  
 

Surgery Details:

On the day of surgery, Dr. Hsu will meet you in the pre-operative area before surgery to make markings on the areas planned for surgery and answer any last minute questions you may have.

Upper blepharoplasty procedures are performed with the patient under local anesthesia for a duration of approximately one hour. Dr. Hsu will make the incision in your natural upper eyelid crease, ensuring that scar will be well hidden. He will remove excess skin, a little bit of fat, and may also tighten up the underlying muscle depending upon the patient’s individual anatomy.  The goal is to create rejuvenated and natural appearing eyelids. 
 

Recovery & Post-operative Instructions:

upper eyelid surgery markings

After the surgery, use a cold compress or hand towel in 20 minute intervals on the surgical area for the first 48 hours to help minimize swelling. 

You must keep your head elevated during the recovery period, making sure to sleep on two pillows at night. For most patients, by two weeks after surgery, bruising and swelling has subsided enough for makeup and concealer to cover any remaining bruising.

Dr. Hsu will usually remove stitches during your first week follow up appointment. Swelling & bruising will peak about 48 hours after surgery but will then decrease significantly in the first two weeks. Most patients can return to work after two weeks, but many patients return even sooner. The biggest limitation for post-operative patients is driving, which should be avoided while taking pain medication. Patients usually stop taking pain medication after five to seven days and plan their work schedules accordingly. Six weeks is usually an appropriate time to gradually return to full exercise and activity.

During the recovery period, we recommend walking within the house several times per day to speed healing and minimize the possibility of developing blood clots. If you have any issues after surgery, Dr. Hsu is available 24 hours for any immediate concerns. For an extended period of time after surgery, Dr. Hsu will see you to make sure you are healing well. Follow up appointments are scheduled one week, two weeks, and several months to a year afterward.

 

Dr. Hsu's view on Upper Eyelid Surgery.

Both upper eyelid surgery and lower eyelid surgery are two of my favorite procedures for patients. These usually give excellent results with immediately visible benefits for patients.  The eyes and their surrounding skin are some of the first areas of the face to experience changes with aging, so early rejuvenation of these areas can make a dramatic difference.

Upper eyelid surgery and the mini-facelift are the two most common procedures I perform.  Most commonly, upper eyelid surgery is done in conjunction with a mini-facelift or facelift.  My approach to upper eyelid surgery is to rejuvenate the appearance in a conservative fashion and to minimize the amount of fat removal.  Until recently, the general approach to eyelid rejuvenation was to remove fatty deposits in the upper and lower eyelids.  However, more recent plastic surgery research has shown that removing fatty deposits excessively can lead to a “hollowed out” look for the upper eyelids.  This is particularly true for certain ethnicities as well.  

Again, every surgeon is different, but based on this research, I prefer to approach the eyelids in a conservative fashion with an emphasis on preserving as much fat and tissue as possible.  Most patients do require some skin removal in the upper eyelids, and often a small amount of fat as well.  As long as the fat removal is conservative, the results can be excellent and long-lasting.