Click here
REFINED BEAUTY, EXPERTLY DELIVERED​

What Is Eyelid Surgery (Blepharoplasty)?

Blepharoplasty is a cosmetic and sometimes functional eyelid surgery that removes or repositions excess skin, fat, and muscle to rejuvenate the eye area. It improves the appearance of tired, puffy, or aged eyes and restores a youthful, refreshed expression. The procedure is commonly performed on both upper and lower eyelids.

Upper Eyelid Blepharoplasty: Technique and Use

In upper eyelid surgery, an incision is made along the natural crease of the eyelid.
Through this incision:
• Redundant skin is excised
• Bulging fat pads (usually medially) are removed or repositioned
• A strip of orbicularis oculi muscle may be trimmed for better contour
• The incision is closed precisely and heals in the natural fold, leaving minimal visible scar
This technique is ideal for:
• Patients with dermatochalasis (excess upper lid skin)
• Obstruction of peripheral vision due to drooping lids
• Cosmetic aging changes such as hooding and heaviness

How it Works

• Upper eyelids only: 45–60 minutes
• Lower eyelids (transconjunctival or transcutaneous): 60–90 minutes
• Combined upper and lower blepharoplasty: 1.5–2.5 hours
• Day 1–3: Swelling, mild bruising, tightness
• Day 4–7: Stitches (upper lid) removed; patients may use makeup
• Day 14–21: Most swelling resolves; return to work and social life
• Week 6–8: Scars soften and fade; eyes look more natural
• Month 3+: Final result with full tissue settling and scar maturation
• Return to light activity in 10 days
• Major swelling subsides by week 3-4
• Visible result 2 month
• Final result 6 month
• Most patients feel socially comfortable by 14-21 days
• Makeup can be used after suture removal (day 10)
• Return to work and social events: After 3-4 week
Gentle massage around the eyes can help reduce swelling, improve lymphatic drainage, and support the healing process—especially in cases where chemosis (conjunctival swelling) or mild lower lid tension is present.
 
When to Start:
• Begin gentle massage 5–7 days after surgery, once stitches are removed and the skin is no longer sensitive.
 
How to Do It:
• Wash your hands thoroughly before each session
• Apply a small amount of moisturizing or healing cream to reduce friction
• Use the two-finger technique (typically index and middle finger)
• Start at the inner corner of the lower eyelid, glide gently toward the outer corner
• At the outer edge, hold the skin gently for 5–10 seconds, then release
• Avoid pressing directly on the surgical site or applying excessive pressure
 
Frequency:
• Repeat the massage 2–3 times per day, for 2–3 weeks or as recommended
• Each session should last 2–3 minutes per side
 
Cautions:
• Do not massage if there is redness, pain, or increased swelling
• Stop immediately and contact your doctor if you notice any unusual changes
• Avoid direct massage over sutures or healing scars for the first week
 
This technique not only supports faster drainage and reduced swelling, but also promotes healthier tissue adaptation and helps maintain a smooth lower eyelid contour.
• Noticeable improvement: 3–4 weeks
• Fully natural appearance and scar fading: 3–6 months

Lower Eyelid Blepharoplasty:
Surgical Techniques

There are two primary approaches:
 
1. Transconjunctival Approach (No skin incision)
  • The incision is made inside the lower eyelid, leaving no external scar
  • Herniated fat pads are removed or repositioned over the infraorbital rim
  • Orbital septum may be tightened
  • This technique preserves eyelid support, reduces complications such as retraction or ectropion
  • Skin quality is improved postoperatively with laser resurfacing or chemical peels, if needed
  • Best for:
  • Younger patients with fat herniation but good skin tone
  • Patients with negative vector anatomy (where excessive skin resection may cause retraction)
  • Those seeking a natural, scarless correction

Lower Eyelid Blepharoplasty:
Surgical Techniques

2. Transcutaneous Approach

  • ncision made just below the lash line
  • Allows access to both fat and excess skin
  • Fat is treated as above; a small amount of skin is removed carefully
  • Can include orbicularis suspension or canthopexy if support is needed
  • Skin quality is improved postoperatively with laser resurfacing or chemical peels, if needed
  • Best for:
  • Older patients with loose, crepey lower eyelid skin
  • Patients with significant skin laxity and wrinkles
  • When muscle tightening or lid suspension is also required

How it Works

• If the skin is loose or wrinkled, mild skin pinch excision can be added to transconjunctival blepharoplasty
• For mild to moderate wrinkles, CO₂ laser or chemical peel can be used instead of cutting skin
• Laser promotes collagen remodeling, improves texture, and tightens skin gently
• Combining transconjunctival fat treatment + laser is a modern, tissue-preserving approach with beautiful results
 
• Removes puffiness and under-eye bags
• Lifts heavy or droopy upper eyelids
• Softens tired, aged, or angry appearance
• Brings attention back to the eyes
• Can improve visual field (upper lid cases)
• Creates a smoother lid-cheek junction (especially when combined with fat repositioning or midface support)
• Upper eyelid alone: 45–60 minutes
• Lower eyelid (transconjunctival or transcutaneous): 60–90 minutes
• Combined upper + lower blepharoplasty: 1.5–2.5 hours
 
• Day 1–3: Swelling, mild bruising, tightness
• Day 4–7: Stitches (upper lid) removed; patients can use makeup
• Day 7–10: Most swelling resolves; return to work and social activities
• Week 3–4: Scars soften and fade; eyes appear more natural
• Month 3+: Final result with full tissue settling and scar maturation
 
• Canthopexy or canthoplasty (if support is weak)
• Fat grafting to tear trough or mid-cheek
• CO₂ laser or TCA peel for skin texture improvement
• Temporal or brow lift if brow descent contributes to upper eyelid heavines

Fat Repositioning vs. Fat Grafting in Lower Eyelid and Midface Surgery


When restoring volume and contour in the lower eyelid and midface region, two common techniques are used: fat repositioning and fat grafting. Both aim to reduce hollowness, smooth the lid-cheek transition, and rejuvenate the under-eye area—but they differ in approach, indication, and results.

Fat Repositioning (with Blepharoplasty)

What is it?
Fat repositioning involves mobilizing the patient’s own orbital fat pads (which normally cause under-eye bags) and transferring them downward over the orbital rim to fill the tear trough or lid-cheek junction.

How it works:
During transconjunctival blepharoplasty, the surgeon releases the fat pads from their original position and repositions them beneath the muscle or periosteum, securing them with fine sutures.

Advantages:
✅ Uses the natural orbital fat already in place
✅ Integrated into eyelid surgery (no additional donor site)
✅ Maintains vascular connection, improving fat survival and minimizing unpredictability
✅ Excellent for patients with bags + hollowness (volume redistribution)
✅ More predictable and smooth integration under thin eyelid skin

Limitations:
– Limited to the amount of fat present; not suitable for patients with fat loss only
– Requires surgical access to the orbital fat (done during blepharoplasty)
– Cannot volumize larger areas like the cheek or temple

Fat Grafting (Fat Transfer)

What is it?
Fat grafting involves harvesting fat from another part of the body (usually abdomen or thighs), purifying it, and injecting it into areas of volume loss in the face—such as under-eyes, cheeks, temples, nasolabial folds.

How it works:
Using gentle liposuction and centrifugation, the fat is processed and then injected in small parcels into the target area using blunt cannulas.

Advantages:
✅ Unlimited supply—fat can be harvested and sculpted as needed
✅ Ideal for patients with generalized facial volume loss
✅ Can treat multiple facial areas in one session
✅ Often used in combination with facelift or eyelid surgery
✅ Long-lasting results if fat survives properly

Limitations:
– Unpredictable fat survival (30–70%) depending on technique, tissue quality, and individual biology
– May require repeat sessions for optimal results
– Risk of irregularities, nodules, or overcorrection in delicate areas like the lower eyelid if not expertly performed
– Slightly longer recovery due to swelling in both donor and recipient sites

Why I Prefer the Transconjunctival Approach with Fat Repositioning and Laser

In lower eyelid surgery, my preferred technique is the transconjunctival approach combined with fat repositioning and laser skin resurfacing. This method offers the most natural and elegant results, especially for patients who have under-eye bags but still maintain good skin quality.
 
Here’s why I choose this technique:
✅ No external scar: The incision is made inside the lower eyelid, leaving no visible scar on the skin.
✅ Preservation of eyelid shape: Since no skin is cut, the natural anatomy and strength of the lower eyelid are preserved, minimizing the risk of eyelid retraction or shape distortion.
✅ Fat repositioning: Instead of removing the fat (which can lead to hollowness), I carefully reposition it to fill the tear trough and smooth the lid-cheek junction. This creates a more youthful, rested appearance without looking “hollowed out.”
✅ Laser for skin tightening: After correcting the fat, I use a gentle CO₂ laser or chemical peel to improve fine wrinkles, skin texture, and mild laxity. This avoids the need for skin excision in most cases.
 
Together, this combination allows me to refresh and rejuvenate the lower eyelid while keeping the results natural, scarless, and harmonious with the rest of your face. Most patients experience faster recovery and long-term satisfaction with this method.

Before/After Gallery

Before
After
Before
After
Before
After

Get a Free Consultation

Please provide your details below and we will contact you within 24 hours to schedule your free appointment