Eyelid Surgery for the San Francisco Bay Area


Eyes are the central focus during social interaction with others. Facial expressions, emotions, and feelings are all accentuated with your eyes. Changes to skin around the eyes can frequently be the most noticeable signs of an aging face. As the upper eyelid skin ages, the skin begins to droop and sag, often making people look tired, sad, or even angry. The lower eyelids can become puffy, swollen, and/or wrinkled. Bags can develop underneath the eyes as a result of the fat pads becoming more noticeable. This makes people look tired and worn out even if they feel refreshed and awake. In addition, some patients of Asian descent may be interested in a procedure known as double eyelid surgery or Asian blepharoplasty. We offer surgical as well as non-surgical options to rejuvenate the eyes.

Upper and/or Lower Blepharoplasty (Eyelid Surgery)

Eyelid surgery on the upper and/or lower eyelid, known as a blepharoplasty, can produce dramatic results. In the lower eyelid, it reduces wrinkles and bags under the eyes. We can often reposition the fat to fill the hollows and create a smoother, refined contour that is more youthful in appearance. A lower lid blepharoplasty can also pull up drooping skin that reveals too much white below the iris.

In the upper lid, it reduces "hooding" and excess skin and gives the eye a rejuvenated appearance, which makes you look more rested and alert. Our goal with blepharoplasty is to restore a more youthful, natural appearance while camouflaging all the incisions in the natural creases of the eyelid skin.

An illustration highlighting the different benefits of upper and lower blepharoplasty.
While upper and lower lid blepharoplasty may be performed in conjunction, they are separate procedures with differing treatment outcomes. Upper blepharoplasty tightens skin at the upper eyelids and removes any excess left over, can better define the crease area, and reduce the hooded appearance that aging eyelid skin can bring with it. Besides correcting a fatigued appearance, an upper blepharoplasty can also serve as a functional procedure to correct any vision obstructions caused by the lax skin. A lower blepharoplasty, on the other hand, is meant to tighten sagging skin that reveals too much white below the iris, and causes undereye bags and wrinkles. Fat in this area can also be repositioned to fill in undereye hollows.

Double Eyelid Surgery (Asian Blepharoplasty)

Patients of Asian descent may be interested in a procedure known as double eyelid surgery or Asian blepharoplasty. This procedure can create a natural-looking crease in the upper eyelid for a subset of patients who do not have a distinct fold. The change to a double fold in the Asian eyelid is considered by many to create a wider or more open eye, which conveys more definition and expression. The double fold eyelid surgery is the most common aesthetic procedure performed on Asian patients, both male and female. The objective of this blepharoplasty surgery is not to create a Caucasian eyelid, but to enhance the natural beauty of the native Asian eye.

Blepharoplasty by Dr. Lieberman and Dr. Parikh

Achieving excellent results from your blepharoplasty procedure requires unique skills and qualifications. The partnership between Dr. Lieberman and Dr. Parikh provides unparalleled service to each and every patient. Collaboration affords them the opportunity to act as a sounding board for one another when determining the best possible treatment plan for each patient. You benefit from their combined skills as board certified and fellowship trained surgeons specializing exclusively in facial plastic and reconstructive surgery.

Why choose Lieberman & Parikh Facial Plastic Surgery?

  • Specialized Training
  • Education & Research
  • Humanitarian Outreach
  • Outstanding Service & Results

Pre-Operative Process

Am I a blepharoplasty candidate?

Not everyone is a candidate for this procedure. Selecting the right candidate for surgery is an important part of every consultation. Common reasons for seeking out a blepharoplasty include:

  • Crowding of the upper eyelid with bunching and/or sagging of the skin in the upper eyelid
  • Bunching of skin at the outside corner of the eyes
  • Puffiness of the lower eyelids with protrusion of fat bags
  • Hollowing, shadowing and/or wrinkling of the lower eyelid
  • Looking tired or even angry

Some patients actually have trouble seeing because of the droopy skin at the upper eyelid. If you are determined to be an appropriate candidate, you may elect to have a brow lift in addition to upper blepharoplasty, as treating the upper eyelids alone may not be enough to rejuvenate the area. The problems around the eyelids may be worsened by sagging of the forehead and brow, causing even more heaviness of the upper eyelids. Many patients who present concern about their eyelids are surprised to hear the problem may actually be due to aging/sagging of their brow, and not their eyelids. Often the general concern that the upper part of the face appears aged and tired is a result of a combination of both eyelid and brow problems, and thus the best approach may be to perform both blepharoplasty and brow lift surgery. Other procedures that may be combined with blepharoplasty are facelift and neck lift.

Preparing for Blepharoplasty

Your blepharoplasty consultation will include a thorough review of your medical history, up to and including how you're feeling that day, any medications you're taking, and prior medical or cosmetic surgeries. You will also be asked to explain your ultimate aesthetic hopes for your eyelid to ensure that the doctor understands what you want to achieve via your surgery.

You will also receive a physical examination that may include a vision test.

In the two weeks before your blepharoplasty surgery, you should avoid taking any medications or supplements related to thinning blood or increasing its flow. You should also avoid drinking alcohol in the days prior to your appointment, and if you smoke, stop at least 14 days before your appointment to ensure your skin is in the best condition it can be in to promote healing and ideal results.

Since the procedure involves the use of an anesthetic, it’s important to coordinate your trip home after your blepharoplasty surgery with a responsible adult who can safely drive you where you need to go and stay with you as necessary while you recuperate, at least for the first night.

Blepharoplasty Technique

How is blepharoplasty surgery performed?

Both upper and lower eyelid surgery and double eyelid surgery can be performed under mild sedation or general anesthesia. Each operation takes approximately 45 minutes. Most patients go home the same day as their blepharoplasty and return on the fourth day after surgery for suture removal. The incisions are carefully placed to render them imperceptible following healing.

What should I expect on the day of my blepharoplasty surgery?

Prior to surgery you will meet the anesthesia team and be asked to review any allergies, as well as your major medical history. You'll be given a medication to help you relax. When you wake up after your blepharoplasty, your vision will be slightly blurry and there will be some ointment in your eye. We work hard with the anesthesiologist to minimize any nausea or pain after surgery. After one to two hours of recovery you can be discharged from the surgery center with a family member or friend. We ask that someone stay with you for the first 24 hours after blepharoplasty surgery.

What does the blepharoplasty surgery itself involve?

After the blepharoplasty patient receives the anesthetic or sedation, the doctor will make an incision appropriate to the eyelid being treated: upper or lower.

The incision on the upper lid will follow a natural crease, which allows for ease of access during the blepharoplasty procedure and will hide any scars in the folds there. The doctor may remove fat through the incision, as well as use it to reposition remaining fat and tighten muscles as necessary. Any excess skin will be trimmed away.

The same changes may be made to the lower eyelid, though this incision is typically placed just below the lash line. If the patient isn’t having any skin removed, the blepharoplasty incision may be positioned on the inside of the lower lid.

The doctor will close up the incisions with removable sutures, after which you will begin the healing process and may schedule your follow-up visits.

Post-Operative Recovery Process

What should I expect after my blepharoplasty surgery?

Our philosophy is to see you early and often after surgery. We will do a careful exam and answer any questions you may have during your post-operative visits. Your sutures will be removed three to four days after blepharoplasty surgery. Bruising and swelling around the eyes may occur, but by one to two weeks after the procedure this has mostly resolved and the residual bruising can usually be camouflaged with make-up or dark glasses. The glasses can also serve as sun protection for the area throughout the healing process.

Some patients have reported dry or irritated eyes following their blepharoplasty surgery, but again, this is temporary. Patients who want to ease any such discomfort can get a prescription for medication, or may try ointments or cold compresses as recommended by the doctor. The For the Face team can answer any questions you have about post-operative recovery and what to expect from a blepharoplasty, so be sure to seek answers to your satisfaction at your consultation and at any subsequent visits.


Bandage Removal


Suture Removal

4 days

Return to Work

7-10 days


2-3 weeks


2-3 months

Our core objective is to provide a safe, comfortable surgical experience that aspires to restore your appearance and aims to produce natural results. We have provided before and after photos of our patients to help you visualize the possibilities.

Blepharoplasty Results

While a blepharoplasty will rejuvenate sagging eyelids, it won't stop the aging process. Many patients enjoy results that keep them looking alert and vibrant for the rest of their lives. Others find that time and gravity work together to eventually cause the skin and tissue to droop once again. One of the best ways to maximize blepharoplasty results is to take good care of your skin by eating well, getting plenty of rest, and hydrating adequately and often.

*Individual patient results may vary

Non-Surgical Eyelid Rejuvenation

A blepharoplasty isn’t the only option for patients looking to get a more alert appearance.

The fine lines and wrinkles at the corner of the eyes can sometimes be treated with Botox® Cosmetic, Dysport®, or Xeomin®. These medications are injected into muscles in order to temporarily improve the look of moderate-to-severe smile lines at the corner of the eyes ("crow's feet"), and they can also be injected into the strong muscles that pull the brow down, temporarily weakening those muscles and creating a brow lift. This opens up the eyes, making a person look more rested and rejuvenated.

When BOTOX® Cosmetic, Dysport®, or Xeomin® are placed in very precise locations, the corner of the eyes will appear softer and smoother. While this type of treatment is a temporary solution, it can serve as a bridge for patients considering surgery or who want a simple way to rejuvenate the area around the eyes. The results typically last several months, after which the eyelids will gradually return to their pre-injection appearance. Patients interested in this method can talk to the doctors at For the Face to determine whether regular maintenance treatments may be right for them.

The skin beneath the eyes starts to thin as we age. This may make the blood vessels underneath the eyes appear like dark circles. The bony depression underneath the eyes is called the "tear trough." As the cheek descends with age, the depression appears deeper, creating a shadow. If the lower eyelid bags begin to show through the skin, that shadow is intensified. All these changes create a contrast of light and shadows.

Dasha, Real Patient
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We can reduce the appearance of all of these changes of the lower eyelid and cheek with the most advanced dermal fillers. Products such as Restylane®, Juvéderm®, Voluma®, Belotero®, Radiesse®, and Sculptra® can restore the volume in this area. These fillers will smooth out indentations and diminish shadows, reducing the appearance of dark circles and bags. We also offer the microcannula injection method (the use of a very thin, blunt needle), which can result in significantly less swelling, bruising, and downtime. We combine an artistic eye with a deep understanding of facial anatomy and the causes of aging to restore harmony to your face.

Some patients may request chemical peels or laser resurfacing to even out uneven pigmentation on their lower lids following a blepharoplasty surgery. For the Face focuses on both surgical and non-surgical facial rejuvenation, so there are a variety of options available to address skin tone.

What Complements a Blepharoplasty?

Some patients find that their newly alert appearance inspires them to make other cosmetic changes to their face. As noted above, a brow lift pairs well with blepharoplasty, since both surgeries combat some of the earliest signs of aging and can help patients to accurately convey the emotions they’re feeling, rather than appearing to be tired, worried, or angry all of the time. Also known as a forehead lift, this procedure can smooth out deep forehead wrinkles and raise eyebrows that have begun to droop.

A facelift can rejuvenate the cheek and jowl areas to give the entire face a rejuvenated appearance, tightening away sagging from below the lower eyelids to the chin. Below that, a neck lift can address loose tissues found there.

Patients may opt to mix and match a blepharoplasty and other surgeries to address areas of particular concern, and the For the Face team is always ready to assess each unique situation and give advice that takes a whole person (not just the eyelids) into account.