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The Blepharoplasty Procedure

Eyes are the central focus during social interaction with others. Facial expressions, emotions, and feelings are all accentuated with your eyes. Changes to the skin around the eyes can frequently be the most noticeable signs of an aging face, but surgical eye rejuvenation can help. Men and women visit the facial plastic surgeons at L&P Aesthetics for blepharoplasty (eyelid surgery) in Palo Alto and Los Gatos, CA, from across the San Francisco Bay Area, including San Jose, Mountain View, and Redwood City.

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.

Woman eye closeup

What to Expect During the Procedure

In the 2 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.


Because 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.

Day of Surgery

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.

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 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 closely with the anesthesiologist to minimize any nausea or discomfort after surgery.

After 1 to 2 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.

Blepharoplasty Procedure illustration

Why L&P and What Does Blepharoplasty Do?

While upper and lower lid blepharoplasty may be performed in conjunction, they are separate procedures with different treatment outcomes.

  • Upper blepharoplasty tightens skin at the upper eyelids and removes any excess leftover. It can better define the crease area and reduce the hooded appearance that aging eyelid skin can bring with it. Besides correcting a fatigued appearance, upper blepharoplasty can also serve as a functional procedure for correcting any vision obstructions caused by the lax skin.
  • 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.

Blepharoplasty Before and After Gallery

View real results from real patients below.

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Facelift Neck Lift before and after treatment

Natural Rejuvenation with Signature Lift

This patient had out L&P Signature Deep Plane Facelift and Neck Lift with tissue contouring, a lower blepharoplasty, a limited fat transfer, and a chin implant. Yes, that is a handful of procedures, but look at how natural her outcome is. We wanted to focus on maintaining volume while contouring deep tissues for a youthful appearance. She mentioned that not even her closest loved ones know that she got surgery… You can always chalk it up to a good night’s sleep!

Facelift Neck Lift before and after treatment

Revision Facelift, Neck Lift, Brow Lift & Lower Bleph

This beautiful patient of ours felt like her looks on the outside didn’t match up with how energetic she felt on the inside. She entrusted us with her face and we feel privileged for that honor. She underwent a revision facelift using our signature L&P technique- modified deep plane technique with deep neck contouring, lower lid blepharoplasty, brow lift, lip lift, chemical peel and chin implant.

Facelift Neck Lift before and after treatment

L&P Signature Facelift & Neck Lift For Woman From San Carlos

This beautiful woman from San Carlos came to Drs. Lieberman and Parikh for full facial rejuvenation. She was concerned that she looked much older than she was, and she was suffering from low self-confidence because of it. Drs. Lieberman and Parikh performed their L&P Signature Facelift and Neck Lift along with a lip lift, upper blepharoplasty (eyelid surgery) and fat transfer for a full and natural transformation.

Recovery and Beyond

An upper or lower eyelid lift (or both) 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, more 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, the surgery 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.

Blepharoplasty FAQs

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 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 wrinkling of the lower eyelid
  • Looking tired or even angry

Many patients who are concerned about their eyelids are surprised to hear the problem may actually be due to aging/sagging of their brow area 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.

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 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 nonsurgical options for rejuvenating the eyes.

The cost for eyelid surgery at our Palo Alto practice depends on whether you have upper eyelid surgery, lower eyelid surgery, or both, and whether you combine your eyelid surgery with other procedures, as well as individual factors. You will be provided with a personalized price estimate during your consultation with one of our facial plastic surgeons.

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 the 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.

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. 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.

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.

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

Wrinkle Treatments

The fine lines and wrinkles at the corner of the eyes can sometimes be treated with BOTOX®Cosmetic, Dysport®, or Jeuveau™ at our Bay Area practice. These medications are injected into muscles 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 Jeuveau 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 L&P Aesthetics to determine whether regular maintenance treatments may be right for them.

Under-Eye Treatments

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.

We can reduce the appearance of all of these changes of the lower eyelid and cheek with the most advanced dermal fillers. These products can restore the volume in this area, smoothing out indentations, diminishing shadows, and 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 skin resurfacing to correct uneven pigmentation on their lower lids following eyelid surgery. L&P Aesthetics focuses on both surgical and non-surgical facial rejuvenation, so there are a variety of options available to address skin tone.

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