Our eyes are one of our most important features. Not only do they allow us to see the world, they express our deepest emotions to others and sometimes even allow us to communicate silently and connect with one another through eye contact. On top of that, they play an important role in the overall aesthetics of the face. The importance of the eyes means that they are often one of the first things we notice about each other when we first meet—which is why many people feel self-conscious about aging in the eye area. The good news is that cosmetic eyelid surgery (blepharoplasty) can restore a youthful look to the eyes and help patients regain confidence and self-esteem. Blepharoplasty in Miami is performed by the expert board-certified plastic surgeons at the Plastic Surgery Institute (PSI) Miami. 

The Effect of Aging Eyes

Throughout the course of the aging process, changes occur around the eyes that impact the overall appearance of the face. Unprotected sun exposure causes ultraviolet rays to penetrate the skin and damage its natural components, including collagen and elastin. Over time, this damage results in wrinkled and lax skin.

The eyes begin to look sunken as the extra skin creates hooding, and the skin of the upper eyelids takes on a droopy and crepe-like appearance. Permanent lines may form in the skin surrounding the eyes. The eyelashes may be sparse and the eye shape becomes ill-defined. Due in part to gravity, the skin of the midface can sag and cause the fat pads under the eyes to bulge and create eye “bags”. Changes around the lower eyelid can also cause a deepening of the tear trough. This combination often causes people to appear tired and worn, even when they are well-rested.

In addition to cosmetic changes that occur around the eyes, aging individuals also often notice that the upper eyelid skin hinders their vision. This causes issues while attempting basic everyday tasks, like reading or driving. In cases where blepharoplasty is deemed medically necessary, a patient’s insurance company may cover the cost of some or all of the procedure.

Cosmetic Eye Surgery

Eyelid surgery may be performed on the upper eyelids, the lower eyelids, or both, depending on the patient’s needs. Tissues may be removed or repositioned, and the procedure can be performed with complementary surgical and nonsurgical procedures for optimal results. The surgeon’s aesthetic goal is to leave the patient with a natural, refreshed look.

Upper Lid Surgery

Upper blepharoplasty describes upper eyelid surgery to remove excess skin, muscle, and fat. At the beginning of the surgery, an incision is created directly in each of the eyelids, and a horizontal flap of skin is cut away. This immediately improves the look of wrinkles and hooding. The underlying tissues are then accessed and repositioned or removed from around the upper eye. The two sides of the incision are sewn together, and the faint scar that remains will be hidden in the natural crease of the eyelid. The skin surrounding the upper lids will appear smoother, and the lashes and eyes become more visible. These changes help to create wider, more alert-looking eyes, and result in a larger visible portion of the eyelid allowing for a larger makeup surface area.

While the eyelid can be improved, upper eyelid surgery will not address the position of the eyebrows, so a brow lift is the best procedure for this particular concern. Brow lift surgery successfully raises the arch and positioning of the brow, corrects asymmetry, and can widen the space between the eyelids and eyebrows.

Lower Lid Surgery

Lower blepharoplasty is performed on the lower eyelids to smooth out wrinkles, remove excess skin, and correct either a hollow or full under eye appearance, depending on the patient’s individual aging pattern. The incision is created either inside the lower lid during a transconjunctival blepharoplasty, or on the external eyelid, close to the lash line. During the procedure, one or more of the fat pads may be reshaped, relocated, or removed. Surgeons are generally conservative when removing extra skin, because the thin skin may lead to the look of a hollowed appearance when too much tissue is removed.

Even young people sometimes notice bags under their eyes that cannot be improved with cosmetics or topical treatments alone, due to their facial anatomy. The positioning of the cheekbones will affect the visibility of under eye fat pads, which must be surgically corrected.

Blepharoplasty Recovery

Patients can return home soon after the surgery is complete, as long as someone can drive them home. During the initial healing period, patients should plan to take one to two weeks off from work while the initial swelling subsides and the incisions heal. Patients should keep their heads elevated and take pain medication as directed to prevent discomfort. Surgeons will provide detailed instructions and include activity restrictions like bending, lifting, and exercise. It is important that patients follow these instructions carefully to prevent complications and promote optimal healing.

“I had my surgery done with Dr. Ghersi because since the moment I met him I felt I trusted him. I did a LOT of searching for the perfect doctor. So I was a little afraid about a young doctor. But none of the other older doctors seemed to know and be as up to date as doctor Ghersi. He explained everything. And I mean Everything to me. My language. Other doctors were selling and trying to look all smart and stuff. Dr. Ghersi was amazing and gave options, lots of them, and never pushed them. So I followed my gut feeling and do not regret it at all. It’s like he said ” a change with no change” – Real patient

Complimentary Plastic Surgery

There are a number of complementary procedures that can be performed alongside blepharoplasty to treat various aesthetic concerns. Laser resurfacing performed on the eyelid and surrounding skin can smooth fine lines and will restore firmness to the skin. Other nonsurgical techniques include dermal injections below the lower lid to plump sunken skin, and Botox injections to prevent muscle movement that forms lines and wrinkles.

When patients seek anti-aging procedures, it is important that they address other areas of aging in order to get a comprehensive transformation. If a patient undergoes upper and lower blepharoplasty, but notices aging in their other areas of the face, these other features will continue to detract from their appearance. Other procedures that can address facial maturity are facial implants, neck lift, and facelift surgery. Sometimes, small areas of the body display similar signs of aging, namely the chest and neck area and the hands. Laser skin resurfacing and dermal injections are two popular procedures for fighting signs of aging in these areas. Combination procedures can be discussed during the initial office visit.

Blepharoplasty Consultation

Good candidates for blepharoplasty are healthy men and women who want to correct signs of aging in the eyelid area. Patients should have no serious health problems, and should have realistic expectations for the results of the surgery. Only a qualified plastic surgeon can determine candidacy, which is one of the reasons every patient must attend an initial consultation before scheduling a blepharoplasty.

During the patient’s first visit to PSI Miami, he or she will need to provide the surgeons with a complete medical and surgical history to ensure there are no health concerns that would cause a safety issue during or after blepharoplasty. The doctor will address eye mobility, the condition of the area skin, extra tissues, and the patient’s aesthetic concerns. The doctor and patient will discuss surgical options, nonsurgical treatments, and the different steps that can be customized during blepharoplasty. Patients may view before-and-after patient photos, and see how improvements would look on their own face with special imaging software. During the consultation, the plastic surgeon will answer any questions the patient may have.

Frequently Asked Questions

Each surgery is designed to modify either the upper eyelids or lower eyelids, and in combination surgeries, both. The upper lids contribute to hooding of the eyes, which camouflages the eyelashes. They may also display excess skin and wrinkles. The lower lids are more commonly plagued by extra bulk below the eyes, a lack of tissue leading to a hollowed appearance, and/or wrinkles.

Generally, upper blepharoplasty is performed under general anesthesia in the operating room. The satisfaction rate from this procedure is exceedingly high. The resulting appearance is youthful and the incisions are well hidden in a natural eyelid crease. Lower blepharoplasty frequently requires light sedation or general anesthesia in the operating room. The incisions are hidden just under the lower eyelashes or may be placed inside the eyelid, leaving no visible scar on the skin.

Blepharoplasty can take anywhere from 20 minutes to one hour to complete. It is important for the doctor to achieve symmetry among the eyes, so final fixes can prolong surgery time.

Some people’s genetics cause them to have hooded eyelids, protruding under eye fat pads, or dark circles from a very young age. However, most people notice signs of aging around their eyes by their late 30s to early 40s.

Recovery from eyelid surgery is typically very reasonable, with most patients returning to work in less than a week. Most of the swelling resolves in a couple of weeks, with residual inflammation undetectable for the remaining month or so. In about three weeks, patients can resume exercise and more rigorous activities. Eyelid surgery is frequently performed with other facial rejuvenation procedures such as a facelift, neck lift or rhinoplasty (a nose job), which can influence overall recovery time.

At the Plastic Surgery Institute of Miami, the surgeons have extensive experience with eyelid surgery. Additionally, all surgeons at the Plastic Surgery Institute of Miami are board-certified by the American Board of Plastic Surgery. They have performed hundreds of eyelid procedures, constantly addressing the small details with finesse and skill in order to deliver beautiful and natural results.

About PSI Miami – The Premier Plastic Surgery Group of Southern Florida
The Plastic Surgery Institute of Miami features board-certified plastic surgeons who each have experience in performing blepharoplasty surgery. In addition to Dr. Marcelo Ghersi, the practice features a professional staff of expertly trained medical professionals for the best patient care possible.

Prospective patients interested in cosmetic eyelid surgery can contact the practice by calling PSI Miami at 305.446.7700 to book a consultation.

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