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Eyelid Surgery

Upper and Lower Blepharoplasty in Los Angeles

As you get older, your face begins to show your age better than any other part of your body. With so much focus on the eyes, the eyelids can be one of your main sources of an aged appearance. Blepharoplasty is a plastic surgery procedure that operates on the eyelid, and is therefore often simply referred to as eyelid surgery. Eyelid surgery can be beneficial for men and women who are wanting to improve the appearance of their upper or lower lids, whether to achieve a more youthful look, or to make their eyes seem bigger or wider.

At Wave Plastic Surgery, we offer both upper and lower Blepharoplasty, as well as specialized methods for Asian eyelid surgery. Not all patients will require surgery on both the upper and lower lids, so we will carefully go through your expectations during your consultation to determine a proper procedure plan.

Upper Eyelid Surgery

Upper eyelid surgery is one of our most popular facial surgeries performed here in Los Angeles. People suffering from a drooping upper eyelid or sagging skin can often appear older, constantly tired, or even sad or angry. Our upper eyelid surgery patients tell stories of how they are being always asked if they’re tired despite feeling well-rested, how they’re thought to be older than they are, or even of how others avoid them because of the assumption they are in a bad mood. If this sounds like you, you may be a good candidate for upper eyelid surgery with one of our trained Los Angeles plastic surgeons.

We also commonly perform a modified version of the upper eyelid surgery for patients of Asian descent who are looking for a larger, wider appearance of their eyes. Visit our Asian Blepharoplasty page for more information.

How is Upper Eyelid Surgery Performed?

For your upper eyelid surgery, we will make a discreet incision along the natural folds of your upper lid. From here, we are able to carefully remove any excess skin or tissue to improve any drooping or sagging of the lid.

Once your incisions are closed, you may return home under the care of a loved one. While the recovery may be uncomfortable at first, our patients often have no regrets once they see their results in the mirror. The drowsy, aged look will be gone and in its place, a younger, brighter appearance.

Lower Eyelid Surgery

For many people, the lower eyelid is one of the first places that changes as part of our natural aging process. It is one of the most common surgeries performed for both men and women. Usually for men, the condition is more severe and noticeable.

Lower eyelid surgery is often used for treating problems such as:

  • Bags beneath the eyelid (protruding fatty deposits)
  • Wrinkles
  • Deep, dark circles
  • Depression of the lower lid border (tear trough)
  • Rounded contour of the lower lid margin
  • Lack of the lower lid orbicularis muscle protrusion

Removing Protruding Fat Beneath the Eyes

There are three separate compartments where the orbital fat resides. As we age, the tissues holding the orbital fat become attenuated and as a result, the fat becomes more visible as it protrudes out more. Depending on the severity and whether there is a depression in the lower portion of the lower lid rim, each individual’s treatment will be different.

If excess fat is the only issue, we can remove it using a transconjuctival approach (inside the eyelid). This prevents unnecessary external scars, and there is less of a chance of disrupting the tissues that can cause evertion of the lower eyelid. The removal of the fat must be conservative to prevent unwanted hollowing.

If the fat is not too significant, but does exist, the tissues holding the orbital fat can be simply tightened. This is called a septal reset. If there is hollowness in the lower lid rim, called a tear trough, the fat can be mobilized and repositioned to the bony rim margin. This helps with the removal of the protruding fat as well as filling in the defect of the tear trough.

Smoothing Wrinkles and Depressions in the Tear Trough (the Lower Lid Margin)

Older men and women may also be facing problems with wrinkles or depressions in the tear trough (the area below the lower lid).

Factors that can be causing this condition include:

  • Thinning of the lower eyelid skin
  • The skin’s attachment to the bone becomes tighter
  • The fat in the cheek descends, leaving a hollowed area below the eyes
  • The orbital fat above becomes more pronounced

In this case, if only the orbital fat is removed, it may cause even more pronouncement of the tear trough depression. Instead, we transfer the orbital fat to the lower lid rim to fill in this area. We have found that, at times, fat is not enough and therefore may need to lift the malar soft tissue with an endoscopic mid-facelift using Endotine.

Reshaping the Lower Lid Margin

A youthful lower lid margin should have a relatively straight, horizontal direction, with a slightly upward tilt towards the end. However, as we age, the lower lid margin tension becomes weak and stretched. This results in a very loose margin, giving the eye a more rounded appearance. Tightening and straightening the margin can achieve a more youthful appearance of the eyes.

The technique used to reshape the lower lid margin is called a lateral canthopexy, where the lateral tendon of the eyes is fixed to the orbital bone. This will provide for a better shape of the eyes and helps to protect against post-surgical ectropion (margin of the eyelid being pulled down), which can occur after removing excess skin.

Sculpting the Orbital Muscle in the Lower Lid:

One of the prominent features of a youthful lower eyelid is the prominence of the orbital muscle just underneath the lower eyelashes. As we age, this can appear less pronounced. We may recommend Alloderm dermal matrix or a fat transfer to sculpt the orbital muscle and restore a youthful appearance.

Schedule Your Eyelid Surgery Consultation

Your eyes tell a lot about who you are – but they don’t need to be giving away your age. Give us a call to schedule your eyelid surgery consultation today.



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