Dr. Andrew Barnett MD Cosmetic Plastic Surgeon

Eyelid Surgery (Blepharoplasty)

The eyes are absolutely critical because one always looks at the eyes first. The goal, clean and crisp, never harsh, hollow, or startled.

-Andrew Barnett, MD

While it's with your eyes that you first relate to people, it's also your eyes that show the first signs of aging. Blepharoplasty, a safe procedure performed for over seventy-five years, is the medical term for eyelid surgery. Through blepharoplasty, we are able to erase many of those years, producing a dramatically pleasing result.

How is eyelid surgery performed?

Using a local anesthetic, either in the office or hospital, the excess skin, muscle, and fat in your eyelids is surgically removed through strategically placed incisions. Sedation is given to make you drowsy throughout the procedure.

That sounds easy. What happens next?

The surgery usually takes about an hour. After that, a light temporary dressing is placed on your lids, ice packs are applied to minimize swelling, and you're allowed to recover for a short period of time. You can then go home, or stay overnight. Stitches are removed in four to seven days.

Will I be black and blue?

Every patient is an individual, and the degree to which you show bruising will determine how much black and blue you develop around your eyes. The bruising generally lasts for five to ten days, though in some cases it can be shorter or longer. After the stitches come out, a light dusting of cosmetics is generally adequate to cover the bruising until it disappears completely. This works for both men and women.

When can I go back to work?

It's important that you take it easy for two to three days. Any straining can cause bleeding to occur, which will slow down your recovery. After three days, you could go back to work, but some bruising will be present. Most patients leave one to two weeks to recover before returning to full activity.

Where are the incisions placed?

On the upper eyelids, the incision is placed at the normal horizontal fold which occurs in the middle of the eyelid. On the lowers, the incision is placed just below your eyelashes. Although all incisions heal with scars, the eyelids are quite kind in this respect, and you can expect an almost invisible scar. In some cases, especially with bags under the eyes, the incisions can be placed on the inside of your eyelid, so there are no external scars.

Can my eyes be reshaped?

With the knowledge we've gained creating folds in Asian eyes and lifting drooping eyelids, changes in shape can be made. These changes require a bit more surgery, which we can discuss in detail at your consultation.

What about cosmetics and eyelid surgery?

Many women decide to have a blepharoplasty when they realize that the lid has drooped so much that it's difficult to apply make-up to the upper eyelid, or that the make-up is hidden by the folds of skin. After your surgery, this is generally corrected. I often suggest a subtle change in the way you apply makeup, so that your new eyes are shown in their best light!

Will insurance pay for the surgery?

If the droop of your upper eyelids significantly reduces your side vision, insurance companies may pay a portion of the surgery, although it is becoming much more difficult to receive coverage. The companies usually require an examination by an ophthalmologist to document this reduced vision.

When should I have eyelid surgery?

When you need it! In a small number of patients, surgery is performed on lower lids in the late teens or early twenties. Women in their early to mid thirties who are very conscious of appearance frequently have upper eyelid surgery, while the forties are the average time for both men and women.

Are men having eyelid surgery?

Definitely! Of all the facial cosmetic surgery performed, blepharoplasty is the most common procedure chosen by men. The reasons are clear. Baggy eyelids not only make one appear older, they can make one appear exhausted. While our society is kinder to men with respect to aging, it can be very hard on the executive who appears "exhausted" because of his or her "bags". Men who choose blepharoplasty frequently give this as their reason.

How long do the results last?

Eyelid surgery is quite long lasting. You never lose the improvement you've gained by the procedure, but the process of aging continues. It's unusual to need additional surgery for at least seven to ten years, and most patients never require additional surgery. Drooping of the eyebrows may create the appearance of heaviness in the upper eyelids, but this is a separate problem. (See the sheet on Brow Lift for additional information.)

Are there any risks to blepharoplasty?

As with any surgical procedure, there are risks. Bleeding, infection, and scarring may occur. Asymmetry between the two eyelids as well as droop of the eyelids may be present after surgery. It is not uncommon to have a sense of dryness in the eyes for a number of weeks after the procedure. Loss of vision, though extremely rare, has been known to occur. This information is given not to frighten you, but to help you make an informed decision. Although eyelid surgery is generally a very safe procedure, it should not be taken lightly.

Is blepharoplasty right for me?

That's a question only you can answer. At your consultation, speak frankly, ask questions, and explain your expectations. We'll work together to help you make the decision that's right for you.


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“I am a registered nurse… so after a lot of research and speaking to other physicians and fellow nurses… my decision was made. He is an artist and I believe the best in his field. Now my favorite thing to do is shop for bras. Thanks Dr. B, you are truly the best.”

-AN, RN, Napa, CA

“As a physician, I know about physician hype and marketing, the go to surgeon nonsense… Having lived and worked in the Bay area for many years, when it was my time I asked colleagues who performs consistently excellent facial work. Your name came up repeatedly… While I was impressed with your professionalism, it is the artistic, balanced, natural result that reminds me everyday that I made the right choice putting my face in your hands. Thank you.”

-LC, MD, Palm Springs, CA

“When I tell people that I have two adult children, they look at me and say, “You must have been a child bride.” Well I love the look on their faces when I tell them I’m 63. Sometimes I say “You know, Dr. Barnett is my secret weapon”, but most of the time I just say, “Oh, I guess I’m lucky. Good genes…” If they only knew! You are wonderful.”

-JG, San Francisco, CA





Copyright 2014. All rights reserved. Andrew Barnett, M.D.