Eyelid Surgery – Blepharoplasty

As we age, our eyelids tend to become heavy, tired-looking, saggy, and puffy. Eyelid skin can also become crepey (thin and wrinkly), which can add years to the way we look.

Blepharoplasty can be effective in restoring a youthful and alert appearance as well as removing obstructions to vision. I frequently perform the procedure in place of more intensive options, such as facelift, because of the impact eyelid surgery alone can make.


44 year old before (above) and after upper and lower lid surgery. Upper lid skin removal was conservative due to her low eyebrow position. Bulging fat was “recycled” to fill the hollows of the dark circles.

44 year old before (above) and after upper and lower lid surgery. Upper lid skin removal was conservative due to her low eyebrow position. Bulging fat was “recycled” to fill the hollows of the dark circles.


My Approach to Blepharoplasty

Upper Eyelids

Upper eyelids can often sag to a point that the extra skin interferes with vision or becomes irritated by the eyelashes. The standard blepharoplasty procedure is to:

  • Excise a small amount of skin and muscle above the upper lid crease.
  • Create a more defined eyelid fold.
  • Conservatively remove bulges of fat for a smoother line.

However, in the right cases, I recommend laser resurfacing rather than excising the skin. In this approach, I use an erbium laser to shrink the tissue around the eyes instead of a scalpel. This can improve sagging skin by about 30 percent. It also can re-texturize the skin, which reduces the appearance of puffy or crepey eyelids.


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6 weeks after upper lid blepharoplasty


Lower Eyelids

Many patients come to my practice to improve dark circles under their eyes or puffy lower lids. Blepharoplasty can address both concerns with the right technique.

Traditional lower eyelid surgery focuses only on reducing puffiness by removing fat from the area. However, this doesn’t help with dark circles. The newer solution and the approach that I use is to:

  • Lift the muscle.
  • Open the periorbital.
  • Tease fat into the depression.

This moves the fat that causes puffiness to the area where it is needed, reducing the appearance of dark circles.


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68 year old with low brows and excess upper eyelid skin


What You Can Expect with Blepharoplasty

In the initial consultation, patients discuss the type of results they want to achieve and get answers to the questions they have. After we determine whether they will have upper and / or lower eyelid blepharoplasty, patients receive testing to ensure they are healthy enough for surgery.

Plastic Surgical Associates of Fort Collins provides an AAAASF-accredited suite of operating rooms and uses only board-certified anesthesiologists. During the procedure:

  • Patients receive local anesthetic and sedation.
  • I conduct surgery and / or RF laser treatment on the eyelids.
  • My approach targets the specific areas of concerns that patients voiced in their consultation.

Recovery from Blepharoplasty

I advise patients to stay comfortable and inactive for three days. Ideally, they recover in a recliner with moist icepacks on eyes. By following these instructions for three days, most patients will be nearly bruise-free by the fourth day.

Blepharoplasty patients return to PSA five days after surgery to have stiches removed. Most are back to office work within one week and heavier physical activity in six weeks. By this point, they can see the final results of their procedure, which typically is a more youthful and energetic appearance.

If your eyes are adding age and fatigue to your appearance or your eyelids are obstructing your vision, consider blepharoplasty. Contact PSA at (970) 493-7445.