Procedures » Surgical Procedures

• Eyelid Surgery (blepharoplasty)
Before and After Photos - Blepharoplasty

"...We are so pleased with the results of your excellent work!..."
—S. K., blepharoplasty patient (and her husband)

Bags underneath the eyes and loose hooded skin of the upper eyelids can create a tired or aged appearance around the eyes for both men and women. As we age, the structural proteins of our skin, specifically collagen and elastin, begin to degrade. Coupled with the relentless effects of gravity, the eyelid skin and its supporting tissues become loose, droopy, and saggy.

But as both men and women today are living longer, healthier and more active lives than ever before—especially here in the greater Jacksonville, Florida and Ponte Vedra Beach areas—many find it important to look as young as they feel.

Blepharoplasty (Eyelid Surgery) Book CoverDr. Pearson co-authored the book chapter on Upper Eyelid Blepharoplasty in Dr. Regan Thomas's Advanced Therapy in Facial Plastic & Reconstructive Surgery.

Blepharoplasty (eyelid surgery) is the name of the plastic surgery designed to correct the aging appearance around the eyes. When considering a patient for rejuvenation of the eyelids, a careful assessment of a patient's eyelids usually reveals differences between the two, and any treatment will need to take these differences into account. At the consultation, any asymmetries will be pointed out, specific measurements may be made, and the specific features of the eyes and eyelids will be noted. Most importantly, your goals and motivations will be discussed to gain a full understanding of your desired outcome and the realistic possibilities of surgery.

Dr. Pearson performs upper eyelid surgery (upper blepharoplasty) through a fine incision hidden in the upper lid crease. Drooping eyelid skin and, if necessary, fat are removed and recontoured to restore a more youthful look. Similarly, fat from the lower eyelid is removed through a small incision just inside the lower eyelid (this is called a transconjunctival lower blepharoplasty). This more modern technique minimizes the likelihood of complications related to eyelid shape or position. If loose skin is also present, Dr. Pearson may also perform a so-called "skin pinch" excision of the lower eyelids in addition to the fat removal and repositioning.

Oftentimes, patients will choose to combine eyelid surgery with a forehead or browlift for maximum improvement in the appearance of the upper face. Blepharoplasty and browlift achieve different but complementary results and package pricing exists specifically for this common situation.

During the consultation the specifics of the custom procedure planned will be discussed in detail. As with any cosmetic surgery, it's important that you thoroughly discuss specific concerns about your eyes to make certain that you and Dr. Pearson have a clear, mutual understanding of the intended result. Only then will Dr. Pearson be able to outline what can and cannot be achieved with surgery.

The following is provided to answer questions relevant to most patients:
  • What happens if I proceed with blepharoplasty (eyelid surgery)?
If Dr. Pearson feels that you are a good candidate for blepharoplasty and you feel that results he expects to achieve coincide with your desires, then several things need to be arranged for surgery. Pre-operative photographs, routine lab work, a physical exam and various paperwork need to be completed. An eye exam to screen for conditions that may preclude having eyelid surgery may also be arranged. A second visit is typically booked shortly before your surgery date. This will allow you time to think over the many things discussed in your initial consultation, and it will allow you time to ask additional questions or address concerns.
  • Where is blepharoplasty surgery performed?
Dr. Pearson performs most of his surgery at Fleming Island Surgery Center or Middleburg Surgery Center. Both are state-licensed outpatient surgical facilities fully accredited by the AAAHC (Accreditation Association for Ambulatory Health Care). Both locations are close to his office (and a conveniently short drive from Jacksonville, Florida). Both facilities offer excellent safety while also providing the privacy and convenience patients desire. Occasionally some blepharoplasty procedures can be performed in-office under local anesthesia only.
  • What anesthesia choices will I have?
Patients may choose between local anesthesia with sedation or general anesthesia, but nowadays most patients prefer to have this type of surgery completely asleep (general anesthesia). In either case, blepharoplasty is usually performed on an outpatient basis.
  • How long does a blepharoplasty take?
Because of the custom nature of the surgery, exact times cannot be given. On average, combined upper and lower blepharoplasty surgery may take about one and a half hours to two hours, depending on the specific steps your surgery requires. You will receive a better estimate during the pre-op visit.
  • What should I expect after eyelid surgery (blepharoplasty)?
Initially the eyelids are bruised and swollen, but usually there is surprisingly little pain. Ice-water-soaked pads placed over the eyelids can minimize these side-effects. In fact, most patients immediately post-op will feel much better than their appearance would suggest. Bruises, as well as any incisions, can be concealed immediately with Lycogel camouflage makeup, if desired. However, other standard cosmetics should be avoided for the first week after surgery. Fortunately, bruising fades in approximately two weeks as does most of the swelling. Some subtle swelling may last for a few more weeks, but is mostly noticeable only by the patient and the surgeon. Scars from the upper eyelid incisions slowly fade to near invisibility by about twelve weeks, but are easily camouflaged before that time. Although heavy lifting and strenuous activity should be avoided for a week or two, patients can resume their normal activities as soon after surgery as they feel able, and can quickly begin enjoying their new appearance.
  • When are the follow-up visits after blepharoplasty?
You will usually be re-examined in the clinic the following day. On post-op day five or six, the patient is again examined in the clinic, and upper eyelid stitches are removed unless fast-absorbing suture is used (dissolvable). Dr. Pearson will discuss with you any variations to this schedule. Dr. Pearson usually also likes to see patients two weeks, six weeks, three months, and one year after surgery. These are at no charge to you, and more visits may be necessary. Dr. Pearson enjoys seeing patients long-term and yearly follow-up after the first year is welcome, but not essential.
  • Does my insurance carrier cover eyelid surgery (blepharoplasty)?
Rarely, insurance will pay for upper eyelid surgery, but only if a patient's field of view is significantly restricted by excess loose skin. In most cases though, for upper and lower blepharoplasty the patient is responsible for the entire cost of surgery. Fortunately, cosmetic eyelid surgery is one of the least expensive cosmetic surgical procedures. Call us for more details.
Cosmetic eyelid surgery has become one of the most popular of cosmetic surgical procedures due to its affordability, generally low degree of discomfort, quick recovery, and noticeable improvement in appearance. For more information about blepharoplasty and cosmetic facial plastic surgery here in Fleming Island (Orange Park) and the greater Jacksonville, Florida area, contact us or call (904) 215-7377 to schedule an appointment.

By the way, if you really want to make your new eyes stand out, you might want to check out Latisse®, the first and only FDA-approved medication for growing longer, thicker, and darker eyelashes. Read more about it on our Latisse page.