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If the eyes are the windows to the soul, then the eyelids need to stay out of the way. Unfortunately, as we age, the upper eyelids can droop, and the lower eyelid can get puffy. The result is a tired or disinterested expression. This is the typical scenario that brings patients to my Walnut Creek Plastic Surgery office seeking Blepharoplasty.

Eyelid Lifts

Blepharoplasty is a relatively short, outpatient surgical procedure performed in an accredited surgery center, which can restore a more youthful appearance.

It’s not uncommon for upper eyelid skin to drop with normal aging. When the upper eyelids drop, the skin can end up resting on the eyelashes. This makes wearing eye makeup problematic. Not only can the redundant skin hide the makeup, but the makeup is often smudged with each blink.

Notice the change in the upper eyelid position in the Blepharoplasty Before and After Pictures below. Before eyelid surgery, the upper eyelid skin is resting on the lashes and pushing the eye closed. After the eyelid lift, the upper eyelid skin is easily seen between the palpebral fold and the eyelashes.

Eyelid Lift before and after pictures (Blepharoplasty)

Upper Eyelid lift before and after pictures: As we age, our upper eyelids can sag until they rest upon the upper eyelashes. After blepharoplasty, the skin above the lashes is clearly visible and the eyes look bigger and more attentive.

In addition to the anatomical changes, there is a change in her overall look. Before blepharoplasty, her eyes appear squinty. Squinty eyes are often interpreted as sneaky or sleepy. After blepharoplasty, her eyes are fully open giving her an alert, receptive and more youthful look.

Upper Eyelid Lifts

The upper eyelids tend to get heavier with age. The fat beneath the eyebrows atrophies and the brow skin slides down, pushing the eyelid skin toward the lashes. Additionally, the attachment between the eyelid skin and muscle loosens allowing gravity to do its worst. The skin on the eyelids also loses collagen and elastin, which leads to thinning and wrinkling as we age.

Upper Eyelid Lift before and after pictures (Blepharoplasty)

Upper Eyelid lift before and after pictures: Heavy upper eyelids give a disinterested or tired appearance and can obstruct vision. After her upper eyelids lift, she looks alert and awake.

The patient above had very heavy upper eyelids, blocking both upward and lateral vision. Her Upper Eyelid Lift is dramatic, but still looks natural. Blepharoplasty improved her peripheral vision and gave her the youthful, well-rested appearance she desired.

Lower Eyelid Lifts

Lower eyelids also change as we age. The fat on the cheeks atrophies and drops, revealing the edge of the bony eye socket and the fat that cushions the eyeball.

The patient below looks tired despite being well rested. He has large bags beneath his eyes, causing premature aging.This is called fat pseudoherniation. Pseudo because it’s not truly a hernia, just a bulge – a bulge no one wants.

Lower Eyelid Lift before and after pictures (Blepharoplasty)

Lower Eyelid lift before and after pictures: In the before picture this patient has large bags under his eyes which make him appear tired. In the after picture his lower eyelid bags have been unpacked and he looks rested.

The secret to a successful blepharoplasty is to remove just enough fat to smooth the lid, but not too much which would cause a hollow appearance.

After Lower Blepharoplasty, this patient’s lower eyelids are smooth and the tired look is gone, even with his heavy upper eyelids. (These were fixed later.) If both upper and lower eyelids are bothersome, they are often rejuvenated together in a single operation.


This next patient is cheating in her before picture. In order to keep her eyes open, she is activating her forehead muscles. While this does help her see, it gives her a slightly startled and stressed appearance. By removing the excess upper eyelid skin, she can relax her forehead, giving her a more relaxed and approachable appearance. In addition, chronic activation of the forehead muscles causes transverse forehead lines.

Eyelid Lift before and after pictures (Blepharoplasty)

Eyelid lift before and after pictures: In the before picture, her eyelids are resting on her lashes. In the after picture there is enough space for eye make up.

Before Blepharoplasty, the upper eyelids are heavy and the upper eyelid skin is resting on her eyelashes. Her eyebrows are also higher on her forehead. In the after picture, the eyebrows are relaxed, and thanks to her eyelid lift, the eyelid skin is higher and no longer in her field of vision.

Eyelid Rejuvenation Consultations

Cosmetic Eyelid Surgery is a surgery that requires great attention to detail. Choose an experienced, Board Certified Plastic Surgeon for the safest and most predictable results. In the San Francisco Bay Area call (925) 943-6353 to schedule your private consultation appointment.

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