Blepharoplasty — upper, lower, or combined — that removes what exhaustion and time have deposited around the eyes, revealing an alert and fully rested version of your face.
Overview
The eyes are the most expressive feature on a human face and the first place another person looks. They are also among the first areas to show the effects of aging — hooded upper lids, puffy lower bags, fine crepey skin along the tear trough. These changes can make a person look tired, older, or vaguely unwell, regardless of how they actually feel. Blepharoplasty corrects them with a degree of precision and impact that is, among all facial procedures, perhaps the most disproportionate relative to the scale of the surgery involved.
This is one of the reasons eyelid surgery has been among the top five most-requested cosmetic procedures in the United States for decades. The incisions are small, the recovery is typically 7 to 10 days, and the change — when done well — is striking. People see it immediately: the eyes look brighter, more open, more rested. The face looks younger, but not surgical. Nobody knows quite what changed, and that ambiguity is the signature of excellent work.
Dr. Newman performs upper blepharoplasty, lower blepharoplasty, and combined upper and lower blepharoplasty. He also performs Asian (double eyelid) surgery as a subspecialty. Each procedure is planned individually based on your anatomy, skin quality, fat distribution, and what you want the result to look like.
Upper eyelid aging is primarily a problem of excess: excess skin accumulates along the upper lid as the skin loses its elasticity and the forehead tissue descends with gravity. In mild cases, the effect is a heavy, tired appearance — the upper lid looks fuller than it once did, and the crease has moved downward or disappeared. In more advanced cases, the excess skin folds over the lash line and may begin to obstruct peripheral vision — a functional issue that can qualify some patients for insurance coverage.
Upper blepharoplasty removes the excess skin — and, when present, excess fat — through an incision placed precisely within the natural eyelid crease. The scar falls into the crease when the eye opens, rendering it invisible in normal conversation and essentially imperceptible without close examination. The procedure takes approximately 45 minutes to an hour under local anesthesia or light sedation, with results that are long-lasting and often permanent for the skin component.
Lower eyelid aging is more complex, and the approach to correcting it requires more nuanced judgment. The typical complaint is puffiness or bagginess beneath the eyes — a combination of herniated orbital fat that has pushed forward past the weakened orbital septum, and in some cases, excess skin along the lower lid. These bags cast shadows and create an aged, fatigued look that concealer can camouflage only so much.
Dr. Newman addresses lower eyelid fat herniation using one of two approaches depending on the patient's anatomy. The transconjunctival approach — in which the incision is made entirely inside the lower lid, leaving absolutely no external scar — is ideal for younger patients with good skin elasticity who primarily need fat repositioned or removed. For patients who also have excess skin laxity, a subciliary approach (incision just below the lash line) allows simultaneous removal of excess skin along with fat management. In both cases, care is taken not to remove too much fat, which can create a hollow, skeletal appearance; the goal is to restore a smooth, youthful contour, not to empty the lower lid.
Asian blepharoplasty — also known as double eyelid surgery — is a procedure that creates or enhances the supratarsal crease in the upper eyelid for patients who do not have a defined crease (the "single eyelid" configuration common in East Asian anatomy). This is one of the most frequently requested cosmetic procedures in East Asia and among Asian patients in the United States, and it requires a surgeon with genuine subspecialty experience and cultural sensitivity. Dr. Newman approaches this procedure with meticulous attention to creating a crease that appears natural within the patient's own anatomy — one that looks as though it simply belongs there, not one that has been surgically imposed.
"Blepharoplasty is one of the most satisfying operations in my practice. The transformation is immediate, the recovery is brief, and the results last. Patients consistently tell me that people around them assume they've simply been sleeping better — and that, to me, is the highest compliment."
The eyelids exist within the broader context of the face, and aging rarely confines itself to a single zone. Blepharoplasty is very frequently combined with a facelift (which addresses the lower face and midface), a brow lift (which addresses the forehead and brow descent that can contribute to upper lid heaviness), or fat transfer to the tear trough and under-eye area to restore volume where hollowing has developed. Combining procedures means a single anesthesia event and one recovery period — and a result that looks balanced and harmonious across the entire face, rather than one zone conspicuously addressed while others remain unattended.
If you are bothered by hooded upper lids, under-eye bags, or the generally tired appearance that eyelid aging creates, we invite you to schedule a consultation with Dr. Newman. The evaluation is thorough, the conversation is honest, and the path forward is one you will understand completely before you commit to anything.
Your Options
Each eyelid procedure addresses a different aspect of eye-area aging. Dr. Newman will assess which procedure — or combination — is appropriate for your anatomy during consultation.
Removes excess skin — and sometimes fat — from the upper eyelid through an incision concealed within the natural lid crease. Addresses hooding, heaviness, and in severe cases, peripheral vision impairment. One of the longest-lasting cosmetic procedures — the skin component frequently permanent. Recovery approximately 7–10 days. Often combined with brow lift for optimal upper face rejuvenation.
Addresses under-eye bags, puffiness, and excess skin through either a transconjunctival (no external scar) or subciliary approach, depending on anatomy. Herniated fat is repositioned or carefully reduced to restore a smooth under-eye contour. Fat transfer to the tear trough is frequently performed at the same time to address hollowing. More nuanced than upper blepharoplasty — requires precise judgment to avoid an overly hollow or operated look.
Upper and lower blepharoplasty performed in a single session for comprehensive eye-area rejuvenation. The most common approach for patients with aging affecting both zones, and the most efficient — one anesthesia, one recovery. The combined result opens and brightens the entire eye area simultaneously. Frequently combined with facelift or brow lift for a harmonious full-face result that addresses multiple zones of aging in one session.
Am I a Candidate?
Blepharoplasty is one of the most broadly applicable facial procedures — effective for patients in their 30s through their 70s. The best candidates typically share the following characteristics:
The Process
Blepharoplasty is one of the more straightforward procedures in terms of patient experience — but careful management at every stage contributes to an optimal result.
Dr. Newman examines your upper and lower lids carefully — assessing the amount and distribution of excess skin and fat, skin texture, tear trough anatomy, lid position, and brow height. For patients with upper lid hooding, he also assesses brow descent to determine whether a brow lift would further improve the result. Digital imaging helps illustrate potential outcomes.
Upper blepharoplasty alone is often performed under local anesthesia with oral sedation, making it appropriate for an in-office or outpatient setting. Combined upper and lower blepharoplasty, or blepharoplasty performed alongside other procedures, is done under general anesthesia at an accredited facility. Dr. Newman will recommend the appropriate anesthesia approach at your consultation.
Upper lid: incision within the lid crease, precise removal of excess skin and fat, layered closure. Lower lid: transconjunctival (no external incision) or subciliary approach based on anatomy, fat management and/or skin removal, and fat grafting to tear trough if indicated. Dr. Newman takes particular care with the lower lid to avoid retraction or rounding that can result from overly aggressive skin removal.
Cool compresses and head elevation for the first 48 hours significantly reduce swelling and bruising. Sutures are removed at 5 to 7 days. Most patients return to desk work and routine activity within 7 to 10 days. Final results, including resolution of mild residual pinkness along the incision lines, are visible within 6 to 12 weeks.
Gallery
A selection of Dr. Newman's blepharoplasty results. All patients are real patients who have consented to share their photographs.
*Each patient is unique. Results may vary. Photos are shown with patient consent.
Frequently Asked Questions
Take the First Step
A brief, private consultation with Dr. Newman is the first step. He will evaluate your upper and lower eyelids, discuss your concerns, and give you an honest recommendation — including whether blepharoplasty alone will achieve your goal, or whether complementary procedures would serve you better.