Eyelid Surgery - Butts by Design

Eyelid Surgery Overview

Our eyes, perhaps more than any other area of our face, affect how we look and how we feel about ourselves.

Maybe you’ve noticed that your upper eyelids have begun to droop, making you appear sad or angry even though you’re in a good mood. Maybe bags under your eyes are creating a permanently exhausted look, despite feeling full of energy.

Eyelid surgery, also called blepharoplasty, is a solution to concerns like these. This surgical procedure removes excess skin and fat from the upper eyelids, lower eyelids or both to create a more alert and youthful appearance.

Whether you’re seeking cosmetic improvement or need help with visual obstruction caused by heavy upper lids, board-certified plastic surgeon Dr. Matthew J. Nykiel can help restore the natural contours of your eye area. Book a consultation at Butts By Design in Newport Beach or Upland, CA, today.

What Is Blepharoplasty?

Blepharoplasty is a broad term for surgical procedures that rejuvenate the eyelids. Within this category, there are procedures that target different areas and serve different goals.

As you age, your skin gradually loses collagen and elastin, the proteins that keep it firm and elastic. Meanwhile, the muscles that support your eyelids weaken, and the thin membrane that holds fat in place begins to loosen. Fat pads may descend due to gravity and loss of supporting tissue structure, leaving you with hollows in some places and bulges in others.

Skincare products and nonsurgical treatments may temporarily reduce the visible impact of these changes. However, they cannot address them on a lasting, structural level. Blepharoplasty surgically corrects these issues by removing excess tissue, repositioning fat and creating smoother contours around your eyes.

Dr. Nykiel performs blepharoplasty as a standalone procedure or in combination with other facial cosmetic surgeries or nonsurgical treatments. Many patients enhance their results with complementary procedures such as a brow lift, facelift or fat transfer to achieve more holistic facial rejuvenation.

Why Choose Eyelid Surgery?

Patients considering eyelid surgery typically fall into two categories: those seeking cosmetic improvement and those requiring functional correction. Many patients discover they can benefit from both aspects of the procedure.

Cosmetic Eyelid Surgery

Cosmetic blepharoplasty focuses on appearance. In the upper eyelids, the procedure removes redundant skin and repositions fat to help your eyes look more open and refreshed. When performed on the lower eyelids, the surgery reduces under-eye bags and smooths the transition between your lower eyelids and cheeks.

Cosmetic eyelid surgery can help resolve:

Puffy upper eyelids caused by excess fat deposits
Loose, sagging upper eyelid skin that creates a tired appearance
Under-eye bags that persist despite adequate rest
A permanently tired or aged appearance around the eyes
Asymmetry between your eyelids

Functional Eyelid Surgery

Sometimes, drooping upper eyelids do more than affect your appearance. If the drooping is severe, it can cause irritation or interfere with your daily activities. As the name suggests, functional blepharoplasty corrects a medical issue or a problem that affects the way your eyes function.

This type of eyelid surgery can help if you experience:

The need to raise your eyebrows constantly to see clearly
Forehead muscle fatigue from continuously lifting your brows
Eye strain or headaches from struggling to keep your eyes open
Difficulty reading or performing detailed tasks
Compromised peripheral vision, especially when driving

Many patients find that functional and cosmetic benefits overlap. Even when the primary goal is improving vision, the removal of excess skin naturally creates a more refreshed, alert appearance.

Am I a Candidate for Eyelid Surgery in Newport Beach?

You may be an excellent candidate for blepharoplasty if you meet the following criteria:

Visible excess skin or fat deposits around the eyes that can be surgically corrected
Good overall health without medical conditions that could impair healing
Age 35 or older, though some younger patients may qualify based on genetic factors
No serious eye conditions or severe dry eye syndrome
No smoking habits, or willingness to quit several weeks before and after surgery
Healthy skin with good elasticity around the eye area
Realistic expectations about what the surgery can achieve
Understanding that the aging process will continue after surgery

A Note From Dr. Nykiel

“One of the most important parts of my job is helping patients understand exactly what their desired surgery can and cannot achieve. Blepharoplasty can do a lot to improve eye aesthetics and function, but it’s not a solution for every aging concern around the eyes. Let me be clear about what eyelid surgery doesn’t address and what the best alternatives are.

Eyelid surgery won’t eliminate your crow’s feet. These wrinkles are caused by muscle movement and are better treated with neurotoxins like Botox. It’s also possible to reduce fine lines around the eyes with treatments like chemical peels and laser resurfacing.

Blepharoplasty won’t fill hollow areas under your eyes or erase dark circles caused by thin skin or visible blood vessels. We can get some improvement from shifting around fat pads, but to address these concerns in more depth, we might consider fat transfer or dermal fillers.

Eyelid surgery won’t change the position of your eyebrows. If your brows have descended over time (a common part of aging), eyelid surgery won’t restore them to their youthful position unless you pair it with a brow lift. I’ll talk more about this in a section below.”

One of the most important parts of my job is helping patients understand exactly what their desired surgery can and cannot achieve. Blepharoplasty can do a lot to improve eye aesthetics and function, but it’s not a solution for every aging concern around the eyes. Let me be clear about what eyelid surgery doesn’t address and what the best alternatives are.

What Types of Blepharoplasty Does Dr. Nykiel Offer?

Blepharoplasty can target the upper eyelids or the lower eyelids.

Upper Eyelid Surgery

Upper blepharoplasty targets the hooding and heaviness that can develop in your upper eyelids. This condition often creates a tired or aged appearance and may eventually interfere with your vision. Dr. Nykiel uses surgical techniques to remove excess skin and fat while preserving enough tissue to maintain natural eye function and appearance.

Lower Eyelid Surgery

Lower blepharoplasty rejuvenates the area beneath your eyes. As you age, fat deposits can push forward while the skin loses elasticity, creating bags and wrinkles. Dr. Nykiel uses surgical techniques to redistribute or remove fat and tighten the skin, creating a smoother under-eye area.

Often, the most dramatic and harmonious improvements come from combining upper and lower eyelid surgery. During your consultation, Dr. Nykiel will determine whether a singular approach or a combination will best achieve your goals.

What Are the Treatment Steps for Eyelid Surgery?

Dr. Nykiel begins your eyelid surgery by making incisions in carefully chosen locations. For upper eyelid surgery, the incision follows your natural lid crease, where it will be virtually undetectable after it’s healed. Lower blepharoplasty incisions are placed just below your lash line or inside your eyelid.

From there, Dr. Nykiel gets to work on the underlying causes of your concerns. He removes or repositions any fat that’s creating puffiness or bags, and trims away excess skin that causes hooding or crepiness. If needed, he also tightens the muscles that support your eyelids.

Most eyelid surgeries take one to three hours, depending on whether you’re having your upper eyelids, lower eyelids or both addressed.

What Anesthesia Is Used During Eyelid Surgery?

Eyelid surgery is performed under general anesthesia or local anesthesia with sedation.

For lower eyelid surgery or combined upper and lower procedures, general anesthesia is preferred. You will sleep peacefully through the procedure, unaware of what’s happening and in no pain.

Local anesthesia with sedation may be an option if you’re only having upper eyelid surgery and are comfortable with being somewhat aware during the procedure. With this approach, the area around your eyes is completely numb, and you’ll be in a twilight state — relaxed and drowsy, but not fully asleep.

What Goes Into the Blepharoplasty Recovery Process?

Recovering from eyelid surgery is often easier than patients expect, though you must be patient with the healing process. The first few days are the most intense part. You’ll want to take it easy and have someone around to help out.

Your first week will be spent mostly at home. Your eyes might feel tight and a bit irritated, and you will notice some swelling and bruising. These are all perfectly normal signs of healing. Plan to sleep with your head elevated, as this helps reduce swelling.

You can start returning to light activities after about a week. Take care to protect your eyes from sun, wind and any activities that could strain them. Most patients feel comfortable going out in public with sunglasses after seven to 10 days. Some bruising may still be visible, but it can be concealed with makeup.

How Is Pain Managed During Eyelid Surgery Recovery?

Dr. Nykiel takes a proactive approach to pain management to ensure you have the most comfortable recovery possible. He has developed his own pain management protocol that starts pre-surgery, continues during the procedure and extends into the recovery period.

Once you’re home, you will have prescribed medications that target different types of pain and discomfort, as well as lubricating eye drops and ointment to prevent dry eyes. While some discomfort is normal, your recovery shouldn’t be miserable. If you ever feel your pain isn’t well controlled or something doesn’t seem right, Dr. Nykiel and his team are just a phone call away.

Where Are Blepharoplasty Scars Located?

One of the most elegant aspects of eyelid surgery is how naturally the incisions are hidden.

For upper blepharoplasty, Dr. Nykiel places the incision in your natural eyelid crease. The scar blends into this natural fold once it’s healed. It can be virtually invisible, even with your eyes closed.

Lower eyelid surgery offers two possible incision locations. The transcutaneous approach places the incision beneath your lower lash line, where it tends to be well concealed. The transconjunctival approach places the incision inside your lower eyelid, leaving no external scar at all.

What Are the Risks of Eyelid Surgery?

While serious complications are rare, especially when your eyelid surgery is performed by a board-certified plastic surgeon, you should be aware of the possible risks before proceeding:

Temporary blurred or double vision
Difficulty closing your eyes completely
Dry or irritated eyes
Asymmetry between eyelids
Reaction to anesthesia
Infection at the incision sites
Bleeding or blood clots
Scarring that’s more visible than expected
Changes in skin sensation around the eyes
Temporary light sensitivity
Need for revision surgery

You can tell a lot from a person’s eyes. But what you may not be able to tell is whether you’re a better candidate for eyelid surgery or a brow lift. Because our eyes and brows work together to create our upper facial appearance, it can be tricky to identify exactly which area is causing your concerns.

Many patients come to my office believing they need eyelid surgery when their main issue is actually a drooping brow, or vice versa. Here’s a simple way to understand the difference:

Place your fingers above your eyebrows and lift the skin upward. Does this dramatically improve the appearance of your upper eyelids? If so, a brow lift might be a great choice for you. Do you still see excess skin on your eyelids even with your brows lifted? If that’s the case, you likely need upper eyelid surgery to take care of your concerns.

In my experience, combining these procedures often provides the best result. A sagging brow can push excess skin onto the upper eyelids, making the eyelid problem appear worse than it is, while addressing only the eyelids might make drooping brows look more noticeable afterward.

This doesn’t mean every patient needs both procedures. During your consultation, we’ll work together to decide which approach will give you the most balanced, natural and refreshed appearance.

When Will I See the Final Results of My Blepharoplasty?

Your results will develop gradually as your healing progresses. Once the initial swelling subsides, you’ll notice your eyes looking more refreshed, though some bruising will still be present. Most of the bruising will fade by two weeks post-surgery, and you’ll start to get a better idea of your results.

Three to four months after surgery, your results will really shine through. The last traces of swelling will have disappeared, and your scars will be fading to thin, barely noticeable lines. The scar maturation process will continue for up to one year.

Is Eyelid Surgery Permanent?

Eyelid surgery creates long-lasting improvements. The results of upper eyelid surgery can last seven to 10 years before noticeable signs of aging reappear. Lower eyelid results tend to be even more enduring, with many patients never needing a second procedure. This is because our lower eyelids generally don’t experience the same degree of stretching and sagging as our upper eyelids.

If you become bothered by the appearance of your eyes again years down the road, revision procedures are possible. Some patients find that less invasive treatments like Botox or fillers are sufficient to address any minor concerns that develop over time.

Contact Our Board-Certified Eyelid Surgery Surgeon in Newport Beach

Ready to discover how eyelid surgery could refresh your appearance and restore your confidence? Join the many satisfied patients who have trusted Dr. Matthew J. Nykiel with their care. Dr. Nykiel brings his exceptional surgical expertise and artistic eye to every blepharoplasty procedure, helping patients achieve natural-looking eyelid rejuvenation.

Call 949-416-0038 or request a consultation online to get started. Butts By Design offers in-person consultations at our Newport Beach or Upland locations, as well as virtual consultations in the comfort of your home.