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The Eyelid 

Your eyes are often the first feature people notice about you. They are also your strongest non-verbal means of communicating with others. Extra skin, wrinkling, sagging of tissue and puffiness around the eyes can cause you to look aged and tired beyond your years. As one ages, the skin in the upper eyelids becomes redundant and hangs down causing heaviness on the eye that can result in a tired appearance. Genetics can also play a role and some patients start to experience these symptoms at a young age. In some cases it may be so severe as to limit vision especially peripheral.

Need more information? 

If you would like to learn more about having a blepharoplasty or eyelid rejuvenating techniques that will suit you best, we invite you to meet with Dr. Nabil Fakih for a private consultation at our office.


Please contact us to schedule an initial consultation with Dr. Nabil Fakih to make an appointment. You may also fill out our contact form to make an appointment.

What is Eyelid Bags Surgery or Blepharoplasty? 

Eyelid surgery, or blepharoplasty, can be performed to treat excess skin folds around the upper eyelids or reduce puffiness and wrinkling in the lower eyelid region. The goal is to restore a fresh appearance to the upper face. The optimal surgical plan will produce a clean and fresh look to the eyes without actually changing their expression or shape. A less tired look results without telltale signs of surgery.


• Tired, Aging eyelids

• Excess skin of the upper eyelids

• Bags and puffiness of lower eyelids


• Removes excess skin of upper eyelids

• Removes excess skin of lower eyelids

• Reduces, or removes bulging fat

• Refreshes and rejuvenates eyelid area


• Upper Lid Blepharoplasty

• Lower Lid Blepharoplasty

• Transconjunctival Blepharoplasty

• Blepharoplasty with Fat Grafts

• Blepharoplasty with Laser Resurfacing


• Length: 1 to 3 hours

• Back to Work:

Upper / Lower Blepharoplasty : 7 days

Blepharoplasty + Fat Grafts : 14 days

• Return to Exercise:

7 days (light cardio)

2-3 weeks (more strenuous exercise)

Who is a candidate for Eyelid Surgery ? 

Aging changes begin around the eyes in the mid-thirties. Most women become candidates for eyelid surgery in their early forties and men about ten years later. A common early complaint in women is wrinkled upper eyelid skin that looks aging and interferes with makeup application. Men also complain of heavy upper eyelids but usually not until much later in life. Both men and women are troubled by bags and circles under the eyes. Sometimes loose or darkened skin contributes to the problem. All of these issues can usually be effectively addressed by surgery.


What should I expect from my consultation? 

During your consultation, you will learn about the surgery, its limitations and risks, and discuss your needs and concerns. This will help Dr. Nabil Fakih understand your expectations and determine whether they realistically can be achieved. Dr. Nabil Fakih will carefully examine your eyelids to assess the shape of the lids and asymmetries to determine what type of procedure would best maximize your result. After your consultation we will take photographs for your medical record and we will discuss the surgery fees and scheduling dates. You should come to the consultation prepared to discuss your medical history. You should provide any relevant information from your ophthalmologist. Also provide information about any medical conditions, drug allergies, medical treatments you have received, previous surgeries and medications that you currently take. It is important for you to provide complete information. All our patient are prepared by Dr. Paula Martin-Marfil with the Pre / Post surgical preparation program to enhance a quick recovery.


Upper Lid Blepharoplasty 

Through upper lid blepharoplasty the excess skin, muscle and fat is removed and contoured creating a natural rejuvenated, sculpted upper eyelid. The sutures are hidden in the natural fold of the eye and are removed five days after. The procedure can be done by local anesthetic, sedacion or general anesthetic. Bruising is usually minimal, and any bruising can be easily camouflaged with sunglasses. Regular work and exercise may be resumed in a few days. It may, however, take several weeks to realize the final results as the swelling from surgery continues to decrease.


Lower Lid Blepharoplasty 

Who is a candidate? 

Several things happen to the lower eyelid as aging occurs. A unique type of fat surrounds the eye and its muscles. As we get older, the membrane that holds that fat into the orbit weakens, causing bulges or bags to form underneath the eyes. These bulges under the eyes are also unmasked as midface volume decreases with aging and can contribute to the skin wrinkling and sagging under the eye. Often people complain of having dark circles under their eyes but what they are actually seeing is a shadow underneath the eyes created when overhead lighting shines down on the bulges. After surgery a smooth contour is created and the shadow goes away thus no signs of dark circles. At times, the muscles of the eye sag and cause what is called “festooning” or multiple bags under the eyes. Lower lid blepharoplasty may help reduce each of these problems.

Different incisions to Lower Blepharoplasty and what to Expect with each: 

A transconjunctival blepharoplasty may be performed for the patient with minimal wrinkles but significant fat in the lower eyelids. With this procedure, no external incisions are made; instead, the fat is repositioned and sometimes partially removed through a small incision inside the lower eyelid. This results in a quicker recovery and no external scar formation. This approach is often combined with fractionated co2 laser resurfacing to tighten up the skin of the lower eyelid.

Transcutaneous blepharoplasty is a better alternative for the patient with excess skin or redundancy in the muscles surrounding the eye. With this approach, a small incision is made just below the eyelashes trailing out into one of the crow’s feet. Through this incision, a dramatic tightening of the lower eyelid skin and muscle may be obtained. Healing is rapid and sutures are removed in five days. At times, there is bruising which may last from seven to ten days. Redness in the lateral portion of the incision may last for several weeks but may be covered up with make-up after seven days.

What to avoid before surgery? 

It is vitally important to avoid all blood thinning medications/supplements for 2 weeks prior to surgery. This includes any aspirin or aspirin-containing products as well as any anti-inflammatories such as ibuprofen or naproxen (including Motrin, Aleve and Advil). It is generally fine to be take Tylenol (Acetaminophen). Avoid supplements such as Vitamin E including multi vitamins, omega 3 fatty acids such as fish oil and flax seed oil. All these medications can contribute to bleeding problems following surgery and can increase the amount of bruising.



All our patient are prepared by Dr. Paula Martin-Marfil with the Pre / Post surgical preparation program to enhance a quick recovery.

Following eyelid lift or blepharoplasty, you will go home on the same day with a friend or family member. Mild swelling and bruising are expected after a blepharoplasty, and generally resolve after four to seven days, although the period of swelling and recovery will be slightly longer when fat transfer (autologous fat grafting) or laser procedures are performed at the same time as your blepharoplasty. Cold compresses will be applied for comfort and to minimize swelling. Sutures will be removed three to five days following blepharoplasty. Dr. Nabil Fakih suggests taking seven days off following a blepharoplasty, however many are able to return to work after four or five days. Following a blepharoplasty with fat and/or laser treatments, Dr. Nabil Fakih recommends taking fourteen days for recovery, although it is indeed possible to return to work as early as ten to twelve days after your blepharoplasty with fat transfer or laser treatment (provided there is no strenuous activity or heavy lifting involved). Light aerobic activity (elliptical or Precor, light treadmill walking, stationary bicycle, recumbent bicycle) may be resumed as early as four or five days following blepharoplasty, and more strenuous activity is begun at two to three weeks. Your relationship with Dr. Nabil Fakih does not end after blepharoplasty surgery; he will see you often through the first weeks and months following your eyelid lift, and will advise you on all matters in your recovery including skin fitness and health including diet, skin care, retinols, antioxidants, and sun blocks to maximize and preserve the rejuvenative effects of your eyelid lift procedure.

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