Craig Mezrow MS, MD, FACS

What is Blepharoplasty?

Blepharoplasty is commonly performed on the upper eyelids, lower eyelids or both, to decrease excess skin and fat resulting in a more youthful, less tired appearance.


Consulting with Dr. Mezrow:

During the consultation, Dr. Mezrow will ask you about your particular concerns regarding your eyelids. This will help determine your expectations and determine whether they can be realistically achieved. 

After obtaining a comprehensive medical and surgical history, Dr. Mezrow will perform an examination of your eyebrow position, upper eyelids, eyes and lower eyelids. There are particular medical conditions that may increase the risks for undergoing eyelid surgery. Some of these conditions include pre-existing dry eyes, thyroid disease, hypertension and or diabetes. Following a complete examination, Dr. Mezrow will discuss with you which of many surgical techniques you are a candidate for. The particular technique that is suggested will depend on many factors such as the amount of excess fat and skin in the eyelid, the position eyelids and eyebrows, and the presence of condition of muscles around your eyelids.

Who is a candidate?

It will be necessary for Dr. Mezrow to know if you were ever told by an opthalmologist that you have a condition called "dry eyes", if you require artificial tears or if you have any other problems with your eyes including any prior injuries.

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How is the procedure done/Where will I have scars?

For upper eyelid surgery, generally an incision is hidden within the natural fold of the upper eyelid and extends slightly beyond the outside corner into the existing creases.

Through this incision, excess skin and fatty tissue are removed. Because the incision follows the natural contour of the upper eyelid, it will typically be camouflaged. For lower blepharoplasty, in which there is both excess fat and skin, a technique often used is an incision that is placed just below the lower lashes. Through this incision, excess skin, muscle and fat are removed.

In cases in which there is only fat excess and no significant skin excess, a technique often employed is an incision placed inside the lower eyelid in which there are no external incisions. Through this internal incision, referred to as transconjunctival blepharoplasty, removes excess fat only. This procedure cannot be used to remove excess skin. A laser or chemical peel may be used in conjunction with this method to decrease lower eyelid wrinkles will typically be camouflaged

In addition, some individuals may require a lower eyelid tightening procedure known as canthoplasty or canthopexy procedure in conjunction with their blepharoplasty. These procedures are typically performed for individuals with preexisting malposition or laxity of their lower eyelids.

Blepharoplasty surgery is performed as an outpatient. The procedure typically takes approximately 1-3 hours to perform depending on whether upper or lower blepharoplasty alone or both are performed and whether a lid tightening procedure is also performed. Most patients recover within 1 to 2 hours after surgery and are discharged home. It is important to arrange for someone to drive you home after surgery and to stay with you for at least the next day or two.


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What are the potential complications?

Fortunately, significant complications from blepharoplasty surgery are infrequent, however, all surgery has risks. Dr. Mezrow will discuss with you, the risks, benefits and alternatives and answer all your questions.

Some potential complications include infection, bleeding, eye irritation or dryness, asymmetries, permanent visual changes, poor scarring, eyelid malposition or altered eyelid function that may require additional surgery. A complication, which delays healing and prolongs recovery, is more common in diabetic patients and those who smoke. Preoperative and postoperative instructions will be given to you by Dr. Mezrow in attempt to reduce the likelihood of complications and make you as comfortable as possible with the whole process. Smokers will be instructed to stop smoking 4-6 weeks prior to surgery and not resume smoking to reduce the risk of delayed healing, wounds, infections and compromised outcome. Aspirin, anti-inflammatory medications as well as agents that cause bleeding should be discontinued two weeks prior to surgery (or as otherwise instructed by Dr. Mezrow and your primary physician) to reduce the likelihood of bleeding.


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What kind of medications will be given to me?

Medications are administered for your comfort during the surgical procedure. Typically, a local anesthetic is administered, so that you will be comfortable throughout the procedure. When surgery is completed, you will be taken into a recovery area where you will continue to be closely monitored. You will have ice over your eyelids and eye lubricant placed. There will be surgical tape over the ends of the external sutures.

What happens after surgery?

After surgery, you should rest quietly with ice packs over your eyelids having your head elevated. Dr. Mezrow will instruct you on the use of eye ointments. It is essential to remember, not take aspirin or certain anti-inflammatory medications to decrease the risk of bleeding.

Strenuous activities including straining, bending and lifting should be avoided for the first several days, since these activities might cause compromised results including but not limited to increased swelling or even bleeding.

After surgery, patients experience varying degrees of swelling and bruising that will resolve with time. Within the first week you will be permitted to use makeup, if desired, to conceal any discoloration. Stitches are usually removed within a week of surgery. The incisions will be initially be reddish and then slowly fade over months resulting in permanent scars that are usually concealed in natural creases.


Your vision may continue to be somewhat blurry for a few days or longer. Your eyes may be temporarily sensitive to light, and you may experience excess tearing or dryness. Dr. Mezrow will recommend eye lubricant to help relieve any burning or itching. You may want to wear dark sunglasses for a couple of weeks to protect your eyes from wind and sun irritation. Contacts will temporally not be worn until Dr. Mezrow instructs you.

When can I return to work?

Depending on your physical condition, you may be able to return to non-strenuous work in approximately one week after surgery. During healing you may experience some mild, periodic discomfort and swelling, such feelings are normal. Severe pain should be reported to Dr. Mezrow.


How long is the healing process?

Removal of fat from your eyelids, which is usually the cause of puffiness and bags, is permanent, and these conditions generally will not recur. The skin continues to age, however, skin laxity along the fine wrinkling of the eyelid area may, at some point, return. Sometimes loss of tone in the forehead causes additional sagging of the eyebrows, which mimics a recurrence of drooping upper eyelids. If this happens, correction may require a forehead lift or a secondary eyelid procedure.

Even though the aging process continues, patients are usually happy with their appearance for many years following eyelid surgery. Some patients find that they want to make additional improvements at a later time.

Blepharoplasty surgery will rejuvenate your eyelids by removing excess skin and or fat obtaining a more refreshed, less tired appearance. After blepharoplasty surgery it is not uncommon to feel more confident about your appearance.

Healing from your surgery is a process that takes up to a year for final result. You will be instructed to return to Dr. Mezrow’s office for follow-up care at prescribed intervals to monitor your progress and optimize your outcome.

If you have any questions or concerns prior to surgery or during your recovery, you should contact Dr. Mezrow.