Blepharoplasty

Many of our patients do not report significant discomfort, and the majority use only Tylenol as needed. Prescription pain medicine is available to you, and we recommend keeping it on hand in case it is needed.

A minimum of 4 appointments are needed for this procedure. This includes your initial consultation with Dr. Kolstad to determine your candidacy, a preoperative visit, the date of your surgery, and at least one post-operative visit. The purpose of the post-op visits is for our team to monitor your healing and adjust your recovery instructions, if needed. This allows us to ensure your results are coming in as expected, and gives you an opportunity to ask questions you may have during the recovery period.

Patients can expect some swelling and bruising in the first week or two, which will temporarily obscure those results. However, this subsides fairly quickly, with minimal residual swelling lasting for several weeks as the area around the eyes continues to heal. At the 3-6 month mark, you’ll see the final results, which will last for decades.

Every incision on the skin >1mm will result in a visible scar. Eyelid incisions and scars tend to heal better than any other incision on the face. Eyelid skin is the thinnest skin on the body and heals better than incisions used for rhinoplasty, facelifts, chin implants, lip lifts, and almost every other plastic surgery. For most people, the blepharoplasty scar is simply a line that is hard to recognize at conversational distance.

Want to learn more about how to prevent scars after blepharoplasty?

For the first 2 weeks, it is advised that you avoid heavier or more demanding exercises to allow your body time to heal properly. Workouts that do not elevate the blood pressure or heart rate are generally okay within the first two weeks, and you can gradually incorporate lighter activities into your routine during that time. After about 2 weeks, it is generally safe to resume your normal routine, but consult with Dr. Kolstad first to ensure you’re cleared.

It is extremely common for patients undergoing blepharoplasty to also have a brow lift at the same time. This produces the most transformative results, opening the eyes while smoothing out sagging or loose skin—a look synonymous with youthful appearance.

Blepharoplasty is considered a safe and effective procedure when performed by a qualified facial plastic surgeon, but as with any surgery, it carries potential risks, such as bleeding, infection, or temporary irritation, dryness, or itching of the eyes. Some patients may experience asymmetry, scarring, or changes in eyelid shape as the area heals. In rare cases, more significant issues, such as difficulty fully closing the eyes or changes in vision, can occur.

Finding the right surgeon is one of the most important steps to achieving safe, natural-looking eyelid surgery results. In San Diego, look for a board-certified facial plastic surgeon with extensive experience in eyelid and periorbital rejuvenation procedures.

Review before-and-after photos to ensure the surgeon’s aesthetic style aligns with your goals, and take time to read patient testimonials to understand their approach to care. A thorough in-person consultation should include a discussion of your concerns, medical history, and realistic expectations.

To achieve the best and most natural upper eyelid appearance, a combination of brow lift and blepharoplasty is typically performed. The differences between brow lifting and blepharoplasty are best demonstrated in the office. During your consultation, Dr. Kolstad will demonstrate how brow position affects your facial appearance. He will be able to simulate the results of a brow lift, upper blepharoplasty, or both using a mirror and a Q-tip. By accurately demonstrating the results of each procedure, patients can make a more informed decision about whether they need a blepharoplasty, a brow lift, or both to achieve their desired outcomes.

For patients with a low eyebrow, prominent lateral hooding

1. Endoscopic forehead and brow lift: This surgery aims to minimize scarring by placing incisions in the hairline. There are a total of 4 incisions required, two in the temples and two very small incisions in the frontal hairline. When healed, the incisions are hidden by the surrounding hair.Endoscopic brow lifts place the incisions far from the surgical site and require cameras, monitors, and technology to aid the surgeon. This procedure is designed for someone who requires lifting of the entire eyebrow and forehead. The surgery typically takes about 1.5 hours and requires sedation anesthesia. Downtime is about 7-10 days.Men with temporal or frontal recession often lack sufficient hair for coverage and are not good candidates for this approach.

• Individual Results May Vary

2) Forehead shortening (trichophytic brow lift): Dr. Kolstad offers this unique approach to accomplish two goals with one surgery. Using a special beveled incision just behind the hairline, the eyebrows can be lifted and the forehead shortened at the same time. Ideal candidates for this surgery have relatively long foreheads and want to shorten the distance between the hairline and eyebrows.

A limitation of the endoscopic browlift is that everything, including the hairline, is lifted upwards and backward. Dr. Kolstad believes that the forehead shortening brow lift creates a more youthful appearance for most people with average to long foreheads. This type of surgery has a longer recovery than the endoscopic lift. The shortcomings of the trichophytic brow lift are numbness lasting several months or longer behind the incision and the potential for a less hidden incision.

• Individual Results May Vary

3) Mini-brow/ temple lift: This procedure is designed for someone with lateral hooding and fullness of the outer part of the eyelid. A temple lift raises the lateral (outer) eyebrow without raising the inner corner. Dr. Kolstad’s Advanced Eyelid Lift combines a minibrow and upper blepharoplasty and is his most popular upper eyelid rejuvenation technique. Two incisions are placed into the temporal hairline and are camouflaged by the surrounding hair.

4) Direct brow lift: Men with temporal or frontal hair loss are not acceptable candidates for endoscopic, forehead shortening, or minibrow lifts. All three of the procedures use thick hairlines to camouflage the incisions. Men with hair loss and deep forehead creases are ideal candidates for direct brow lifts. Dr. Kolstad removes 1-2 cm of skin above the eyebrows to raise them to a more youthful location. The resulting scar appears like a normal forehead wrinkle.

For most men, Dr. Kolstad advises against brow-lifting surgery. Hollywood has countless examples of men whose eyebrows were lifted much too high. Over-elevating a man’s brow does not make the person look any younger. They just look different. Dr. Kolstad’s philosophy is never to raise men’s eyebrows unless absolutely necessary.

• Individual Results May Vary

5) Coronal brow lift: This historical type of surgery may have contemporary indications, but Dr. Kolstad does not know of any. For most patients, there are more modern and more effective techniques to lift the eyebrows and forehead.

The incision used for a lower eyelid lift (blepharoplasty) is depicted in the image.

A) The incision is placed just under the eyelashes and extends into one of the crow’s feet laterally. The eyelashes camouflage the scar and are often difficult to detect.

Dr. Kolstad has several techniques to make your lower eyelids look their best. Aging in the lower eyelids is typically due to three things: bulging fat, hollowing, and loose skin. Dr. Kolstad uses four procedures tailored to the signs of aging in your eyes.

• ‘Scarless’ blepharoplasty: this procedure is designed for youthful eyelids that have fat bulging, creating a tired, puffy appearance. Fat bags, prominent at an early age, are often hereditary and can make the eyes look much older than a person’s actual age. Dr. Kolstad employs a transconjunctival (inside the eyelid) incision to access the fat. There is no skin. Incisions and no external scarring.
• Skin tightening lower blepharoplasty: This surgery removes excess skin from the lower eyelids. Not everyone has prominent lower eyelid fat bulging through the lower eyelid. For patients seeking to tighten skin without removing fat, Dr. Kolstad uses the skin-pinch blepharoplasty technique. This procedure is safe to perform in the office using local anesthesia.
• Combined lower blepharoplasty: by far the most common type of lower eyelid surgery combines the gentle excision of lower eyelid fat with skin tightening. Dr. Kolstad addresses the fat bags through the transconjunctival approach and tightens the skin on the surface. This modern blepharoplasty technique is less invasive and less likely to cause postoperative ectropion or eyelid malposition.
• Fat grafting blepharoplasty: Some eyelids age by hollowing. Dr. Kolstad’s preferred technique for rejuvenation of hollowing is to harvest fat from the lower body and transfer it as fat grafts to the cheeks, midface, and orbital area. Fat grafting blepharoplasty is the most technically challenging type of eyelid surgery Dr. Kolstad performs.

No surprised faces here. This unacceptable outcome is completely avoidable when using the right technique. When surgeons lift the brow too high or remove too much fat and skin, the results do not make the eyes look any younger; they just look different.

Dr. Kolstad’s expertise as a Facial Plastic Surgeon allows him to achieve long-lasting results without making his patients look “done.”

Many of our patients express concerns about looking plastic after eyelid surgery. There are limitless examples of unnatural, operated results. When surgeons pull too tight, a rounded eyelid can result in an “operated” look.

It is very important to choose a plastic surgeon who specializes in operating on the face and is comfortable with the challenging anatomy and procedures.

Blepharoplasty is an outpatient procedure, meaning you will be able to go home after surgery. The eyes will be swollen and a little blurry, so you will not be able to drive yourself home. If sedation is used, it is recommended to have someone stay with you for the day of surgery.

Upper eyelid and skin pinch lower blepharoplasty are most commonly performed in the office using local anesthesia. Direct brow lifts and some advanced brow lifts can be performed in the office.

The type of surgery you need is the most important factor in determining where it will take place. Fat excising, lower eyelid surgery, and most brow lifts are safer to perform in a surgery center.

Patient safety is paramount, and Dr. Kolstad does not take chances with your health. If it is safer to perform a procedure under general anesthesia, then it is always best to have the surgery done in a surgery center.

Blepharoplasty is an outpatient procedure, meaning you will be able to go home after surgery. The eyes will be swollen and a little blurry, so you will not be able to drive yourself home. If sedation is used, it is recommended to have someone stay with you for the day of surgery.