Upper & Lower Blepharoplasty
Eyelid surgery, or blepharoplasty, is one of the most commonly performed and most impactful facial rejuvenation procedures. The eyes are the first feature people focus on during conversation — and heavy upper lids or prominent lower bags convey fatigue and age regardless of how you actually feel. Dr. Rafizadeh performs blepharoplasty under local anesthesia with moderate sedation, making the procedure gentle, efficient, and recoverable within days.
“I have mastered facial surgery over 35 years to achieve the most significant results with the shortest scars and the fastest recovery. Doing eyelid surgery under local anesthesia with moderate sedation makes the procedure less invasive, yet improves the overall result.”
Upper Eyelid Surgery
Upper blepharoplasty removes excess skin and, when appropriate, a small amount of fat that creates a hooded or drooping upper lid. The incision is hidden within the natural upper eyelid crease, leaving a virtually invisible scar. In some patients, drooping of the upper lid is worsened by brow descent — and a combined brow lift and upper blepharoplasty may be the most appropriate plan.
Lower Eyelid Surgery
Lower blepharoplasty addresses under-eye bags caused by prolapsed fat, excess skin, or both. Dr. Rafizadeh uses a transconjunctival approach (incision inside the lower eyelid, no external scar) when excess skin is not the primary concern, or a transcutaneous approach (very fine incision just below the lash line) when skin laxity also needs addressing. Fat repositioning is used when appropriate to avoid the hollow look associated with fat removal alone.
Eyelid Reconstruction & Revision
Dr. Rafizadeh is also experienced in reconstructive eyelid surgery for conditions such as entropion (eyelid rolling inward) — a painful condition that can restrict lifestyle. Several patients have sought him specifically for his ability to correct complications from prior surgeries and restore both function and aesthetics.
Recovery Timeline
Days 1–3: Swelling and bruising around the eyes. Cold compresses and elevation help significantly.
Days 4–7: Sutures removed. Most patients feel presentable with sunglasses.
Week 2: The majority of swelling resolves. Most patients return to work and social activity.
Months 1–3: Fine-tuning of the result as residual swelling settles and scars fade.
A Highly Individualized Procedure
Eyelid surgery can be performed on the upper lid, the lower lid, or both together, and is frequently combined with a facelift or brow lift. In combined cases the brow or cheeks are addressed first. The procedure is highly individualized — sometimes only skin is removed; other times muscle or fat must be removed or repositioned. When the lower lid is lax, tightening through lateral canthopexy is required. Dr. Rafizadeh has developed a specific canthopexy technique designed to minimize chemosis, one of the more common complications of lid-tightening procedures.
Dr. Rafizadeh performs blepharoplasty under local anesthesia with intravenous sedation, typically taking 1½ to 2 hours for all four lids. He uses fine non-absorbable sutures removed in three to four days — producing less reaction and less scarring than absorbable alternatives. Iced compresses are applied after surgery; patients keep the head elevated the first night. Bruising and swelling typically subside within 10 days.
The Surgical Technique
For the upper eyelid, skin is removed so that the closure sits within the natural crease, making the scar nearly imperceptible. The lower eyelid can be approached from inside the lid (trans-conjunctival) or through an incision beneath the eyelashes. New trends favor conserving fat and transposing it into the tear trough area — creating a natural auto-augmentation effect. Candidates range from age 30 upward, though most patients are in their 50s or older. When excess upper eyelid skin interferes with the visual field and an ophthalmologist documents the impairment, insurance may cover the procedure.
Possible complications include lower lid retraction and dry eye syndrome — both significantly reduced by Dr. Rafizadeh's preoperative evaluation protocol and his specialized canthopexy technique. With meticulous surgery performed by experienced hands, complications can be avoided or greatly reduced. The combination of experience, proportion, and harmony achieves a result that looks naturally refreshed — not operated.
