Eyelid Surgery (Blepharoplasty)

Blepharoplasty at Pacific Plastic Surgery Group in San Francisco addresses upper eyelid heaviness, lower eyelid bags, and puffiness by surgically removing or repositioning excess skin, fat, and muscle. Dr. Edward P. Miranda (MD, FACS) performs upper, lower, or combined eyelid procedures with incisions placed in natural creases or along the lower lash line. Initial recovery is one to two weeks; final results emerge over several months.

Eyelid surgery (blepharoplasty) at Pacific Plastic Surgery Group is performed by Dr. Edward P. Miranda, whose board certification, FACS credential, and UCSF training cover the anatomical precision that periorbital surgery demands. The eyelid region is one of the most technically exacting areas of aesthetic surgery — the skin is the thinnest on the body, the margin of error for incision placement is small, and the functional anatomy of eyelid opening and closing must be preserved throughout. Upper blepharoplasty addresses heaviness and drooping of the upper eyelids caused by excess skin (dermatochalasis) and protruding fat pads, which can partially obstruct the peripheral visual field and create a fatigued appearance. Incisions are placed precisely within the natural upper eyelid crease, concealing the scar in the fold. Excess skin and, where appropriate, a conservative amount of orbital fat are removed to restore a lighter, more youthful eyelid contour. Lower blepharoplasty addresses under-eye bags formed by prolapsed orbital fat and, in older patients, skin laxity and fine wrinkling. Dr. Miranda can access the lower eyelid fat via a transconjunctival incision (hidden inside the eyelid — no external scar, preferred when skin excess is minimal) or via an incision placed just below the lower lash line (when skin removal is required). Fat may be removed or repositioned to fill the tear trough hollow below the bag, avoiding the hollowed appearance that can result from over-aggressive fat removal alone. Combined upper and lower blepharoplasty is frequently performed as a single operative session. Procedures are performed under local anaesthesia with sedation or general anaesthesia depending on the scope. Swelling and bruising typically resolve in one to two weeks; makeup is generally applicable after seven to ten days. Final refinement of eyelid contour continues over several months.