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Cosmetic Surgery of the Eyelids

Men > Blepheroplasty (Eyelid Lift)

Modern Approach to Eye Lid Surgery

Lower lid bags and excess eyelid skin are the most common complaints offered by both women and men alike.

There are multiple surgical and nonsurgical procedures for eyelid aesthetics.

Choosing the appropriate procedure depend on the accurate diagnosis of the real problems. There are several factors one has to take in consideration.

  1. The position of the eye brow. Drooping brow can give the illusion of excess skin of the upper eye lids.
  2. Actual excess eyelid skin
  3. Herniated fat, causing severe fullness of the upper lids.
  4. Lower lid bags of fat
  5. Deep tear tough giving the appearance of bags in the lower lid.
  6. Excess skin
  7. Festoons or lid cheek bags

Making the proper diagnosis and the appropriate treatment will restore beauty to the eyes. Restoring the youthful eyes is probably the most dramatic change in facial rejuvenation.

An open eye, with properly positioned eyebrow, eye lids devoid of bulges or wrinkles is the ultimate goal in eye lid rejuvenation.

Fat is lost from the aging face, causing hollow features and loss of youthful look.

In the eye lids, Hollowness is treated restored by fat transfer. Fat transfer is an office surgical procedure. It involves harvesting the fat by gentle liposuction. The harvested fat is then carefully cleaned, then centrifuged to separate it from the anesthetic solution and debris, then placed into smaller syringes for injection. The one or two tiny incisions made to introduce the cannula to harvest the fat require no sutures.

Fat can be also injected into the lateral brow area to restore the natural fullness.

Fine skin wrinkles around the eye lids are erased by laser resurfacing.

Lower lid bags are approached through a Transconjunctival incision (inside the eye lid). Some fat may need to be removed, but the majority of the fat is redistributed to fill hollow area and prevent Hollow eyes created by surgery, and aided by age.

Many changes occur around the eye region with aging. These changes can make you look tired, angry, or sad. Bags around the eyes and dark circles are the most common complaints. Wrinkles and excess skin is common. Some of the wrinkles at the smile lines area can be treated with Botox®.

Plastic surgery of the eyelids is effective in smoothing puffy, baggy eye lids, tired eyes look more youthful and in many cases more awake. In particular, it can produce open eyes by removing excess skin. It lifts heavy folds in the upper lids. Cosmetic surgery eyelid surgery (Eye lid lift) can even change Asian eyelids by redefining the crease of the upper eye lid. Surgery must be tailored to each individual, depending on their concerns and the condition of their eyelids. The position of the eye brow is very important in how the upper lid looks.

Dr. Shureih is a Board Certified Plastic Surgeon Practices Cosmetic Surgery in Baltimore and Ellicott City. He has over 20 years of experience and thousands of procedures. He was chosen TOP DOC in Baltimore Magazine, twice, and in the National Guide for TOP DOCS for many years.

The bags in the lower lids are pockets of fat misplaced or herniated. Deep crease in the lower lid cheek junction becomes prominent, known as the tear trough, to improve these problems a thorough knowledge of the aesthetics and anatomy is essential for proper evaluation and formulating a plan to improve on the eye lid aesthetics. It is imperative to avoid the operated on look and the hollow eye look after surgery.

Evaluation of the upper lid must include the position of the eye brow. A droopy eye brow accentuates the upper lid aging. In those situations the eye brow must be positioned back to normal position. This is done with a forehead lift or a brow lift.

In the upper lid the incision is hidden in the upper lid crease, once healed it is hardly noticeable. The crease should be positioned at the right height from the lashes.

Through that incision excess fat is removed only when absolutely needed other wise a hollow eye will result. In most cases only skin is removed to keep the full youthful eye and avoid the hollow look.

Lower lid lifts are more involved and require experience and artistry. The approach is through either of two incisions:

  1. Transconjunctival, that is through an incision inside the lower lid. Bags are dealt with, and the skin can be smoothed either by laser resurfacing or skin peel, or pinch excision.
  2. Subcilliary, or through the skin just below the eye lashes. The bags of fat are redistributed to fill the hollow crease in the lower lids, and occasionally some of that fat is removed. The lower lid is supported with special sutures (Canthoplasty), and the excess skin is conservatively removed to smooth the skin.

Scars heal very well and are hardly noticeable.

Cosmetic eye lid surgery requires accurate planning and excellent surgical skills.

Dr. Shureih is a TOP Baltimore Plastic surgeon who can deliver excellence on cosmetic surgery.

Risks and complications are rare but do occur:

Infection: Eye lid infection is rare; antibiotics are given to decrease the chances of infection.

Bleeding: It is a rare complication, It is due to bleeding in the fat compartments after the surgery is over.

Blurred vision: This is due to swelling, or damage to any of the muscles that surround the eyeball and coordinate its movement. Most often, these symptoms are temporary. Fortunately, this is a rare problem.

Dry eye syndrome: This can be due to a variety of reasons, however the most common is preexisting dry eye that has not been recognized, or fully manifested itself.

Inability to close your eyes (LAGOPHTHALMUS): This is usually due to removal of too much upper eyelid skin. In severe cases, skin grafting may be necessary to correct this problem.

Corneal abrasion: This can occur during ANY operation, whether it is on the eyes or any part of the body, because the eyes may sometimes open during surgery, rendering them susceptible to being scratched. Treatment involves antibiotics and taping the eye shut for 2-3 days while the abrasion heals.

Hollow (sunken) eyes: occur when too much fat removed from the eyelids. This can usually be prevented by conservative removal of fat or no removal at the time of surgery.

Ectropion: Where the lower lid hangs down.

Prolonged swelling


Eyelid Surgery Recovery

Recovery may take up to one week.

surgery is usually done under local anesthesia with sedation.

Surgery time is one to two hours.

It is highly recommended to have an ophthalmology exam done prior to eye lid surgery.

Dr. Shureih and staff will assure you of excellent medical care, in a safe and confidential environment.



  1. Mild burning and discomfort
  2. Some swelling of the eyelids
  3. Some bruising, it varies from one individual to another
  4. May see minimal amount of blood
  5. Vision may be blurred when using eye ointment


  1. Elevate the head between 30-45 degrees
  2. Cold ice compresses to the eye, a bag of frozen peas mold to the contour of the face. Use continuously for 24-48 hours
  3. May wash face and shower
  4. No heavy activity, no lifting, pushing, or straining for at least one week
  5. Avoid alcohol, aspirin, nicotine, and vitamin E supplements
  6. Avoid driving, flying, or operating heavy machinery while recovering and while on pain medication
  7. Rest the first 48-72 hours
  8. Take your medications:
    • antibiotics
    • pain medication only when there is pain
  9. Diet normal
  10. Watch for infection
    • sudden increase in pain
    • increased swelling
    • redness around eyes
    • purulent discharge

    Contact Dr. Shureih immediately if you think there is infection and/or go to the nearest emergency room.

  11. Watch for bleeding
    • increased swelling and bruising
    • increased pain of the eyes
    • vision disturbances
    • double vision
    • blindness
  12. No eye make-up until the sutures are removed about 4-5 days post operative
  13. Schedule your first post operative appointment 4-5 days post-op, call for an appointment