On Blepharoplasty with Oculoplastic Surgeon Dr. Maryam Zamani

Blepharoplasty surgery removes excess skin, opening up the eye area to create a more youthful appearance. As we age and our skin loses elasticity, the area around our eyes starts to wrinkle and for some, the skin begins to sag, bulge, and cause the eyes to look tired. Blepharoplasty is one of the most popular types of cosmetic surgeries to correct these eyelid issues.

We spoke to Dr. Maryam Zamani, a leading Oculoplastic Surgeon and Aesthetic Doctor currently practicing in London to learn more about blepharoplasty.

What are some common causes of under eye bag sagging and wrinkling?

The first thing that we see with eye aging is fine lines and wrinkles that are caused by sun and lifestyle choices.  This area is also highly susceptible to movement lines around the eyes called crow’s feet or number 11 lines in-between the eyebrows. Motion wrinkles are caused by normal everyday activities and expressions.  

Bags under the eyes sometimes it can a) appear like fat bags or b) be fat bags. Sometimes people call the darkness ‘bags’ when in reality it is darkness caused by volume loss.  Other times it can be that one, two or three of the fat pads in that area are pushing forward actually causing a bulge. 

How can a patient determine if they are a good candidate for blepharoplasty?

There is upper and lower eyelid blepharoplasty. (Upper eyelid blepharoplasty) is perfect for those that have excess skin on the upper eyelid that can cause hooding and even diminished peripheral vision.

Lower eyelid blepharoplasty is great for those who have sagging or bulging under eye circles. Blepharoplasty treats aged eyes for a more youthful appearance.

You are a good candidate for surgery if you are in good health and have realistic expectations for improvement.

What does the blepharoplasty procedure entail?

Upper eyelid blepharoplasty is a short 30-minute surgical procedure to permanently remove excess skin and medial fat from the upper eyelid. Patients tend to use the forehead muscle, called the frontalis, to help lift this excess skin but this also contributes to horizontal forehead rhytides. (The procedure) can be done under local, twilight or general anesthesia. Stitches remain for 1 week.

Lower eyelid blepharoplasty can either be done to remove either skin or fat, or both. It is also a short surgical procedure. Transconjunctival lower eyelid blepharoplasty removes fat from the lower eyelids through a hidden scar in the conjunctiva. (The conjunctiva is the lower eyelid lash line and having the incision here avoids leaving an externally visible scare.) Once removed, fat does not return.

The subciliary approach is (creating the incision) beneath the lash line and can be used to remove just skin or fat or both. Stitches there remain for one week.

What non-surgical methods can be used to achieve similar results as blepharoplasty?

None. Blepharoplasty is the only gold standard to treat excess skin and/or fat from the upper and lower eyelid. There are no other means to remove fat. Hyaluronic acid filler can mask the issue if there is a small amount of fat herniation but is a temporary measure. Skin can be treated with a laser to treat laxity, but blepharoplasty is the gold standard.

What can a patient expect after the procedure? When do they see results?

Results are immediate. Patients need to take 1 week off from work. It is normal to have some swelling and bruising with the culmination on day 3 with rapid improvement. I recommend no major events for 6 weeks.

Upper eyelid skin crease incisions generally look red for about 6-8 weeks before it fades. Lower eyelid subciliary is similar to the upper eyelid. Patients can use Oxygenetix as a cover-up 1-week post-treatment.

Lower eyelid blepharoplasty, transconjunctival, has no visible scar so recovering is much faster.

Special thank you to Dr. Maryam Zamani. You can find Oxygenetix at Dr. Zamani’s Cadagon Clinic, on Sloane Street in London. - drmaryamzamani.com

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Dr. Maryam Zamani has had extensive medical training that shows in her meticulous work as a surgeon to create stunning natural results. With twelve years of practice and alongside her two fellowships at London’s Imperial College NHS Trust and Chelsea Westminster NHS Trust, Dr. Zamani is a Fellow of the American Board of Ophthalmology, an associate member of the British College of Aesthetic Medicine and the Royal College of Ophthalmology and a member of numerous societies including Surgical Eye Expeditions International and the European Society of Ophthalmic Plastic and Reconstructive Surgeons. Residing in London, Dr. Zamani works from her base at the Cadogan Clinic, on Sloane Street.