UPPER BLEPHAROPLASTY
Precision where it matters most
The upper eyelid is one of the most visible features of the face, and one of the most technically exacting areas to operate on. Excess skin, heaviness of the lid, or hooding that encroaches on the visual field can make a person look tired, older, or less alert than they feel. Upper blepharoplasty addresses this precisely, removing carefully measured excess tissue while preserving the natural architecture of the lid crease and the character of the eye.
The goal is never to create a dramatic change. It is to restore the eyelid to a version of itself that is open, defined, and natural, without looking operated. The crease incision heals within the natural fold of the upper lid and is almost imperceptible once mature.
"The upper eyelid crease is one of the most forgiving scars in the face. Placed correctly, it disappears entirely."
In most cases, upper blepharoplasty is performed in the office under local anesthesia. The procedure takes approximately one hour. Local anesthetic takes effect quickly, and patients feel nothing after the first moments of injection. There is no general anesthesia, no surgical facility, and no prolonged recovery. When more complex work is indicated, including gland or fat management, brow lift, or combined procedures, the surgery is performed under general anesthesia in an accredited facility.
Trained at the intersection of cosmetic and reconstructive surgery
Upper blepharoplasty benefits from both artistic judgment and anatomical depth. The experience here spans cosmetic eyelid surgery, orbital trauma, and complex reconstructive cases around the eye.
American Board of Otolaryngology – Head & Neck Surgery
American Board of Facial Plastic & Reconstructive Surgery
Extensive experience with cosmetic eyelid surgery, orbital fractures, lacerations, and endoscopic orbital decompressions. A deep familiarity with the structures around the eye informs every cosmetic case.
Upper blepharoplasty is routinely performed in-office under local anesthesia, a setting that requires the same precision and care as an operating room, with the added comfort of a familiar environment.
Is upper blepharoplasty right for you?
Candidacy is assessed carefully in consultation. These are the presentations most commonly addressed.
Excess upper lid skin
Redundant skin that hangs over the lid margin, creating heaviness or hooding. May be cosmetic, functional, or both. When the excess skin obstructs the visual field, the procedure may have functional as well as aesthetic indications.
Lid heaviness or fatigue appearance
A persistently tired or heavy appearance despite adequate rest, driven by the weight of excess skin or fullness of the upper lid. Patients often describe looking older or more fatigued than they feel.
Complex upper lid anatomy
Cases involving lacrimal gland prolapse, significant fat herniation, or upper lid ptosis require a more involved approach. These are typically performed under general anesthesia and may be combined with a brow lift or other procedures when indicated.
Combined procedures
Upper blepharoplasty is frequently performed alongside lower blepharoplasty, brow lift, or facelift. When bundled with other procedures, surgery is performed under general anesthesia in an accredited facility, with the same surgical team and standard of care.
A careful assessment before a plan is made
A detailed ocular history is obtained at every consultation. Prior eye surgery, dry eye, contact lens use, and any history of lid or retinal conditions are reviewed. The position and tone of the upper lid, the depth of the crease, the degree of brow ptosis contributing to hooding, and the overall proportions of the upper face are assessed before any surgical plan is discussed.
It is important to distinguish between skin excess and brow descent. When the brow has dropped, it contributes to upper lid fullness in a way that blepharoplasty alone may not fully correct. This distinction is made clearly in consultation, and if a brow lift would meaningfully improve the result, it is discussed openly.
Goals are reviewed honestly. Upper blepharoplasty produces consistent, meaningful results in the right candidate, and what to expect will be communicated clearly before any decision is made.
Done in the office, comfortably
In most cases, upper blepharoplasty is performed right in the office. There is no surgical center, no general anesthesia, and no overnight preparation required. Local anesthetic is administered to both upper eyelids at the start of the procedure. It takes effect quickly, and after the first moments of injection, the area is completely numb. Patients are awake and comfortable throughout.
The procedure takes approximately one hour. Excess skin and, when present, a small amount of fat or muscle, is carefully removed through the crease incision. The incision is closed with fine sutures, which are removed at the one-week visit.
When the surgery involves more complex anatomy, such as lacrimal gland work, significant fat management, or upper lid ptosis repair, or when it is combined with a brow lift or other procedures, it is performed under general anesthesia in an accredited surgical facility with the full surgical team present.
"One hour in the office. A result that lasts years. For the right candidate, upper blepharoplasty is one of the highest-value procedures we offer."
Follow-up care after upper blepharoplasty includes a stitch removal visit at one week. By one to ten days, most patients look well and are comfortable in public. The scar sits within the natural crease of the upper lid and is well concealed once healed.
If there is residual redness of the scar at around two months, a steroid injection can be placed to help it fade. This is a routine part of the follow-up process and is included in the care provided, not an add-on. The goal is the best possible result, and minor adjustments along the way are part of that commitment.
Before your procedure
Upper blepharoplasty in the office setting requires minimal preparation. The process is straightforward and well-supported from start to finish.
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Medical optimization
For in-office procedures under local anesthesia, medical clearance is not typically required. A detailed ocular history and medication review are completed at consultation. If the procedure is performed under general anesthesia due to complexity or combination with other surgeries, standard pre-operative requirements apply.
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Medications & supplements
Aspirin, ibuprofen, fish oil, vitamin E, and turmeric must be paused one week before the procedure. Prescriptions will be sent to your pharmacy in advance. Have everything filled and on hand before your appointment.
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Ancillary considerations
Take care of routine appointments and obligations in the days before the procedure. No makeup on the day of surgery. Arrange your schedule so the days immediately following are relaxed and low in demands.
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Arranging support
For in-office procedures, you may be driven home by anyone, including a rideshare. Having someone available for the first evening is helpful but not required for most patients. If the procedure is performed under general anesthesia, a designated adult must be present for discharge and should stay the first night.
What to expect when you arrive
For in-office upper blepharoplasty, arrive at the time given at scheduling. The office address is 1691 El Camino Real, Suite 400, Palo Alto, CA 94306. Wear comfortable clothing and avoid makeup around the eyes. The entire visit, including preparation and the procedure itself, takes approximately 90 minutes.
Arrival & preparation
A brief check-in and review of the plan. The surgical markings are made with you upright so the natural anatomy of the eyelid is respected. Photographs are taken for the record.
Local anesthesia
Local anesthetic is administered to both upper eyelids. The injection takes only moments and the area becomes completely numb quickly. Patients are awake and relaxed throughout the procedure. Most describe the experience as far more comfortable than they anticipated.
The procedure
Excess skin is precisely excised through the crease incision. When indicated, a small amount of fat or muscle is addressed as well. Fine sutures are placed to close the incision within the natural lid fold. The procedure takes approximately one hour.
Discharge
Most patients leave the office within 15 to 20 minutes of the procedure completing. There is no recovery room wait. You may be driven home by anyone. That evening, Dr. Hashemi will reach out personally to check in.
Engaged care, directly from the surgeon
Recovery is not a period of uncertainty. Patients have direct access to Dr. Hashemi throughout the healing process.
Evening of the procedure
Dr. Hashemi personally reaches out the evening after surgery to check in and address any questions before the first night.
Direct access throughout
All patients have a direct number for Dr. Hashemi. Photos may be sent by text at any time during recovery. Stopping by the office during the first week to have anything checked is always welcome.
Included follow-up care
Suture removal at one week and scar follow-up at two months are part of the care provided. If a steroid injection would help with scar maturation, it is included, not an additional charge. The goal is the best possible result.
Back to yourself in about a week
Upper blepharoplasty has one of the lightest recovery profiles of any facial procedure. Most patients are comfortable and presentable within one to ten days.
Swelling & bruising
Swelling and bruising are most noticeable during the first three to four days and then gradually improve. Swelling is often worse in the morning. By one week, most patients have some yellowish discoloration and are comfortable going out with sunglasses. By ten days, most people look fully presentable.
Cold therapy & positioning
Elevate the head on two to three pillows for the first week. Apply a cool compress gently to the eyes for 10 to 15 minutes every four hours while awake during the first three days. No direct ice on skin.
Incision care
Gently clean the stitches and around the eyes with a warm water-soaked cotton swab. A small amount of diluted peroxide may be used to loosen any crusting, but keep it away from the eyes. Apply a thin film of erythromycin ointment to the incision after cleaning, three times daily. No makeup or creams near the eyes for at least two weeks.
Eye comfort
Temporary blurred vision from swelling or ointment is common and resolves quickly. Use preservative-free Refresh Plus artificial tears for any dryness or irritation. Avoid rubbing or touching the eyes for at least two weeks. Only drive when vision is clear and narcotic medications have been discontinued.
Your care regimen
Medications will be sent to your pharmacy in advance of the procedure. Fill everything ahead of time so it is ready when you arrive home.
- Tylenol: 650mg every 4 hours as needed (max 4,000mg/day). Most patients do well with Tylenol and Celebrex alone.
- Celebrex: once morning and evening. Do not combine with ibuprofen or aspirin while taking Celebrex.
- Erythromycin ointment: applied to incision line 3 times daily, best after gentle cleaning.
- Doxycycline: oral antibiotic, complete the full course as directed.
- Refresh Plus: preservative-free artificial tears for dryness or irritation, as needed.
- Any sudden change in vision
- Severe or increasing pain, swelling, or redness
- Pus or foul drainage from the incision
- Fever above 101.5°F
- Shortness of breath or chest pain, call 911
Office: 650-313-2338
All patients have direct after-hours access to Dr. Hashemi.
Returning to normal life
Upper blepharoplasty carries a minimal activity restriction timeline. Most patients return to their routines within days of the procedure.
Days one through fourteen: Avoid strenuous exercise, bending, heavy lifting, swimming, and hot tubs. Light walking is fine after a few days. Do not drive until vision is clear and narcotic medications have been discontinued. Do not let water run directly over the stitches when showering; gentle splashing is fine.
Two weeks: Normal activity resumes for most patients.
No ibuprofen, Motrin, Advil, or aspirin while taking Celebrex.
What to expect and when
Recovery from upper blepharoplasty moves quickly. Scar maturation continues for several months, but the visible recovery is largely complete within the first two weeks.
Sutures removed. Some bruising and swelling present. Comfortable going out with sunglasses.
Most patients fully presentable. Surgery not obviously apparent to others.
Scar assessed. If residual redness present, steroid injection placed. Included in care.
Scar fully mature. Crease well-defined. Result stable and natural.
Your eyes. Your identity. Your result.
Upper blepharoplasty is one of the most reliably satisfying procedures in facial surgery. The recovery is light, the results are lasting, and the change, while meaningful, looks entirely natural. For those considering upper blepharoplasty in Palo Alto or the Silicon Valley area, a consultation is the right first step.
Schedule a Consultation