Behind the Scenes of an Upper Blepharoplasty in Washington, DC

Performed by Board-Certified Plastic Surgeon, Dr. Coleman Brown

The upper eyelids are often one of the first facial areas to show signs of aging. Because the skin is thin and highly expressive, it can loosen over time, resulting in hooding, heaviness, and a fatigued appearance. An upper eyelid lift—known as an upper blepharoplasty—is a meticulous surgical procedure that removes excess skin and, when appropriate, small pockets of fat to restore a smoother, more youthful eyelid contour.

Recently, Dr. Brown performed an upper blepharoplasty for a patient, Lisa, who hoped to rejuvenate her eye area without dramatically altering the overall balance of her face. Her case demonstrates how carefully planned, conservative upper eyelid surgery can deliver undetectable yet noticeable and natural results.

 

Thoughtful Planning: Dr. Brown’s Pre-Operative Consultation

Before determining the best approach, Dr. Brown conducted a detailed examination to evaluate:

• Skin redundancy on the upper eyelids
• The prominence of upper eyelid fat pads
• Brow position and stability
• Eyelid crease symmetry and function

During this assessment, Dr. Brown noted that Lisa’s brows were already well-positioned. This distinction is crucial: many patients assume eyelid heaviness stems solely from the eyelid itself, when in fact brow descent is often responsible. Because Lisa’s brow support was excellent, she did not need a brow lift—a procedure that, when unnecessary, can create an exaggeratedly elevated or “surprised” look.

Instead, her concerns were caused by true excess upper-eyelid skin and a small pocket of medial fat contributing to fullness and overhang. Botox, which she had tried previously, could provide a slight lift but could not correct the redundant skin without risking an unnatural “Spock brow.” Dr. Brown recommended a conservative upper blepharoplasty to address the problem directly and create a naturally refreshed appearance.

Preparing for Lisa’s Eyelid Lift in DC

On the day of surgery, patient comfort and safety were Dr. Brown’s top priorities. The eyelid area was numbed using a combination of local anesthesia and topical numbing drops. Corneal protectors—thin, curved eye shields placed beneath the eyelids—were inserted to safeguard the eyes and temporarily block vision during the procedure.

Dr. Brown then used meticulous measurements to mark the precise amount of skin to be removed. For Lisa, approximately 7 mm above the lash line was measured to maintain symmetry and eyelid function. This planning step is essential; removing too much skin may interfere with eyelid closure, while removing too little may not achieve the desired rejuvenation.

Inside the Operating Room: Dr. Brown’s Upper Blepharoplasty Technique

With preparations complete, Dr. Brown began by making a fine incision along the natural eyelid crease so that the final scar would remain discreet. He then:

1. Removed the pre-planned amount of redundant skin
2. Conservatively excised a narrow strip of underlying orbicularis muscle for improved contour
3. Reduced a small pocket of medial fat to soften fullness without creating a hollowed appearance

The incision was closed with delicate Prolene sutures, chosen for their precision and compatibility with the thin eyelid skin. These ultrafine sutures produce minimal scarring and excellent healing within the natural crease.

Why Many Patients Choose Upper Blepharoplasty Over Other Facial Procedures

Compared with other facial rejuvenation options, upper blepharoplasty offers several distinct advantages:

• It directly corrects upper-eyelid aging: No amount of filler, skin tightening, or neuromodulator treatment can remove true excess eyelid skin. Blepharoplasty is uniquely effective for correcting hooding and restoring lid definition.
• The results are natural—not dramatic: Unlike a facelift or brow lift, upper blepharoplasty provides subtle yet meaningful rejuvenation that preserves a patient’s natural expressions.
• Recovery is typically quick: Most patients return to normal routines within 5–7 days, with mild swelling and bruising that gradually fades over the first week.
• It can improve both appearance and function: Removing excess skin can restore peripheral vision and relieve the feeling of heaviness around the eyes—benefits not always achieved through nonsurgical treatments.
• It enhances—not replaces—other treatments: After surgery, many patients find that makeup applies more smoothly and that they require less Botox for brow elevation.

Recovery and Expected Results

Lisa experienced the typical post-operative swelling and bruising that peaked around 48 hours and steadily improved throughout the week. Most upper blepharoplasty patients feel comfortable returning to work or social activities within one week, while the incision continues to refine over several weeks.

Her final results show a brighter, smoother upper eyelid with renewed definition and a well-rested appearance. Dr. Brown’s conservative approach ensured that her natural eyelid shape and facial balance were preserved.

Considering Upper Blepharoplasty in Washington, DC?

For patients experiencing eyelid heaviness, makeup smudging, or a persistent “tired” look, upper blepharoplasty may be an ideal solution. Dr. Brown and his team offer personalized evaluations to determine whether upper eyelid surgery, or another facial rejuvenation procedure, best meets each patient’s goals.

To learn more or schedule a consultation to discuss options for blepharoplasty in DC, please contact our office.