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Blepharoplasty
(Eyelid surgery)

PROF. ALI PIRAYESH

"After eyelid surgery, you become a fresher, younger version of yourself."

Recovery
Treatment
Anaesthesia
Consultation
Upper eyelid surgery

Do people keep saying that you look tired, even if you don’t feel tired? Do you have a gloomy expression? Are your eyelids puffy or sagging? Are they touching your eyelashes, or do they limit your sight? Then you are a candidate for upper blepharoplasty: this worthwhile procedure can visibly rejuvenate your face. The excess skin and other tissue are removed, and the shape of the eye is enhanced. Your eyes will look rested and fresh again. An additional benefit is that the scars fall into the natural arch and crease and are barely visible. The noticeable results of an upper blepharoplasty last for five to ten years — and sometimes even a lifetime.

Lower eyelid surgery

Bags under the eyes or drooping lower eyelids make you look tired and older than you are. Lower eyelid surgery removes your bags and corrects your drooping lower eyelids to regain your youthful appearance.

A combination of treatments for best results

Eyelid surgery doesn’t correct crow's feet, wrinkles, dark circles, or sagging eyebrows. Sometimes, a cheek lift or mid-face lift is required to improve the section between your eyelid and sunken cheeks. An eyebrow suspension or brow lift could be advisable if you have sagging eyebrows. Crow's feet can be softened with Botox®, chemical peels, or laser treatments. Dark circles can be treated with fillers such as hyaluronic acid, your body’s fat, or Platelet Rich Plasma (growth factors from your blood). We will inform you about your best approach during a personal consultation.

Treatments are constantly improving

Surgical methods are becoming increasingly sophisticated. For example, the latest surgical procedure for correcting sagging upper eyelids and swollen lower eyelids ensures a reduction in trauma and, therefore, less scarring compared to older methods. Existing fat can be transposed to its original position to soften the impact of hollow eyes and dark circles.

PROF. ALI PIRAYESH

“I strongly object to cosmetic surgeons offering cookie-cutter treatments to answer today’s ‘beauty shopping list’ culture. I believe that to create beautiful and natural results with plastic surgery, you need to start with a thorough consultation and offer a customised treatment plan.” 

Always choose quality

We often see patients with the results of fixed-price ‘cookie-cutter’ eyelid surgeries: an asymmetry of the eyebrows or eyelids or a gloomy (instead of fresh and rested) look. Some clinics which offer single treatments and fixed, low prices perform eyelid surgeries as if on a conveyor belt: often, all they do is remove a piece of skin from the eyelids. This is regrettable because, very often, more work needs to be done to achieve a truly beautiful and natural result: adjusting the orbital eye muscle, modifying or partially removing excess fat from the orbit, and often transposing the eyebrows. Prof. Pirayesh takes his time during surgeries and works very carefully in his pursuit of minimal, beautiful scars, a speedy recovery, and the slightest possible risk of complications.

It all starts with a consultation

No two pairs of eyes are the same. The cosmetic needs and expectations of patients are unique. To ensure that you are happy with the result of your treatment, prof. Pirayesh develops a customised surgical plan for each patient. During the consultation, he will take the time to get to know you, discuss your requirements and help you make an informed decision.

He will ask about your general health and medical history, perform a physical examination, and assess the condition of your skin and the underlying tissues. Naturally, prof. Pirayesh will ask you to point out what look you wish to achieve, after which he will indicate whether your wishes are realistic. He will explain which type of facelift is the best option for you and which technique he will use. A clear photograph of yourself at around age 35 is very useful as a reference to the structure of your face.

Prof. Pirayesh will answer any questions, give instructions on preparing for the operation, and inform you about the cost. 

Facts about eyelid surgery:

  • Your eyes reflect both your personality and your mood. Unfortunately, your eyes also see the first signs of ageing, such as wrinkles above your eyes. As elasticity decreases and gravity takes over, excess skin will appear around the upper and lower eyelids. Puffiness under your eyes makes you look older than you are or just plain tired.

  • Upper eyelids: The most common treatment for the upper eyelids is removing excess skin, fat, and a small piece of protruding eye muscle. Before the incision is made, the excess skin is marked to ensure the scar will fall exactly in the crease and will be invisible when the eye is opened: it starts just beyond the outer corner and disappears into your crow’s feet or other existing lines. Prof. Pirayesh often performs scar revision and fat transposition through lipofilling with excellent results when reconstructing the upper eyelid.

  • Lower eyelids: When treating lower eyelids, several techniques are available. With the conventional method, an incision is made which passes just a little beyond the outer corner and disappears into the crow’s feet or other existing lines. Some surgeons use a technique in which the incision is made on the inside of the eye. However, Prof. Pirayesh chooses not to use this method because the scar on the inside of the eyelid can sometimes irritate the eye. Lower eyelid surgery is often combined with a so-called cheek lift or mid-facelift. This combination of treatments dramatically improves facial puffiness and sagging cheeks. Laser treatments are often used to promote healing.

Surgery overview and Timeline

Duration of the operation: 1 to 3 hours
Anaesthesia: usually, local anaesthetic
Length of stay: outpatient; you may go home after about one hour. You need to be picked up by someone because you cannot drive yourself home. 
Post-operation: swelling and temporary blurred vision because of the soothing ointment that protects your eyes during surgery. A cold dressing is applied to counter swelling and bruising. You will receive pain medication and instructions on wound care.
Complications: rare: puffiness, discomfort, infection.
Recovery time: You should rest for the first few days, refrain from exerting yourself and any bending or lifting, and keep your head upright. After the first week, you may start using makeup.
Results: after eyelid surgery, you will look fresher and rested. You'll notice less pressure on your eyes, making you feel less fatigued.
Scarring: The stitches are removed by the surgeon within a week of surgery, and your scars will fade after a few months. Dr. Pirayesh has developed a program, APS Scar Care, including aloe vera-based creams, laser treatments, and (if necessary) injections to ensure that your scars heal in the best possible way. 

Eyelid Surgery in Six Steps

On the day of your surgery, prof. Pirayesh will mark the eyelid crease to determine how much excess skin must be removed. In addition, photos will be taken for your medical record.

Step 1. Anaesthesia

On the day of your surgery, prof. Pirayesh will mark the eyelid crease to determine how much excess skin must be removed. In addition, photos will be taken for your medical record.

Step 2. Different techniques

Prof. Pirayesh will discuss the best combination of treatments with you before the surgery.

Step 3. The incisions
  • Prof. Pirayesh will make the incisions above or below the eyelids

  • A small strip of skin is removed from the upper eyelid; sometimes, the orbital eye muscle needs to be slightly modified. If necessary, some orbital fat is removed or transposed.

  • Leaking blood vessels are thermally sealed.

Step 4. Suturing and bandaging

The incisions are closed with very small subcutaneous and topical sutures. Prof. Pirayesh uses a microsurgical technique that only skilled plastic surgeons are capable of. Skin-coloured bandages are applied to protect the stitches.

Step 5. Recovery and aftercare

You will remain in our surgery clinic for a few hours, in the care of prof. Pirayesh and his team, until he feels it is safe for you to return home. You must be picked up or take a taxi home, as you cannot drive yourself. A cold dressing is applied to counter swelling and bruising. You will receive pain medication and instructions on wound care.

  • During the first 72 hours after the operation, you may experience some swelling and bruising; this usually settles within seven to ten days.

  • You should rest for the first few days, refrain from exerting yourself, bending or lifting, and keep your head upright.

  • To prevent swelling, you must place a bag of frozen peas on your eyelids.

  • After the first week, you may start using makeup.

  • The sutures and tape are removed the week after surgery.

  • Your eyes may be temporarily sensitive to light and watery or dry in windy or cold weather. You must wear sunglasses to protect your eyes from the wind and sun.

  • As a rule, you can resume your normal activities within ten days. Your vision may be blurred; therefore, office work and reading may prove difficult.

  • Avoid the solarium or sauna, and don’t drink alcohol or take blood thinners like aspirin (paracetamol is allowed).

  • After two weeks, the scars (which are hidden in the crease of your eye) will fade.

Step 6. Wound healing and scars

Prof. Pirayesh is very savvy when it comes to promoting rapid healing. He has developed a customised regimen, APS Scar Care, including aloe vera-based creams, laser treatments, and (if necessary) injections to ensure that your scars heal in the best possible way.


This regimen has ensured that many of prof. Pirayesh’s patients have hardly noticeable scars. However, it is impossible to pre-determine if patients will have problems with their scars healing.

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