Potomac Plastic Surgery: Houtan Chaboki, MD
2311 M Street, N.W. Suite 501
Washington, DC 20037
Phone: (202) 800-2085
Monday - Friday: 8 a.m.–4 p.m.
Large, open eyes are a universal sign of youth and beauty; however, the eyelids are one of the first areas to show signs of aging. Droopy upper eyelids, sagging eyebrows, or puffy lower eyelid bags can make you appear tired or older than you actually feel. While wrinkles typically come with age and sun exposure, some people are born with excess skin or fat around the eyes. Eyelid surgery is one of the first cosmetic procedures many patients undergo. As a board-certified facial plastic surgeon, Dr. Chaboki specializes in all aspects of cosmetic eyelid surgery, technically called blepharoplasty. At his Washington, DC, practice, people from Arlington and Ashburn, Virginia; Bethesda and Chevy Chase, Maryland; and other nearby cities trust him for attractive, natural-looking results.
Keep in mind that each patient is unique and your results may vary.
Blepharoplasty is a relatively straightforward cosmetic plastic surgery procedure that’s designed to create a more alert, rested, and youthful appearance. Upper eyelid surgery lifts hooded or sagging eyelids. Lower eyelid surgery can improve the appearance of bulging lids or undereye bags. Even though eyelid surgery is performed to reverse signs of aging, it’s also performed on younger patients who may have inherited hooded lids or undereye bags from their parents.
Upper blepharoplasty and brow lift surgery can both open up the eyes. For some patients, a brow lift alone may help improve the appearance of the upper eyelid because raising the eyebrows naturally leaves less redundant upper eyelid skin. Others require an upper blepharoplasty combined with a brow lift to attain the desired results. In some patients, the eyebrows may actually drop lower after upper blepharoplasty, if the eyebrows are not stabilized or lifted with a brow lift.
As with other surgical procedures, Dr. Chaboki tailors each blepharoplasty to the patient’s precise specifications. During your consultation, he performs a thorough physical examination, evaluating factors including wrinkles, skin laxity, fat deposits, and volume loss. You also discuss your lifestyle, health history, and skincare habits. This helps him visualize your specific concerns and develop a surgical plan that gives you ideal results.
Depending on your aesthetic goals, your blepharoplasty can focus on your upper eyelids, lower eyelids, or both. Dr. Chaboki takes care to explain exactly what you can expect both before and after surgery, as well as what you can do to prepare. If you smoke, you should quit at least several weeks prior to surgery, as smoking increases your risk of certain complications. Dr. Chaboki may also advise you to temporarily discontinue the use of some medicines and supplements, such as blood thinners.
Each patient — and each procedure — is unique, and the ultimate cost of any plastic surgery procedure depends on a few different factors, including the surgeon’s fees, facility fees, and fees charged by the anesthesiologist. During your consultation, we provide you with a personalized quote that accurately reflects your procedure. Learn more about paying for plastic surgery here.
Most people in good overall health are candidates for blepharoplasty. It’s also important that eyelid surgery patients don’t smoke or are willing to quit for several weeks before and after the procedure. You may be a good candidate if you’re concerned about:
Another important consideration is that you have realistic expectations about what eyelid surgery can accomplish.
Dr. Chaboki is pleased to meet the needs of his patients of Asian descent with specialized eyelid surgery just for Asian eyes. Sometimes called double-eyelid surgery, this procedure adds definition to the upper eyelid and creates a clear eyelid crease. This creates a more “open” eye without sacrificing the patient’s ethnic identity.
Certified by both the American Board of Otolaryngology and the American Board of Facial Plastic and Reconstructive Surgery, Dr. Chaboki has extensive knowledge of the intricacies of the face and neck. When you choose him for your procedure, you’re choosing one of the most reputable facial plastic surgeons in DC, as well as a nationwide leader in preservation rhinoplasty.
Learn MoreDr. Chaboki performs blepharoplasty using local anesthetic with sedation or general anesthesia, depending on the extent of your surgery. Dr. Chaboki can combine upper and eyelid surgery or perform only one of the procedures.
When performing upper eyelid surgery, Dr. Chaboki carefully places incisions within the natural creases of the lid. Using these incisions, he removes or repositions fat, tightens muscle, and removes excess skin. He then sutures the incisions. The resulting scar is virtually imperceptible.
The incisions for lower eyelid surgery may be made externally along the lash line or on the inside of the lid (transconjunctival approach), depending on the specific needs of each patient. The transconjunctival approach is best suited for patients who have bulging fat pads but no excess skin.
To minimize swelling after surgery, Dr. Chaboki recommends the following:
After blepharoplasty, you will need to avoid strenuous activity for at least 2 weeks so you can heal. For the first few days after surgery, you should keep ice on your eyes while you are awake to control swelling. You should also keep your head elevated at all times and sleep upright using several pillows or in a chair.
Each patient is unique and follows his or her own pattern of recuperation. Blepharoplasty is one of the more comfortable facial surgeries, and some patients don’t require any sort of prescription medicine. Dr. Chaboki works with you to help you manage your discomfort. The following timeline is typical:
When swelling has fully resolved after several weeks, you might be hearing, “Wow, you look fabulous,” instead of, “You look tired.” No matter what other people say, what’s important is that you are happy with your fresh, younger-looking eyes.
Dr. Chaboki offers a variety of surgical and non surgical treatments to complement the results of your eyelid surgery. Explore your options:
Hooded eyelids can create a “tired” appearance even when you’re rested and alert. They are often a genetic trait, but can also develop with age. Upper blepharoplasty addresses hooded eyes by removing excess skin and soft tissue that causes the condition.
The procedure itself is performed using either a local anesthetic with sedation or with the patient under general anesthesia. You’ll remain comfortable or asleep during the procedure, depending on the type of anesthetic used. Discomfort during your recovery can be managed with either prescription pain medication or over-the-counter pain relievers.
Eyelid surgery, as with other elective cosmetic procedures, includes some risk. However, when performed by a board-certified facial plastic surgeon such as Dr. Chaboki, the risk involved is minimal. Infection is the primary risk. We provide post-op instructions that help you care for your incisions as they heal.
Eyelid surgery patients may be any age. Some women and men in their 20s get eyelid surgery because of inherited conditions, such as hooded eyes. Patients in their 40s, 50s, 60s, or older schedule blepharoplasty to reverse signs of aging that make them appear older than they feel.
Many patients can benefit from a non surgical approach to improve the appearance of their eyes. Injectable treatments such as BOTOX and fillers can temporarily lift eyelids, minimize wrinkles around the eyes, and add volume under the eyes. Fat transfer is another minimally invasive treatment, although it requires liposuction to harvest the patient’s fat.
Eyelid surgery creates a rested, more alert appearance often associated with a youthful look. Droopy or hooded eyelids and dark circles under the eyes can make people appear older than they are.
The results of eyelid surgery can last for years. The aging process continues and eyelids will inevitably sag at some point, but patients can enjoy the results for 10, 15, or more years.
Strenuous activities or exercise after plastic surgery will increase the risk of bleeding, swelling, and bruising. Activity restriction during the recovery period varies based on the operation performed and patient’s medical condition. Light activities, such as slow walking, may be performed soon after anesthesia. Heavy activity, such as aerobics, yoga, cycling, running, heavy lifting, or similar vigorous activities are allowed 2 weeks after the procedure. Contact sports are generally allowed after 6 weeks.
Patients can go to work or school the next day or work from home, if desired. Most patients, however, plan at least 1 week off from work or school after plastic surgery. A longer period of recovery may be necessary for combined procedures.
Patients should remain in the area at least the first day after plastic surgery. Regional travel by car is allowed the following day after surgery. Patients should wait at least one week before air travel after plastic surgery, but waiting two weeks is preferred. The risks associated with travel reduce with time.
Makeup should not be used around the operated area for the first week after surgery. Contact lenses are usually allowed after the first week from eyelid surgery. As healing is monitored, Dr. Chaboki will help determine an appropriate time to resume makeup on operated areas.
Any plastic surgery procedure (surgical or non surgical) may result in bruising and swelling, which may peak in the first day before improving. In addition, the bruising generally fades away faster than swelling. Lastly, surgical procedures tend to swell or bruise more, as compared to non surgical treatments performed in the office.
To ensure the best outcomes after eyelid surgery, make sure to read and follow our plastic surgery care instructions and the following guidelines below:
Avoid Blood Thinners
Some normal medications or herbs may worsen bruising. Stop all ibuprofen, aspirin and aspirin-like products for at least 2 weeks prior to your procedure. Avoid any herbal teas, supplements, or medications which thin the blood such as St. John’s wort, ginkgo, ginger, garlic, ginseng, kava, vitamin C, and vitamin E.
Elevate Your Head
Let gravity play a role in the recovery process. Positioning your head on top of a few pillows, or elevated mattress top, will help reduce bruising and swelling in the treated area. Avoid bending over as much as possible, too.
Apply Ice
In addition to reducing swelling, a cool compress helps constrict blood vessels, which may decrease the extent of bruising. Ice, however, should not be placed directly on the skin. A soft cloth helps spread the cooling effects. Ice is the most important during the first 2 days after cosmetic treatments.
Avoid Heavy Activity
Heavy or strenuous activity that increases the heart rate or blood pressure can increase bruising and delay recovery. Heavy activities to avoid include, but are not limited to, all types of exercise and sex. Even lighter activity, such as yoga, should be avoided. This restriction on activity is for the first 2 weeks after plastic surgery.
Try Arnica Montana and Bromelain
Herbal supplements that help some patients reduce bruising and swelling include Arnica montana and bromelain. Both of these are available over the counter without a prescription. You should look for these supplements in a tablet form. Bromelain is also found in pineapples.
Bruising improves faster than swelling after plastic surgery. On average, most bruising resolves within the first 1 to 2 weeks in the early phase of healing.
The immediate swelling after eyelid surgery may last approximately a week or 2, depending on several factors. After this initial healing period, swelling is still present, but usually only noticeable by the patient. The very last tiny bit of swelling takes several months to gradually abate.
It’s possible to have swelling in areas of the face and eyes adjacent to the surgery site, even though plastic surgery was not necessarily performed in those areas. This extension of facial swelling is due to gravity and the natural movement of fluid in the tissues. In addition, keep in mind that the eyelids, face, and nose are very sensitive to swelling from other factors, such as allergies, diet, hormones, gravity, sleep, etc.
Non surgical eyelid procedures (e.g., BOTOX® or Restylane®) are performed in the office with local anesthesia. Minor surgery (e.g., upper blepharoplasty) is also normally performed with local anesthesia. Eyelid surgery may be performed with either IV (twilight) sedation or general anesthesia at accredited facilities with a licensed anesthetist.
Patients are safe and comfortable during their procedures. The decision on the type of anesthesia used during plastic surgery depends on the extent of surgery, additional cosmetic surgery procedures along with the eyelid surgery, patient factors and preference, and surgeon factors and preference. After an evaluation, the plastic surgeon and patient decide together the appropriate anesthesia type for plastic surgery.
A patient’s safety is always our primary concern. Any plastic surgery has inherent risks, but eyelid surgery is considered a safe surgery in healthy patients.
Dr. Chaboki will review your medical history and medications, in addition to an appropriate examination to evaluate not only the aesthetic plan, but also to perform plastic surgery safely. Some patients may also need testing and/or preoperative medical evaluation by their primary care physician before surgery.
The upper eyelid incision is placed in a natural contour in the skin, hidden from view. The lower eyelid incisions may be placed externally under the eyelashes (subciliary approach) or internally in the pink area of the eyelid (transconjunctival approach).
The incision location and length vary largely based on the age of the patient and how much lift he or she needs. Dr. Chaboki will minimize the incision but maximize the lift, without creating an unnatural appearance. The eyelid surgery incision, regardless of exact location, fades from view over time.
The shape of the eyes may appear to change in some patients after removal of sagging skin, muscle, or fat. Dr. Chaboki’s general goal in cosmetic surgery is not necessarily to change people, but rather to improve and freshen their existing appearance.
Dark circles often require different treatments for improvement. Skin treatments including eye creams, tretinoin, laser therapy, or chemical peels can improve some dark circles. Hollow eyes and volume loss contributing to dark circles are treated with facial fillers (such as Restylane®) or fat transfer. Excess eyelid skin and sagging muscle are usually treated with blepharoplasty.
