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Upper Eyelid Blepharoplasty


Upper Eyelid Blepharoplasty (Cosmetic Eyelid Surgery) by Dr. Rona Silkiss and Dr. Kasra Eliasieh in San Francisco, Oakland, Palo Alto, Corte Madera, Walnut Creek, San Leandro, Fremont. 

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Upper Eyelid Blepharoplasty


Upper Eyelid Blepharoplasty (Cosmetic Eyelid Surgery) by Dr. Rona Silkiss and Dr. Kasra Eliasieh in San Francisco, Oakland, Palo Alto, Corte Madera, Walnut Creek, San Leandro, Fremont. 

UPPER EYELID BLEPHAROPLASTY (EYELID LIFT)

As we grow older, our eyelid skin tends to lose elasticity and become thinner, and the deeper orbital fat behind our eyelids tends to protrude forward. This often results in a sensation of heaviness and a tired, older, or puffy appearance. In some people the excess skin can actually block peripheral vision. In women, the overhanging skin may cover the area of the eyelids where eyeshadow is usually applied. 

THE PROCEDURE

An upper eyelid blepharoplasty consists of removing this excess upper eyelid skin. If the fat pockets protrude, they can be excised at the same time. An upper eyelid blepharoplasty can give a more youthful appearance and may even improve peripheral vision. If the eyelids are also drooping (ptosis), or the brows are sagging, an upper eyelid blepharoplasty maybe performed at the same time as ptosis surgery or brow lift. It can also be performed at the same time as a lower eyelid blepharoplasty. The surgery will not eliminate fine wrinkles along the sides of the eyelids. Botox is usually the preferred treatment for that and can be administered at the same time as surgery, or separately in the office. 

Our doctors will discuss their assessment with you and go over your personal plan and what to expect after surgery during your preoperative visit. The surgery may be performed in the office using only local anesthesia or in the operating room under sedation (twilight) depending on your surgical plan.

RECOVERY AFTER SURGERY

Surgical time usually varies between 30 minutes and 2 hours depending on the particular details of each case. You may expect to go home on the day of surgery.  There is usually minimal to no pain after blepharoplasty surgery and most patients resume their normal daily activities the following day. Heavy lifting should be avoided for 1-2 weeks. You may experience mild discomfort, which is controlled with oral medication. Swelling and bruising significantly improves after a few days and usually is minimally noticeable after 2 weeks, however healing time can vary between individuals. Sutures are removed on the first postoperative visit, usually 7-10 days after surgery. Eyelid make-up and contact lens use may usually be resumed 1-2 weeks after surgery. 

SPECIAL CONSIDERATIONS

Our doctors will perform a thorough eye exam prior to any eyelid surgery. If you have a history of dry eyes, you should be treated appropriately prior to surgery because upper eyelid blepharoplasty may worsen dry eye symptoms. Sometimes surgery is postponed or determined to be inadvisable if symptoms are significant enough. A history of prior eyelid surgery may put you at risk for inadequate eyelid closure or dry eyes after surgery. It is important to see an eyelid specialist to coordinate a surgical plan that will not only give the most aesthetically natural appearance but more importantly, maintain vital eye health. 

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Lower Eyelid Blepharoplasty


Lower Eyelid Blepharoplasty (Cosmetic Eyelid Lift Surgery) by Dr. Rona Silkiss and Dr. Kasra Eliasieh in San Francisco, Oakland, Palo Alto, Corte Madera, Walnut Creek, San Leandro, Fremont. 

Lower Eyelid Blepharoplasty


Lower Eyelid Blepharoplasty (Cosmetic Eyelid Lift Surgery) by Dr. Rona Silkiss and Dr. Kasra Eliasieh in San Francisco, Oakland, Palo Alto, Corte Madera, Walnut Creek, San Leandro, Fremont. 

LOWER EYELID BLEPHAROPLASTY (LOWER EYELID BAGS)

A very common complaint we hear as oculofacial plastic surgeons is that of bags or dark circles under the eyes. With aging, the facial support structures that keep the normal orbital fat inside the eye sockets weaken and shrink, resulting in an outpouching of orbital fat and the appearance of bags. Aging may also results in loss of tissue volume in the lower eyelid and descent of the cheek. This results in a hollow area under the eyelids known as a tear trough deformity, which can give the appearance of dark circles under the eyes. Younger patients often have tear trough deformity simply as an inherited condition. Loss of elasticity in the skin, especially in patients with a history of significant sun exposure may result in thinning and wrinkling of the lower eyelid skin. The goal of a lower eyelid blepharoplasty is to smooth out bags and circles to give a more youthful appearance.

THE PROCEDURE

There are many different surgical techniques that address cosmetic lower eyelid issues such as bags, dark circles, and wrinkles. Fat can be removed or repositioned via a "scar-less" transconjunctival approach (the incision is made behind the eyelid, leaving the skin intact). If excess skin must be removed, the incision is hidden just underneath the eyelashes. Lower eyelid blepharoplasty is often combined with upper eyelid procedures such as upper eyelid blepharoplasty and/or ptosis repair, to reduce total recovery time. 

A non-surgical option for the lower eyelids is facial fillers such as Juvederm. Fillers can fill in hollow areas and are ideal for younger patients. 

Our doctors will discuss their assessment with you and go over your personal plan and what to expect after surgery during your preoperative visit. The surgery is usually performed in the operating room under sedation (twilight).

RECOVERY AFTER SURGERY

Surgical time is usually about 2 hours depending on the particular details of each case. You may expect to go home on the day of surgery.  There is usually minimal to no pain after blepharoplasty surgery and most patients resume their normal daily activities the following day. Heavy lifting should be avoided for 1-2 weeks. You may experience mild discomfort, which is controlled with oral medication. Swelling and bruising significantly improves after a few days and usually is minimally noticeable after 2 weeks, however healing time can vary between individuals. Sutures are removed on the first postoperative visit, usually 7-10 days after surgery. Eyelid make-up and contact lens use may usually be resumed 1-2 weeks after surgery. 

SPECIAL CONSIDERATIONS

Our doctors will perform a thorough eye exam prior to any eyelid surgery. If you have a history of dry eyes, you should be treated appropriately prior to surgery because blepharoplasty surgery may worsen dry eye symptoms. Sometimes surgery is postponed or determined to be inadvisable if symptoms are significant enough. A history of prior eyelid surgery may put you at risk for inadequate eyelid closure or dry eyes after surgery. It is important to see an eyelid specialist to coordinate a surgical plan that will not only give the most aesthetically natural appearance but more importantly, maintain vital eye health. 

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Asian Eyelid Surgery


Asian Blepharoplasty (Double Eyelid Surgery) by Dr. Rona Silkiss and Dr. Kasra Eliasieh in San Francisco, Oakland, Palo Alto, Corte Madera, Walnut Creek, San Leandro, Fremont. 

 

Asian Eyelid Surgery


Asian Blepharoplasty (Double Eyelid Surgery) by Dr. Rona Silkiss and Dr. Kasra Eliasieh in San Francisco, Oakland, Palo Alto, Corte Madera, Walnut Creek, San Leandro, Fremont. 

 

ASIAN BLEPHAROPLASTY (DOUBLE EYELID SURGERY)

Asian eyelids look different than Caucasian eyelids due to several anatomical differences. The upper eyelid crease in the Asian eyelid is often absent or positioned lower than that of the Caucasian eyelid. The crease is also often shaped differently, or consists of multiple creases. The fat pads that surround the eye extend closer to the eyelashes, sometimes causing a puffy appearance. Asian eyelids also often have an epicanthal fold, a downward angled fold of skin that covers the inner corner of the eye. 

Eyelid surgery is the most common cosmetic surgery performed among people of Asian descent. A common misconception regarding Asian blepharoplasty is that the goal is to "westernize" the Asian eyelid in order to make it look less Asian. Actually, the goal of Asian eyelid surgery is to create a youthful and attractive look, while preserving the natural shape and characteristics of the Asian eyelid. 

THE PROCEDURE

Asian eyelid surgery can vary quite a bit depending on each individual's goals and eyelid anatomy. For the upper eyelids, usually an incisional approach is taken, allowing fat and a strip of muscle to be excised if necessary, and placing sutures internally to create a subtle eyelid crease. A  "scar-less" transconjunctival approach may be taken for the lower eyelids, whereby the incision is made behind the eyelid, leaving the skin intact. 

RECOVERY AFTER SURGERY

Surgical time usually varies between 30 minutes and 2 hours depending on the particular details of each case. You may expect to go home on the day of surgery.  There is usually minimal to no pain after blepharoplasty surgery and most patients resume their normal daily activities the following day. Heavy lifting should be avoided for 1-2 weeks. You may experience mild discomfort, which is controlled with oral medication. Swelling and bruising significantly improves after a few days and usually is minimally noticeable after 2 weeks, however healing time can vary between individuals. Sutures are removed on the first postoperative visit, usually 7-10 days after surgery. Eyelid make-up and contact lens use may usually be resumed 1-2 weeks after surgery. 

SPECIAL CONSIDERATIONS

Our doctors will perform a thorough eye exam prior to any eyelid surgery. If you have a history of dry eyes, you should be treated appropriately prior to surgery because blepharoplasty surgery may worsen dry eye symptoms. Sometimes surgery is postponed or determined to be inadvisable if symptoms are significant enough. A history of prior eyelid surgery may put you at risk for inadequate eyelid closure or dry eyes after surgery. It is important to see an eyelid specialist to coordinate a surgical plan that will not only give the most aesthetically natural appearance but more importantly, maintain vital eye health. 

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Brow Lift


Brow Lift by Dr. Rona Silkiss and Dr. Kasra Eliasieh in San Francisco, Oakland, Palo Alto, Corte Madera, Walnut Creek, San Leandro, Fremont. 

 

Brow Lift


Brow Lift by Dr. Rona Silkiss and Dr. Kasra Eliasieh in San Francisco, Oakland, Palo Alto, Corte Madera, Walnut Creek, San Leandro, Fremont. 

 

BROW LIFT

A brow lift can reverse the effects of gravity by tightening the skin and soft tissues of the forehead and above the brow in order to restore a more youthful brow contour. In men, a youthful brow rests just above the orbital rim, whereas in women there is more of a pronounced arch. With age, the brows can sag, resulting in a tired or sad look. This commonly occurs in the outer corners of the brows. Sagging brows may contribute to excess upper eyelid skin, which may block the peripheral vision. Some people complain of headaches from constantly having to raise their eyebrows in order to see. 

THE PROCEDURE

There are various methods used to surgically raise the eyebrows to a more youthful position. 

Lateral brow lift elevates the outside portion of the brow, which is the most common area that sags. The incision is made just above the hairline, so no scars will be visible. 

Browpexy may be performed at the same time as an upper eyelid blepharoplasty or ptosis repair because it utilizes the same incision. Internal sutures are placed to suspend the brow at the desired height. 

Direct Brow Lift consists of making an incision just above the brow and removing skin to lift the brow. This procedure is more often performed for men with heavy forehead furrows that can hide the scar, or for patients with severe brow drooping. 

A brow lift is commonly performed at the same time as other eyelid procedures such as upper eyelid blepharoplasty, lower eyelid blepharoplasty, and/or ptosis repair. 

Our doctors will discuss their assessment with you and go over your personal plan and what to expect after surgery during your preoperative visit. The surgery may be performed in the office using only local anesthesia or in the operating room under sedation (twilight) depending on your surgical plan.

RECOVERY AFTER SURGERY

You may expect to go home on the day of surgery.  There is usually minimal to no pain after brow lift surgery and most patients resume their normal daily activities the following day. Heavy lifting should be avoided for 1-2 weeks. You may experience mild discomfort, which is controlled with oral medication. Rarely, numbness or tingling in the brow may be experienced after surgery. Swelling and bruising significantly improves after a few days and usually is minimally noticeable after 2 weeks, however healing time can vary between individuals. Sutures are removed on the first postoperative visit, usually 7-10 days after surgery. 

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Fat Grafting


 

Fat Grafting (Fat Transfer) by Dr. Rona Silkiss and Dr. Kasra Eliasieh in San Francisco, Oakland, Palo Alto, Corte Madera, Walnut Creek, San Leandro, Fremont. 

Fat Grafting


 

Fat Grafting (Fat Transfer) by Dr. Rona Silkiss and Dr. Kasra Eliasieh in San Francisco, Oakland, Palo Alto, Corte Madera, Walnut Creek, San Leandro, Fremont. 

FAT GRAFTING

With aging comes not only drooping and wrinkles, but a loss of volume in the cheeks and under the eyes due to loss of natural fat. Fat grafting, also known as autologous fat transfer, allows the surgeon to replace lost volume in the face with the patient's own belly or thigh fat. Autologous fat is an ideal filler because since it comes from the patient's own fat stores, there is no chance for any allergic reaction. Also, it's effects are long lasting and often permanent because the fat cells continue to live in the implant site. Fat grafting is ideal for softening facial creases and wrinkles, and restoring volume loss due to aging, trauma, or other conditions. 

THE PROCEDURE

Fat grafting is performed under sedation in an operating room. Fat is first carefully harvested from the belly or the thigh using a technique similar to liposuction. The site that the fat is harvested from heals well and only has minor temporary swelling. The fat is then processed to maximize healthy fat cells and injected into the areas of volume loss. Fat grafting may be combined with other cosmetic or reconstructive procedures if indicated. 

RECOVERY AFTER SURGERY

You may expect to go home on the day of surgery.  There is usually minimal to no pain after fat grafting and most patients resume their normal daily activities the following day. Heavy lifting should be avoided for 1-2 weeks. You may experience mild discomfort, which is controlled with oral medication. There is usually minimal swelling or bruising.