Eyelid Surgery (Blepharoplasty) in West Palm Beach, FL

Eyelid Surgery (Blepharoplasty) in West Palm Beach, FL is performed by Dr. Albert Carlotti at BellaNova Cosmetic Surgery's state-registered Level III surgical center at 1261 S Congress Ave in West Palm Beach.

The eyes carry more of how rested someone looks than any other feature. A heavy upper lid, a shadowed lower lid or a hollow beneath the eye reads as tired regardless of how much sleep you actually get — which is why patients so often describe the complaint as being told they look tired rather than as looking old.

Eyelid surgery is a small operation with a large effect, and it is also one of the easiest to overdo. Removing too much upper lid skin or too much lower lid fat produces the hollow, skeletonised look that is very difficult to reverse.

Am I a candidate for eyelid surgery (blepharoplasty)?

Consider blepharoplasty if you have:

• Excess upper lid skin that rests on the lashes or obstructs peripheral vision
• Puffiness or bags in the lower lids, often worse on waking
• A hollow or dark shadow at the junction of the lid and cheek
• Fine crepey texture of the lid skin
• Asymmetry between the two sides

If the brow has descended, upper lid surgery alone will not correct the heaviness and can worsen it. In that case a brow lift is the correct operation, alone or combined. Distinguishing brow descent from lid excess is the most important part of the examination.

Upper and lower lids are different operations

Upper blepharoplasty. A precisely measured strip of skin is removed through the natural lid crease, with conservative treatment of the underlying muscle and medial fat pad. The measurement matters more than the technique — enough skin must remain for the lid to close completely, and the crease must be set at a height appropriate to your anatomy and, where relevant, your ethnicity. Performed under local anesthesia with sedation in many cases.

Lower blepharoplasty. Two approaches. A transconjunctival incision inside the lid gives access to the fat pads with no external scar and no disruption of the lid support — preferred when fat is the problem and skin is good. A transcutaneous incision just beneath the lashes allows skin removal as well, and is used when there is genuine skin excess.

Fat repositioning rather than removal. The modern approach to the lower lid is generally to release and redistribute the fat over the orbital rim rather than excise it. Removing fat treats the bag but deepens the hollow beneath it. Repositioning treats both, because the bag and the hollow are the same problem seen from two sides.

Lid support. In lower lid surgery, the tone of the lid margin is tested before anything is removed. A lid with poor support that is operated without a canthopexy can round or pull downward. This is the most common cause of an unhappy lower blepharoplasty result and is preventable.

Recovery timeline

Every recovery is individual. This is the pattern most patients follow, and you will receive a written plan specific to your procedure.

When	What to expect
Days 1–3	Cold compresses, head elevated. Swelling and bruising peak around day two to three.
Days 5–7	Sutures removed. Bruising begins to yellow and fade.
Weeks 2	Most patients are comfortable in public, often with light makeup. Return to desk work commonly at 7–10 days.
Weeks 3–4	Exercise resumed. Incision lines pink but settling.
Months 2–6	Scars fade into the lid crease and lash line. Final shape settles; lower lids take longest.

Risks and considerations

Risks include dry eye or transient irritation, difficulty closing the lids fully, lower lid malposition (rounding, scleral show or ectropion), asymmetry, visible scarring, over- or under-correction, and — very rarely — visual disturbance. Patients with pre-existing dry eye, thyroid eye disease or prior LASIK need specific assessment before surgery.

Cost and financing

Your procedure is self-pay. The practice provides a written quote for your recommended surgical plan. See cost and financing for payment options.

Before and after results

Dr. Carlotti maintains a photographic result archive organized by procedure — real patients, consistent lighting and angles, published with consent. View eyelid surgery (blepharoplasty) before and after photographs.

Eyelid Surgery (Blepharoplasty): questions patients ask