Case #2009
Upper Blepharoplasty
A man in his 60s felt he always looked tired and angry. Dr. Azadgoli performed a brow lift, upper blepharoplasty, and transconjunctival lower blepharoplasty with fat transfer to the midface and under-eyes.
A man in his 60s felt he always looked tired and angry, and wanted a more rested look while keeping a natural, masculine appearance. Dr. Azadgoli performed a brow lift, an upper blepharoplasty, and a transconjunctival lower blepharoplasty (no external lower-lid incision) with fat transfer to the midface and under-eye area.
Why this approach
The decisions that shaped this surgical plan.
- Several procedures combined into one operative plan. The order, the tissue handling, and the recovery were all designed for the combined case, not bolted together from individual plans.
Pre-op preparation
What to do before surgery. Specific to this case.
- Discontinue blood thinners (NSAIDs, aspirin, fish oil, vitamin E) two weeks out. Acetaminophen remains safe; the full list is reviewed at pre-op.
- Full nicotine cessation 6 weeks pre- and post-op. This includes vapes and nicotine replacement products; the constriction effect is the same.
- Set up an elevated sleeping arrangement — extra pillows or a wedge — to keep the head above the heart for the first week. Stock soft, low-sodium foods.
- Day-of transport and an overnight companion (24 hours minimum) are required for discharge.
- 3 additional procedures planned — plan for at least 2 weeks of in-home help rather than the standard 1 week.
- Medical clearance and a current EKG are obtained pre-op. Anesthesia review confirms any chronic-condition adjustments.
Recovery timeline
Milestones specific to this case. Individual recovery varies.
- Day 1–7
Cold compresses, head elevated, low-talking the first 72 hours. Most bruising peaks at day 3 and starts to soften by day 5.
- Week 2
Visible bruising is mostly resolved by day 10. Sutures out by day 7. Patients return to indoor activities, low-impact only.
- Week 4
Residual swelling continues to refine. Most patients return to normal social and work life; light cardio begins.
- Week 6
Cleared for most activity; the longest-recovery component still sets the pace. Strength training holds another 2 weeks.
- Month 3
Tissue settles into final position. Subtle technique details (jawline definition, tip refinement) become visible now.
- Month 6
Final aesthetic emerges. Last-mile adjustments (fat grafting, nipple reconstruction) typically scheduled now.
Continued care
Recommended aftercare, skincare, and MedSpa services for Upper Blepharoplasty.
- Cold compresses for the first 48 hours
- Head elevated for sleeping for 1 week
- No strenuous activity or heavy lifting for 2 weeks
- Sutures removed at 5–7 days
- Lubricating drops as directed for temporary dryness
- Gentle eyelid hygiene as directed
- SkinCeuticals C E Ferulic for scar healing
- SPF 50+ around the eyes once healed
- LED light therapy weekly for the first 8 weeks
- Lymphatic drainage if swelling persists
- Hold eye-area treatments until fully healed
- Aftercare
Activity progression coordinated with PT — formal check-in scheduled for week 4.
Older patients benefit from a guided return-to-activity plan.
- Aftercare
Combination case: in-home support extended to 14 days, calibrated to the slowest-healing component.
Combination procedures stack recovery demand.
- Skincare
Medical-grade skincare reintroduced at week 3 — gentle retinoid alternative first, full actives by month 2.
Active skincare resumes on a healing-friendly ramp after facial surgery.
