Eyelid Surgery (Blepharoplasty)

Dr. Andrew S. Frankel performs upper and lower eyelid surgery from his AAAHC-accredited Lasky Clinic in Beverly Hills using a philosophy of restructuring rather than removal — preserving orbital fat where possible to avoid a hollowed result. Upper blepharoplasty addresses redundant upper eyelid skin and, where indicated, herniated fat, restoring an open, youthful appearance. Lower blepharoplasty repositions orbital fat to reduce under-eye puffiness and address tear trough hollowing. Both procedures last approximately one to two hours and are commonly combined with facelift or brow lift surgery.

Blepharoplasty at Beverly Hills Plastic Surgery Group reflects Dr. Andrew Frankel's training in facial plastic and reconstructive surgery, where periorbital anatomy and the nuances of eyelid ageing are a central focus. The practice's approach is guided by a philosophy of conservative tissue management: rather than maximising skin and fat removal — which can result in an operated, hollow, or skeletonised periorbital appearance — Dr. Frankel emphasises restructuring the existing tissue architecture to achieve a natural, rested result. Upper blepharoplasty addresses the accumulation of redundant upper eyelid skin that occurs as the levator aponeurosis weakens and the brow descends with age, causing the upper eyelid skin to drape over the eyelid margin. In cases where dermatochalasis impairs the upper visual field, the procedure may qualify for partial insurance coverage when visual field testing documents functional ptosis. The surgical technique involves an incision placed precisely within the upper eyelid crease — typically 8–10 mm above the eyelid margin in women and slightly lower in men — followed by excision of the calculated skin excess and conservative management of the medial and central orbital fat compartments. Preservation of at least 20 mm of upper eyelid skin between the brow and the lash line is maintained to ensure complete eye closure post-operatively. Lower blepharoplasty at the practice addresses the three orbital fat compartments of the lower eyelid — medial, central, and lateral — which herniate through the orbital septum with age, creating the bulging under-eye appearance. The treatment approach varies by the patient's anatomy: for patients with primarily fat prolapse and adequate skin tone, the transconjunctival approach accesses the fat compartments through the inner surface of the lower eyelid without any external incision, with fat repositioned over the orbital rim rather than excised where tear trough hollowing coexists. For patients with concurrent lower eyelid skin laxity, fine crepey texture, or festooning, a subciliary external approach allows skin management alongside the fat repositioning. Both procedures are performed under local anaesthesia with sedation or under general anaesthesia at The Lasky Clinic. Recovery involves cold compresses, head elevation, and avoidance of contact lens use for the first two weeks; most Beverly Hills patients return to desk work within three days and to full social activities at two weeks.