Eyelid Surgery (Blepharoplasty)

De La Cruz Plastic Surgery Houston performs upper and lower eyelid blepharoplasty to address hooding, excess skin, and under-eye puffiness or hollowing. Upper blepharoplasty removes redundant skin and fat from the upper lid crease, restoring an open, alert periorbital appearance and improving peripheral visual field where hooding is significant. Lower blepharoplasty addresses under-eye fat prolapse (bags), loose skin, and festoons through transconjunctival or external approaches with optional fat repositioning to soften the tear trough. Blepharoplasty is commonly combined with deep plane facelift or brow lift for comprehensive upper-face rejuvenation.

Eyelid surgery at De La Cruz Plastic Surgery Houston addresses one of the most visible and age-sensitive regions of the face — the periorbital zone — where the earliest signs of facial ageing often appear. Upper blepharoplasty corrects dermatochalasis, the excess skin redundancy of the upper eyelid that descends over the lid crease and may encroach on the visual field, creating functional as well as aesthetic concerns. The surgical approach involves carefully marking the amount of skin to be excised, considering the patient's natural eyelid crease height and pretarsal show, and removing a precise ellipse of skin and the underlying strip of orbicularis oculi muscle. Where upper lid fat prolapse is present, the medial and central fat pockets are addressed conservatively to avoid the hollowed, skeletonised periorbital appearance that over-resection of upper lid fat may produce. Lower blepharoplasty addresses the herniation of the three lower orbital fat pockets — medial, central, and lateral — through an aging orbital septum, which manifests clinically as the characteristic lower eyelid bags of the mature face. Two primary approaches are used depending on the patient's anatomy: the transconjunctival approach places the incision on the inner lining of the lower eyelid, leaving no external scar, and is preferred for younger patients with good lower eyelid skin tone and primarily fat prolapse; the subciliary external approach is used when lower eyelid skin redundancy or significant orbicularis laxity requires direct excision. Fat repositioning — rather than simple fat excision — is employed where a tear trough deformity or nasojugal groove depression exists, allowing the prolapsed fat to be transposed into the hollow and sutured to the periosteum of the inferior orbital rim, softening the junction between the lower lid and cheek and avoiding the gaunt appearance that fat excision alone may produce. Dr. De La Cruz commonly incorporates blepharoplasty into a comprehensive facial rejuvenation plan alongside deep plane facelift, brow lift, or fat grafting to achieve harmonious, balanced upper-face restoration. Procedures are performed under general anaesthesia or local anaesthesia with sedation at Cypress Surgicare of Texas. Bruising and swelling resolve in seven to fourteen days; incision lines mature to near invisibility over three to six months.