Eyelid Surgery (Blepharoplasty)

Dr. Krau performs upper, lower, and combined eyelid surgery (blepharoplasty) to address drooping upper lids, excess upper lid skin and muscle, under-eye bags, puffiness caused by herniated orbital fat, and lower lid skin redundancy. The transconjunctival approach is available for lower blepharoplasty in patients without excess skin, avoiding an external scar. Eyelid surgery is frequently combined with a facelift or brow lift for comprehensive periorbital and facial rejuvenation.

Blepharoplasty — surgical reshaping of the eyelids — addresses one of the most visible aspects of facial ageing: changes to the periorbital region that produce a tired, heavy, or aged appearance. Dr. Ary Krau performs upper, lower, and combined blepharoplasty procedures tailored to the specific anatomical findings in each patient. Upper blepharoplasty corrects dermatochalasis (excess upper eyelid skin), hypertrophic orbicularis muscle, and prolapsed orbital fat from the medial and central upper lid compartments. The procedure involves excision of carefully measured skin and, where needed, a conservative strip of muscle and fat, restoring the natural supratarsal fold and opening the visual field for patients whose redundant skin encroaches on their superior vision. The surgical scar is placed precisely within the natural upper lid crease, where it heals to near invisibility. Lower blepharoplasty at Dr. Krau's Miami practice targets the under-eye puffiness and hollowing caused by herniated orbital fat from the three lower lid fat compartments, along with any skin redundancy and festooning of the lower lid. For patients with adequate lower lid skin tone and isolated fat herniation, Dr. Krau uses the transconjunctival approach — an incision entirely within the inner surface of the lower eyelid, leaving no external scar whatsoever. Fat is either removed or redistributed into the tear-trough hollow to smooth the transition between the lower lid and the cheek. For patients who also have lower lid skin laxity, a subciliary (below-lash) external incision is added to allow skin resurfacing or excision in the same session. Combined upper and lower blepharoplasty is a common procedure that restores overall periorbital freshness in a single surgical episode. Dr. Krau frequently combines eyelid surgery with a facelift when addressing multiple planes of facial ageing, and with a brow lift when forehead descent is contributing to an artificial sense of upper lid heaviness. Fat transfer to the tear trough and orbital rim can be performed as an adjunct for patients in whom volume restoration is part of the aesthetic plan. Post-operative care involves cold compresses, head elevation, and temporary avoidance of strenuous activity; most patients are presentable for social settings within ten to fourteen days.