Eyelid Surgery (Blepharoplasty)

Dr. Robert Schwartz performs upper and lower blepharoplasty from his Dallas practice to address excess eyelid skin, under-eye bags, and puffiness that contribute to a tired or aged appearance. Upper blepharoplasty removes redundant skin from the upper lid that can impair the visual field or simply obscure the natural lid crease. Lower blepharoplasty targets fat pseudoherniation and skin redundancy beneath the eye, smoothing under-eye bags and improving the periorbital region. Procedures run up to two hours under general anaesthesia or IV sedation, with return to work in three to seven days.

Dr. Robert Schwartz Plastic Surgery Dallas provides blepharoplasty surgery for the upper eyelids, lower eyelids, or both, using precise surgical techniques to restore a more alert and rested periorbital appearance. The upper eyelid procedure addresses dermatochalasis — the gradual accumulation of excess skin on the upper lid — which in its more advanced form creates a visible hood of redundant tissue that partially obscures the supratarsal crease and can impinge upon the superior visual field. In cases where dermatochalasis causes measurable visual field restriction, upper blepharoplasty may qualify as a functional procedure and be covered in whole or in part by medical insurance; the practice assists patients in obtaining appropriate ophthalmological visual field testing to support insurance documentation. The surgical technique for upper blepharoplasty involves precise excision of the redundant skin along a carefully planned incision line placed within the natural upper lid crease, so that the scar is concealed within the fold when the eye is open. Accompanying fat prolapse — which creates a fullness or puffiness of the upper medial or central lid — is addressed through conservative fat excision or repositioning. Lower blepharoplasty targets the lower periorbital region, where a combination of orbital septum weakening, fat pseudoherniation through the septum, and loss of skin elasticity produces the characteristic 'bags under the eyes' appearance. Dr. Schwartz performs lower blepharoplasty via a subciliary (external) incision placed just below the lower lash line, or via a transconjunctival (internal) approach for patients requiring fat removal only without skin excision. Fat compartments of the lower lid — medial, central, and lateral — are conservatively reduced or repositioned to the tear trough region to smooth the transition between the lower lid and upper cheek. Laser skin resurfacing or chemical peeling of the lower lid skin can be combined with transconjunctival blepharoplasty for patients with fine periorbital lines and skin laxity not requiring full skin excision. Procedures are performed as outpatient surgery under general anaesthesia or IV sedation. Cold compresses are applied in the immediate postoperative period to minimise oedema and ecchymosis; most patients return to desk work within three to seven days and to exercise at three weeks, with residual swelling resolving fully over six to eight weeks.