Eyelid Surgery (Blepharoplasty)

Dr. Roy David performs upper and lower eyelid surgery (blepharoplasty) at his Sorrento Mesa San Diego practice, using local anaesthesia with sedation for upper procedures (20–30 minutes) and adapting approach for lower eyelid cases based on the extent of fat herniation and skin laxity present. Laser blepharoplasty is available as an alternative technique. Eyelid procedures are commonly combined with the La Jolla Lift® facelift or brow lift for comprehensive periorbital and facial rejuvenation.

Blepharoplasty at Ora Plastic Surgery San Diego is performed by Dr. Roy David, whose fellowship-level training in facial plastic and reconstructive surgery includes specialised periorbital anatomy and the full range of eyelid rejuvenation techniques. Upper blepharoplasty addresses the accumulation of redundant upper eyelid skin that develops as the brow gradually descends and the eyelid skin loses elasticity — in moderate to severe cases, the overhanging tissue obstructs the superior visual field, which may qualify the procedure for partial insurance reimbursement when supported by formal visual field testing documentation. The surgical technique involves a precisely planned incision within the natural upper eyelid crease, excision of the calculated skin and orbicularis muscle strip, and conservative management of prolapsed medial and central orbital fat compartments. Preservation of adequate eyelid skin is essential to avoid post-operative lagophthalmos. Upper blepharoplasty at the San Diego practice is typically performed under local anaesthesia with sedation in approximately 20–30 minutes, allowing for a short procedure time and relatively rapid recovery. Lower blepharoplasty targets the three orbital fat compartments of the lower eyelid — medial, central, and lateral — which herniate through the weakening orbital septum with age, creating bulging under-eye bags. The transconjunctival approach, performed through the inner conjunctival surface without any external skin incision, is available for patients whose primary concern is fat prolapse with good residual skin tone; fat may be conservatively reduced or repositioned to blend the transition from the lower eyelid into the tear trough. Where lower eyelid skin excess, fine surface creasing, or pigmentation changes are also present, an external subciliary approach permits skin excision alongside fat management. Laser blepharoplasty — using laser energy rather than scalpel incisions — is offered as an alternative technique with the advantage of simultaneous skin surface resurfacing during the procedure. Eyelid surgery at the San Diego practice is frequently combined with the La Jolla Lift® facelift, brow lift, or other facial procedures in a single anaesthetic setting to achieve comprehensive periorbital and lower facial rejuvenation with a single recovery period.