Eyelid Surgery (Blepharoplasty)

Dr. Mark Mandell-Brown performs upper and lower blepharoplasty (eyelid surgery) to address excess upper eyelid skin, herniated orbital fat causing under-eye puffiness, and fine lower eyelid skin crinkling. His facial plastic surgery board certification reflects focused training in periorbital anatomy and aesthetics. Upper blepharoplasty removes excess skin and, where indicated, fat from the upper eyelid to restore an open, alert appearance and — in cases of functional ptosis — may qualify for insurance coverage by improving the upper visual field. Lower blepharoplasty addresses under-eye bags and hollowing through transconjunctival or subciliary approaches depending on the extent of skin involvement. Eyelid procedures are frequently combined with facelift or brow lift surgery.

Blepharoplasty performed by Dr. Mark Mandell-Brown draws on his board certification in Facial Plastic Surgery, a specialty with particular depth of training in the periorbital region where aesthetics and function intersect closely. The upper eyelid complex is one of the first facial areas to show visible ageing: the orbital septum weakens, allowing fat prolapse into the upper eyelid; the skin loses elasticity and accumulates redundant folds; and brow descent from the forehead further loads the upper lid with excess tissue. Upper blepharoplasty addresses these changes through a precisely placed incision within the natural upper eyelid crease. The calculated amount of redundant skin — and where indicated a conservative strip of orbicularis oculi muscle — is excised, and prolapsed medial and central fat compartments are conservatively reduced or repositioned. Preservation of adequate skin for comfortable eye closure is an absolute technical priority. In patients where the overhanging skin drapes below the eyelid margin and obstructs the upper visual field, formal visual field testing can document functional impairment to support an insurance coverage claim. Lower blepharoplasty targets the three orbital fat compartments — medial, central, and lateral — that herniate through an ageing orbital septum to create the puffiness and shadowing of under-eye bags. For younger patients with good lower eyelid skin tone who present primarily with fat prolapse, the transconjunctival approach — performed entirely through the inner surface of the lower eyelid without external incision — allows fat reduction or repositioning over the orbital rim to simultaneously address tear trough hollowing. Where lower eyelid skin excess, fine surface crinkling, or festooning is present, a subciliary external incision approach allows simultaneous conservative skin pinch resection. Blepharoplasty is frequently combined with brow lift or facelift surgery to address the full periorbital and lower facial ageing complex in a single anaesthetic event, minimising total recovery time for patients seeking comprehensive rejuvenation.