Eyelid Surgery (Blepharoplasty)

Upper and lower eyelid surgery (blepharoplasty) at Torrey Pines Plastic Surgery Del Mar, performed by Dr. Kayva Crawford. Upper blepharoplasty uses incisions placed within the natural eyelid crease to remove excess skin and fat; lower blepharoplasty uses internal or external incisions to address periorbital fat herniation and lower lid laxity. Procedure takes 1–2 hours. Patients typically return to social activities within 7–10 days.

Blepharoplasty at Torrey Pines Plastic Surgery in Del Mar is performed by Dr. Kayva Crawford, whose training in otolaryngology and facial plastic and reconstructive surgery encompasses deep expertise in periorbital anatomy — the relationship between the eyelid, orbital fat compartments, lacrimal system, and the facial nerve branches that control orbicularis function. This anatomical depth is particularly relevant for eyelid surgery, where knowledge of the orbital septum, the levator aponeurosis, and the retro-orbicularis oculi fat (ROOF) layer differentiates surgeons who can produce natural, symmetric results from those who may over-resect or under-address the relevant structures. Upper blepharoplasty at the clinic addresses dermatochalasis — the excess upper eyelid skin that creates a hooded appearance, can impair the superior visual field in advanced cases, and contributes significantly to facial fatigue. The upper eyelid incision is placed precisely within the natural supratarsal crease, concealing the scar within the eyelid fold when the eye is open. Skin, a strip of orbicularis muscle, and herniated medial and central fat pads are removed or repositioned as indicated to restore a defined upper eyelid platform. The brow position is assessed pre-operatively, as brow ptosis can masquerade as upper lid excess — Dr. Crawford evaluates whether brow lifting should be performed concurrently. Lower blepharoplasty addresses the three lower periorbital fat compartments (medial, central, and lateral pads) that herniate anteriorly as the orbital septum weakens with age, producing under-eye puffiness and lower lid fullness. Incisions can be placed transconjunctivally (inside the lower lid, no external scar, preferred where skin laxity is minimal) or subciliary (just below the lash line, allowing skin excision in patients with lower lid skin excess). The procedure takes one to two hours, depending on whether upper, lower, or both are performed. Bruising and swelling are expected for the first one to two weeks. Most patients are presentable for social occasions within seven to ten days and may wear eye makeup from week two.