The first thing people notice.
The eyes communicate more than any other feature — energy, warmth, alertness, age. When excess skin hoods the upper lids or puffiness weighs down the lower lids, the effect is immediate and unmistakable. Dr. Larry Nichter performs eyelid surgery with precision and restraint, restoring a natural brightness that looks like rest, not surgery.
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The procedure
Eyelid Lift in Newport Beach
An eyelid lift — known medically as blepharoplasty — is a surgical procedure that removes excess skin, tissue, and fat from the upper eyelids, lower eyelids, or both. It corrects the hooding, puffiness, and sagging that make the eyes appear tired, heavy, or older than the patient feels.
Upper eyelid surgery addresses excess skin that folds over the natural lid crease, sometimes enough to obstruct peripheral vision. Lower eyelid surgery targets the puffiness, bags, and fine wrinkles beneath the eyes that contribute to a fatigued appearance. Many patients benefit from both, performed together in a single procedure.
Blepharoplasty is one of the most commonly performed facial procedures — and one of the most consistently satisfying. The recovery is relatively short, the incisions heal to near-invisibility within the natural creases of the eyelid, and the results are both immediately noticeable and long-lasting. It is frequently combined with a brow lift or facelift to rejuvenate the full face, but it also stands entirely on its own as a focused correction.
His approach
The Discipline of Less
The most important decision in eyelid surgery is how much tissue to remove — and it is a decision with very little margin for error. Remove too much skin from the upper lid and the eye cannot close fully, creating dryness and a hollow, startled appearance. Remove too little and the improvement is insufficient. The same principle applies to fat: excessive fat removal beneath the eyes creates a sunken look that ages the face rather than rejuvenating it.
Dr. Nichter's approach to blepharoplasty follows the same philosophy that guides all his facial work — intervene precisely, remove only what is necessary, and prioritize a result that looks natural over one that looks operated on. In upper eyelid surgery, he makes an incision within the natural crease of the lid, removes a carefully measured amount of excess skin and, when appropriate, repositions or removes a small amount of fat. The incision, once healed, is hidden within the crease and is essentially invisible.
For the lower lids, the technique depends on the anatomy. Patients with puffiness caused primarily by fat pads may be candidates for a transconjunctival approach — an incision made inside the lower lid, leaving no external scar at all. When excess skin and laxity are also present, he uses an incision just below the lash line, where it heals discreetly. In both cases, the goal is to smooth and refresh the under-eye area without hollowing it.
His academic career and published research have given him a precise understanding of periorbital anatomy — the structures around the eye that determine how eyelid surgery heals, how the lids sit after surgery, and how the result evolves over time. That knowledge translates directly into how he plans and performs the procedure.
Is it right for you
Am I a Good Candidate for an Eyelid Lift?
Blepharoplasty is appropriate for patients who notice excess skin, puffiness, or sagging around the eyes that contributes to a tired or aged appearance. It is one of the few facial procedures sought as often for functional reasons — impaired peripheral vision from heavy upper lids — as for cosmetic ones.
An eyelid lift may be right for you if:
- Excess upper eyelid skin folds over the natural crease, making your eyes look heavy or hooded
- Drooping upper lids interfere with your peripheral vision
- Puffy bags beneath the eyes create a perpetually tired appearance
- You have lost the natural crease of the upper lid
- Fine wrinkles and loose skin beneath the eyes bother you
- You are in good general health with no eye conditions that would complicate healing
It is important to distinguish between eyelid aging and brow descent. In some patients, a low brow pushes tissue onto the upper lid, mimicking the appearance of excess eyelid skin. In these cases, a brow lift — alone or in combination with blepharoplasty — may be the more appropriate correction. Dr. Nichter evaluates both during consultation and recommends the approach that addresses the actual cause.
For men
Eyelid Surgery for Men
Eyelid surgery is one of the procedures men ask about most often, and for a practical reason: heavy upper lids and puffiness beneath the eyes read as fatigue, and men hear about it — at work, from family, in photographs. Many men who would never consider a facelift are entirely comfortable with a procedure that makes them look rested.
The surgical goal is different for a man. The male brow sits lower and flatter, close to the bony rim of the eye, and the upper lid shows less of its crease. Dr. Nichter removes skin conservatively — enough to clear the lashes and lighten the lid, never enough to create a high, open, hollow crease that reads as feminine or startled. In the lower lids, he generally repositions fat rather than removing it, so the eye is smoothed without being hollowed. Incisions sit inside the lid or within the natural crease; male skin is thicker and heals well, but bruising can be more visible and there is no makeup to conceal it, so timing the procedure around work and social commitments matters.
Because the male brow is meant to sit low, brow descent is treated more cautiously in men. Elevating a man's brow into an arch feminizes the face; the more common answer is a carefully judged upper-lid procedure with the brow left close to where it is. Dr. Nichter evaluates both during consultation. Most men are back at their desks within a week to ten days, in sunglasses for a little longer, and the result — alert, rested, and unchanged in character — is one that colleagues notice without being able to say why.
This patient had the lower eyelid surgery, which is designed to re-drape and remove sagging excess eyelid skin.
This 58-year-old gentleman had a Blepharoplasty (Eyelid Lift). The Eyelid Lift is designed to re-drape and remove sagging excess eyelid skin.
This gentleman had a Blepharoplasty (Eyelid Surgery)
This patient had the lower eyelid surgery, which is designed to re-drape and remove sagging excess eyelid skin.
What to expect
Your Eyelid Lift Experience
Consultation and Planning
Dr. Nichter examines the eyelids, the position of the brow, the skin quality, and the underlying fat distribution. He assesses whether the concern involves the upper lids, lower lids, or both — and whether the brow position is contributing. He explains the recommended technique, discusses what the procedure can and cannot achieve, and answers every question.
The Day of Your Procedure
Blepharoplasty is typically performed under local anesthesia with oral or IV sedation. General anesthesia is available if preferred or if the eyelid lift is being combined with other procedures. Surgery takes approximately one to two hours, depending on whether the upper lids, lower lids, or both are being addressed.
For upper eyelid surgery, Dr. Nichter makes an incision within the natural crease of the upper lid. Through this incision, he removes a precisely measured amount of excess skin, repositions or removes a small amount of fat if needed, and may tighten the underlying muscle. A small triangle of tissue near the outer corner of the lid may be removed to improve the contour where the lid meets the brow. The incision is closed with fine sutures that dissolve on their own.
For lower eyelid surgery, the approach depends on the anatomy. If the concern is primarily fat pads causing puffiness, a transconjunctival incision — made inside the lower lid — allows fat to be repositioned or removed with no visible external scar. If excess skin and laxity are also present, an incision is made just below the lash line, where it becomes nearly invisible once healed. Excess skin is removed and the area is smoothed.
If combined with a brow lift, facelift, or LiteLift®, all procedures are performed in a single session with one recovery period.
Immediately After
You are monitored as the sedation clears. Cool compresses are applied to reduce swelling. Vision may be temporarily blurry from lubricating ointment. A friend or family member will need to drive you home, and someone should stay with you for the first twenty-four hours. You leave with detailed post-operative instructions and prescribed eye drops or ointment.
Recovery
Recovery and Downtime
Blepharoplasty has one of the shortest recoveries of any facial procedure. Most patients are pleasantly surprised by how quickly they feel and look better.
The First Few Days
Expect swelling and bruising around the eyes — this is most pronounced in the first forty-eight hours. Your eyes may feel tight, dry, or watery. Use prescribed eye drops or ointment as directed. Apply cool compresses gently to reduce swelling. Keep your head elevated, including during sleep. Avoid rubbing your eyes. Some sensitivity to light is normal — wear sunglasses if going outdoors.
Week One
Swelling and bruising begin to subside noticeably by day five to seven. Dissolvable sutures are typically absorbed on their own; if non-dissolvable sutures were used, they are removed around day seven. You may begin to wear makeup at this point. Avoid contact lenses for approximately two weeks. Do not lift anything heavy, swim, or exercise vigorously.
Weeks Two Through Four
Most patients feel comfortable returning to work and social activities within ten to fourteen days. Residual swelling and minor bruising may still be present but are easily concealed with makeup. Light exercise can resume around week two, as cleared by Dr. Nichter. Avoid anything that significantly raises your heart rate or blood pressure. Continue wearing sunglasses outdoors to protect the healing skin.
Six Weeks and Beyond
By six weeks, the incision lines have faded significantly — often to the point of being invisible within the natural lid crease. Any remaining swelling is subtle. The eyes look brighter, more open, and naturally rested. Full results, with all swelling resolved and tissues fully settled, are typically apparent by two to three months.
Results
Natural, lasting improvement.
Improvement is visible almost immediately, even through the initial swelling and bruising. By two to three weeks, most patients see a meaningful difference — brighter, more open eyes and a rested appearance. Final results emerge at two to three months as the remaining swelling resolves and the incision lines mature.
Upper eyelid surgery results typically last five to seven years or longer. Lower eyelid surgery often produces results that last indefinitely, as the fat pads, once repositioned or removed, generally do not recur. The natural aging process continues — skin may gradually loosen over many years — but the improvement from blepharoplasty is among the most durable in facial surgery.
Consistent sun protection and good skin care help preserve the results.
This patient had the upper and lower eyelid surgeries, which are designed to re-drape and remove sagging excess eyelid skin.
This patient had the eyelid surgery, which are designed to re-drape and remove sagging excess eyelid skin.
This patient had the upper and lower eyelid surgeries, which are designed to re-drape and remove sagging excess eyelid skin.
This patient had the upper and lower eyelid surgeries, which are designed to re-drape and remove sagging excess eyelid skin.
Galleries: Eyelid Surgery 37Double Eyelid Surgery 10
Investment
Cost and Financing
The cost of blepharoplasty depends on whether the upper lids, lower lids, or both are being treated, the technique used, anesthesia, and whether the procedure is combined with other treatments. A detailed, transparent quote is provided after consultation, once Dr. Nichter has examined you and discussed your surgical plan.
Financing options are available — please ask at your consultation.
Common questions
Frequently Asked Questions
What is the difference between upper and lower eyelid surgery?
Upper eyelid surgery removes excess skin and sometimes fat from the upper lid, correcting hooding and restoring the natural crease. Lower eyelid surgery addresses puffiness, bags, and loose skin beneath the eyes. Many patients have both performed together for a complete rejuvenation of the eye area.
Can an eyelid lift improve my vision?
Yes. If excess upper eyelid skin is heavy enough to droop over the lash line, it can obstruct peripheral vision. Upper blepharoplasty removes this excess skin and restores a full field of view. In some cases, this functional benefit may qualify for insurance coverage — Dr. Nichter can discuss this during consultation.
Do I need an eyelid lift or a brow lift?
Sometimes the issue is excess eyelid skin; sometimes it is a descended brow pushing tissue onto the lid; sometimes it is both. Dr. Nichter evaluates the eyelid and brow together during consultation and recommends the procedure — or combination — that addresses the actual cause. See the brow lift page for more on how these procedures complement each other.
Will the scars be visible?
Upper eyelid incisions are placed within the natural crease of the lid and become essentially invisible once healed. Lower eyelid incisions are placed just below the lash line or inside the lid (with no external scar at all). Eyelid skin heals particularly well, and scarring is rarely a concern.
How long should I take off work?
Most patients return to work within ten to fourteen days. Some feel comfortable returning sooner with the help of sunglasses and light makeup. If your work involves physical exertion, plan for two weeks.
Can I wear contact lenses after surgery?
You should avoid contact lenses for approximately two weeks after surgery. Glasses can be worn immediately. Dr. Nichter will advise when it is safe to resume contact lens use.
How long do eyelid lift results last?
Upper eyelid results typically last five to seven years or longer. Lower eyelid results are often more durable — in many cases lasting indefinitely, since the fat pads do not typically recur. The aging process continues, but the improvement is among the most lasting in facial surgery.
Schedule Your Consultation
If heavy lids, under-eye puffiness, or a perpetually tired appearance has been bothering you — whether for months or years — a consultation is a good place to start. Dr. Nichter will evaluate your eyelids and brow position, explain what blepharoplasty can achieve for your specific anatomy, and answer every question.
Request a Private ConsultationDr. Nichter sees patients from across the United States and internationally. The office is located in Newport Beach, CA.