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Eyelids (Blepharoplasty)

Eyelid puffiness in the lower eyelids is caused primarily by excess fat and is usually corrected by a transconjunctival blepharoplasty. The incision in this procedure is made inside the lower eyelid and excess fatty material removed. Usually, no sutures are needed to close this kind of an incision. If sutures are needed, they are invisible to the eye and are also self-dissolving. No scar results since the incision is inside the eyelid.

Excess skin combined with eyelid puffiness may require a different approach to lower eyelid surgery. The above transconjunctival blepharoplasty may be combined with a chemical peel of the lower eyelid skin to reduce the wrinkles and tighten the excess skin of this area. In transcutaneous blepharoplasty, the surgeon makes the incision on an inconspicuous site just below the lash line. Excessive fat and loose skin are removed and the incision is closed with fine sutures. Your surgeon can help you determine which procedure is right for you.

About The Procedure

In upper eyelid surgery, incisions follow the natural lines of the eyelid - the creases above the upper eyelid. Excessive fat and loose skin are removed. Fine sutures are used to close the incisions, thereby minimizing the visibility of a scar. In lower eyelid surgery, the surgeon makes the incision on an inconspicuous site just below the lash line. Excessive fat and loose skin are removed and the incision is closed with fine sutures.

Upper eyelid surgery may be performed under a local anesthesia with an intravenous or oral sedative. Lower eyelid surgery is usually performed under twilight anesthesia.

For the first 48 hours after this type of surgery, cold compresses are applied to the eye area to reduce swelling and bruising. Most patients are ready to get back to their normal lifestyles two days after the procedure. Strenuous exercise is avoided for one week. There is little or no pain after surgery. Sutures are removed in a week.

Upper and lower eyelid surgery is almost always performed at the same time to achieve maximum improvement in the appearance of the eyes. The results usually last forever and this one procedure, which is non-invasive.


Dr. Holzapfel has been selected for Top Doctors in Cincinnati, the prestigious list of peer-voted distinction, each year since 2013.



In her practice of plastic surgery, Dr. Lied is particularly interested in body contouring, facial rejuvenation and breast reconstruction.

Top-rated, board-certified facial plastic surgeons and board-certified plastic surgeons in Cincinnati and Northern Kentucky, offering eyelifts, browlifts, facelifts, breast implants and breast reductions, rhinoplasty, reconstruction after cancer or trauma, liposuction, CoolScultping, Fraxel, Botox, Dysport, peels and fillers such as Restylane, Radiesse and Juvederm, and other procedures to refresh and renew your appearance.   Voted Best Doctors 2015-2016