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Blepharoplasty
The eyes are one of the primary points of human interaction. They express our personality, emotions, thoughts and vitality through every encounter. If drooping upper eyelids or bags beneath your eyes are creating an aged, tired or stern appearance that doesn't reflect how you feel, you may wish to consider surgical options that can bring your appearance into better alignment with how you perceive yourself and wish to be perceived by others.
What Is Blepharoplasty?
Blepharoplasty is eyelid surgery performed to remove or reposition excess tissue around the eyes. Dr. Meathrel performs two different types of eyelid surgery, upper blepharoplasty and lower blepharoplasty, to target different areas of the eyelids.
What is Upper Blepharoplasty?
Upper blepharoplasty involves removing excess skin and fat from the upper eyelids. This procedure is commonly used to address sagging or drooping eyelids, which can create a tired or aged appearance. During the procedure, an incision is made in the natural crease of the eyelid, allowing the surgeon to remove excess skin and fat, and tighten the remaining skin. The incision is then closed with sutures.
What is Lower Blepharoplasty?
Lower blepharoplasty targets the area beneath the eyes, including the lower eyelids and the area known as the tear trough. This procedure is used to address issues such as under-eye bags, dark circles, and wrinkles. During the procedure, the surgeon may remove excess fat or redistribute it to create a more youthful and refreshed appearance. In some cases, the surgeon may also tighten the skin and muscle around the lower eyelid.
What Is the Difference Between Upper and Lower Blepharoplasty?
Overall, the main difference between upper and lower blepharoplasty is the area of the eyelid that is targeted. While upper blepharoplasty focuses on the upper eyelids, lower blepharoplasty targets the lower eyelids and the area beneath the eyes. Both procedures can be performed separately or together, depending on the patient's goals and needs.
What Are the Benefits of Eyelid Surgery?
Blepharoplasty is often done for cosmetic reasons, but it is not just for enhancing appearance. It can make a functional difference in your everyday life.
In the hands of an experienced plastic surgeon like Dr. Meathrel, eyelid surgery can:
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Restore a visible upper lid platform and reduce hooding above the lash line
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Reveal an expanded canvas for makeup application
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Create a smoother, firmer eye contour
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Smooth the transition between the lower lid and the cheek
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Reduce puffiness caused by herniated or displaced fat pads
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Soften the hollows and shadowing that contribute to dark under-eye circles
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Give the face a more rested, alert appearance
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Improve peripheral vision when excess upper lid skin obstructs the visual field
The Bespoke Approach to Blepharoplasty
Our eyes are one of our most distinctive and delicate features, therefore eyelid surgery demands precise execution. The gap between a well-rested appearance and an over-operated one is measured in millimetres.
At Bespoke Skin MD, Dr. Meathrel considers a variety of factors, independently and in relation to each other, when planning your blepharoplasty procedure. She evaluates the state of your eyelids, your eye shape, your brow position, your mid-face volume and your facial proportions. This thorough assessment determines whether eyelid surgery is the right course of action for you.
Dr. Meathrel also plans blepharoplasty within the context of longer-term facial aging. Removing too much tissue now can limit your treatment options later. Leaving the appropriate amount of tissue preserves the ability to address future changes without compromising eyelid function or appearance.
Meet Dr. Meathrel
Dr. Kim Meathrel has served Kingston since 2006. She combines world-class expertise with a sophisticated aesthetic eye, integrity, restraint, and respect for each patient’s unique identity.
“I aim to ensure that every intervention enhances who you already are, and supports how you live. Your face, body, and confidence are not replaceable.”
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Certified Plastic Surgeon by the Royal College of Physicians and Surgeons of Canada
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Undergraduate — BSc (Biology), Queen’s University, Kingston
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Medical School — MD, Queen’s University, Kingston
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Residency — Plastic Surgery, McMaster University, Hamilton
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Burn Trauma Fellowship — Ross Tilley Burn Centre, Sunnybrook Hospital, Toronto
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Cosmetic Plastic Surgery — Mentorship under Dr. Lloyd Carlsen, Toronto
Who Is a Good Candidate for Eyelid Surgery?
Good candidates for blepharoplasty are individuals in stable health who have visible changes around the eyelids that concern them and who have realistic expectations about what surgery can accomplish.
Upper Lid Blepharoplasty Candidates
Upper lid blepharoplasty is recommended for individuals who have excess skin and fat in their upper eyelids. This excess skin and fat can create a tired or aged appearance and may even impair vision in some cases.
People who may benefit from upper lid blepharoplasty include those who have:
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Sagging or drooping upper eyelids that create a tired or sad appearance.
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Excess skin and fat on the upper eyelids that make it difficult to apply makeup or obstruct vision.
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A natural fold of skin that covers the eyelashes or the natural crease of the eyelid, which can create a heavy or hooded appearance.
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A desire to improve their overall facial appearance and reduce signs of aging.
Lower Lid Blepharoplasty Candidates
Lower lid blepharoplasty is a cosmetic surgical procedure that is recommended for individuals who have signs of aging or excess skin and fat in their lower eyelids. This procedure can help to improve the appearance of the under-eye area and create a more youthful and refreshed look.
People who may benefit from lower lid blepharoplasty include those who have:
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Under-eye bags or puffiness caused by excess fat.
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Dark circles or hollows beneath the eyes due to volume loss or thinning of the skin.
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Fine lines, wrinkles, or loose skin around the lower eyelids.
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A desire to improve their overall facial appearance and reduce signs of aging.
What to Expect From Blepharoplasty Surgery
Consultation
Your blepharoplasty process begins with a consultation at Bespoke Skin MD. Dr. Meathrel will discuss what bothers you, recommend a surgical approach based on the concerns you express and explain what the process will entail. If your concerns include visual impairment or physical discomfort, Dr. Meathrel and her team can assist you in obtaining insurance coverage for your procedure. You will leave the appointment with a clear understanding of the plan, the risks, the timeline and your financial responsibilities.
Preparation
Preparation typically begins two to four weeks before eyelid surgery. You will need to stop taking medications and supplements that increase bleeding risk, including aspirin, anti-inflammatory medications and certain herbal supplements. Smoking and nicotine use must be discontinued well before surgery and throughout recovery.
You will attend a preoperative appointment two to three weeks before your surgery day. At this appointment, you will finalize paperwork and take preoperative photographs. Be sure to address any lingering questions or concerns with Dr. Meathrel. You may also meet with Katherine Kennedy, a registered psychotherapist who practices within the clinic, if you’d like additional support preparing for your surgery.
Procedure
Upper blepharoplasty is typically performed under local anesthesia with sedation and takes approximately one hour. The incision is placed within the natural crease of the upper eyelid. Through this incision, Dr. Meathrel removes or repositions excess skin and fat to restore a smoother lid with a defined crease.
Lower blepharoplasty may involve an incision just below the lash line or an incision inside of the lower lid. Dr. Meathrel then removes or repositions fat to smooth the contour between the lower lid and the cheek. The procedure typically takes one to two hours.
When Dr. Meathrel performs upper and lower blepharoplasty together, the combined procedure generally takes two to three hours.
Bespoke
bi-ˈspōk
Specially made for a particular person
"Bespoke means built around you. Your anatomy, your concerns, your goals, your timeline, your life. We don't work from a menu, cookie-cutter packages or rigid protocols, and we don't recommend the same plan twice. Your treatment plan is shaped by what we see and hear during your consultation, backed by the sound judgment and long-term thinking that only come from years of experience. That is the standard we hold ourselves to for every patient, every time."
— Dr. Kim Meathrel, Plastic Surgeon & Medical Director
What Is Recovery Like After Eyelid Surgery?
The downtime for upper and lower lid blepharoplasty can vary depending on several factors, including the extent of the surgery and the individual's healing process. However, in general, patients can expect a recovery period of about 1-2 weeks for upper lid blepharoplasty and 2-4 weeks for lower lid blepharoplasty.
During the initial recovery period, patients may experience some swelling, bruising, and discomfort around the eyes. This can be managed with pain medication and cold compresses. It is important to avoid strenuous activities, heavy lifting, and bending over during this time to allow for proper healing.
After about a week, patients may return to work or resume their normal daily activities, but should still avoid any activities that could strain the eyes or cause further swelling. Strenuous exercise and contact sports should be avoided for at least four weeks after the surgery.
The final results of blepharoplasty may take several months to fully develop as the swelling continues to subside and the tissues settle into their new position. Patients should follow their surgeon's post-operative instructions carefully to ensure a smooth and successful recovery.
What Results Can Blepharoplasty Achieve?
Most patients enjoy the results of upper blepharoplasty for five to 10 years before the natural aging process produces enough change to consider revisiting the area. Lower blepharoplasty results can last 10 to 15 years, and sometimes a lifetime.
To preserve your results, protect your skin from the sun with sunscreen and sunglasses, maintain a consistent skincare routine, stay hydrated and avoid smoking. Maintenance treatments such as injectables or laser resurfacing can help keep the area around your eyes rejuvenated.
Are There Alternatives to Eyelid Surgery?
There are several alternative treatments to blepharoplasty that can help to address issues with the eyelids and under-eye area. These include:
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Injectables: Dermal fillers such as hyaluronic acid and collagen can be used to add volume to the under-eye area and reduce the appearance of dark circles and hollows. Neuromodulator injections can also be used to smooth out fine lines and wrinkles around the eyes.
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Plexer Plasma Pen: The device can be used for a non-surgical "blepharoplasty," but the results may not be as dramatic as those achieved through traditional surgery and may require multiple treatments.
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Fotona Smooth Eye: A laser treatment that uses a unique combination of two laser wavelengths to address a range of concerns around the eye area, including wrinkles, fine lines, and bags under the eyes.
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Morpheus 8 Prime: A non-surgical, minimally invasive treatment that combines microneedling and radiofrequency (RF) energy to improve skin texture, tone, and firmness. It is important to note that Morpheus 8 Prime may not provide the same level of improvement as surgical blepharoplasty for those with significant excess skin or fat in the eye area. Several treatments are required.
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PDO threads: Threads can be used to address a range of concerns, including sagging skin around the eyes. The procedure can be used to create a "cat-eye" lift, which involves lifting the outer corners of the eyes to create a more youthful and alert appearance.
It is important to note that these alternative treatments may not provide the same dramatic results as blepharoplasty and may require multiple treatments to achieve the desired outcome.
Can I Combine Blepharoplasty With Other Procedures?
Blepharoplasty is frequently performed alongside other facial procedures for a more impactful result.
The most common combinations are eyelid surgery with a facelift when changes around the eyes coincide with laxity in the lower face, and eyelid surgery with a brow lift when the brow line has descended enough to contribute to upper lid fullness. Fat grafting to the temples or mid-face is sometimes added to restore volume.
Nonsurgical treatments such as skin resurfacing or neuromodulator injections are also frequently paired with blepharoplasty to address texture, pigmentation and crow's feet in the surrounding skin.
Book Your Blepharoplasty Consultation in Kingston
Ontario plastic surgeon Dr. Kim Meathrel has helped many happy patients put their best face forward with eyelid surgery. To request a consultation, book online or contact Bespoke Skin MD at 613-549-7546. We look forward to being your partner on this journey.
Frequently Asked Questions About Eyelid Surgery
Does blepharoplasty change the shape of the eyes?
No. Eyelid surgery addresses excess skin and displaced fat around the eyes. It does not alter the fundamental shape, size or structure of the eye itself. Your eyes may appear more open and alert after the procedure, but their natural character will remain intact.
Is eyelid surgery only cosmetic?
Not always. Upper blepharoplasty is sometimes performed for functional reasons when excess skin on the upper lids obstructs the peripheral visual field or causes discomfort. This is a recognized medical indication. The procedure may be covered by health insurance when documented symptoms meet the established criteria.
Will the scars be visible?
Upper blepharoplasty incisions are placed within the natural crease of the eyelid. Once healed, they are typically concealed by the fold of the lid. Lower blepharoplasty incisions, when placed just below the lash line, heal to fine lines that are often difficult to detect. Transconjunctival incisions, which are placed within the lower eyelid, leave no visible external scar.
What are the risks of blepharoplasty?
All surgery carries risk. The most common risks associated with blepharoplasty include bruising, swelling, temporary dryness of the eyes and asymmetry. Less common but more serious risks include infection, scarring, difficulty closing the eyes and changes in vision. Dr. Meathrel reviews the risks in detail during your consultation so that you can make a fully informed decision about proceeding with surgery.
Can blepharoplasty be covered by provincial health insurance?
In Ontario, upper blepharoplasty may be covered by OHIP when the procedure is deemed medically necessary due to documented visual field obstruction. This requires a formal visual field test and a referral. Dr. Meathrel can assess your situation during your consultation and advise on the appropriate steps.
When can I wear contact lenses after eyelid surgery?
Most patients need to wait one to two weeks before they can resume wearing contact lenses. Pulling or touching the area increases the risk of infection and the risk of reopening the incisions. There are no restrictions on wearing eyeglasses. Dr. Meathrel will let you know when it's safe to wear your contact lenses again.