Blepharoplasty in Brazil | Eyelid Surgery

By Dr. Walter Zamarian Jr. · Updated: 17/02/2026

Blepharoplasty in Londrina: rejuvenation of the gaze with fat grafting

The eyes are the first area of the face to reveal the signs of time. Heavy eyelids, fat bags, deep dark circles, and drooping eyebrows can make you look tired, sad, or older than you really are. Blepharoplasty — also known as eyelid surgery or eyelid lift — is the surgery that corrects these problems, restoring a rested and rejuvenated gaze.

I have been performing blepharoplasties for over twenty years, with more than eight thousand facial surgeries in my curriculum. My training with Professor Ivo Pitanguy and my experience as a full member of the Brazilian Society of Plastic Surgery and the American Society of Plastic Surgeons have given me a comprehensive view of periorbital aging. As a board-certified plastic surgeon in Brazil, I can affirm: modern blepharoplasty goes far beyond the simple removal of skin and fat. Today, we work with volume replacement, cellular rejuvenation, and harmonisation of the entire eye area. International patients seeking cosmetic surgery abroad choose my clinic in Londrina for the combination of expertise, personalised care, and exceptional results in eye bag removal and eyelid rejuvenation.

Blepharoplasty is the surgical correction of the eyelids, addressing excess skin, fat bags, deep dark circles, and drooping eyebrows that create a tired or aged appearance. What many people do not realise is that this procedure benefits both mature patients seeking rejuvenation and younger individuals born with heavy eyelids or prominent fat pads that affect their confidence. In severe cases, excess upper eyelid skin can actually limit the visual field, making blepharoplasty a functional necessity as well. At my clinic in Londrina, I perform a detailed evaluation of each patient, mapping the specific changes present and designing a personalised surgical plan. My goal is never a generic correction but rather a result that respects each person's unique anatomy and facial harmony. With over twenty years of experience and more than eight thousand surgeries, I have refined an approach that consistently delivers natural, refreshed results without an operated look.

What modern blepharoplasty can treat

The eye area ages in multiple ways, and each patient presents a unique combination of changes. During the consultation, I carefully assess which problems are present in your case:

Excess skin on the upper eyelids: that "curtain" of skin that weighs down the eyes, sometimes even obstructing vision;
Fat bags: both on the upper eyelids (medial fat) and on the lower ones (the famous "bags under the eyes");
Deep dark circles: the dark groove between the fat bags and the cheek, which gives a permanently tired appearance;
Sunken eyes: loss of volume in the upper eyelids, creating a skeletal appearance;
Loss of malar volume: sinking of the cheekbones that accentuates the dark circles;
Drooping eyebrows: ptosis of the eyebrow that worsens the appearance of excess skin;
Skin quality: fine wrinkles, loss of elasticity, and irregular texture.

My approach: beyond simple removal

Traditional blepharoplasty focused solely on removal: taking away skin, taking away fat, taking away muscle. This approach, while effective for some cases, often left the eyes looking "operated" or even prematurely aged. After all, aging is not just excess tissue; it is also loss of volume.

My philosophy is different. I work with the concept of redistribution and replacement: I reposition the excess fat, add volume where it is lacking, and rejuvenate the skin with stem cells derived from the patient's own fat — a technique I detail on the page about facial fat grafting. The result is a naturally youthful gaze, not a "stretched" look.

Fat grafting: the differential of my technique

Autologous fat (from the patient) has revolutionised periorbital surgery. I use two forms of processing, each with specific indications:

Microfat

Microfat is obtained through liposuction with fine cannulas, usually from the abdomen or thighs. After careful processing, I inject this graft into areas that have lost volume with aging:

Malar region: when the cheekbones are sunken, the dark circles appear deeper. Restoring malar volume is essential for a harmonious result;
Sunken upper eyelids: in patients with "deep-set eyes", the microfat graft fills the depression above the eyeball, restoring a youthful appearance.

Nanofat for dark circles

Nanofat is an additional refinement: the fat is processed until it has an extremely fine, almost liquid consistency. This technique is especially valuable for treating deep dark circles, that dark depression just below the fat bags of the lower eyelids.

Why nanofat and not hyaluronic acid? The difference is significant. Hyaluronic acid, when injected into the dark circle area, often causes the so-called Tyndall effect: a bluish or purplish discolouration that appears under the thin skin of this area. It is a common problem that frustrates many patients. Nanofat does not cause this effect, as it is autologous tissue that integrates naturally into the site.

Moreover, fat carries adipose stem cells that promote real skin rejuvenation. Scientific studies show that these cells stimulate collagen production, improve vascularisation, and regenerate damaged tissues. The result is not just filling; it is regeneration.

Brow lifting: techniques that work

Often, what appears to be excess skin on the upper eyelid is, in fact, drooping of the eyebrow. In these cases, simply removing skin does not solve the problem and can even worsen the appearance.

I do not perform endoscopic brow lifts or the technique popularly known as "foxy eyes". Why? Because, in my experience, the results of these techniques do not last. The eyebrows tend to droop again in a short time, frustrating the patient.

For cases that truly require brow lifting, I use techniques with a small and discreet incision, positioned close to the upper part of the eyebrows, on the lateral third. Depending on each patient's anatomy, I apply variations such as:

Minicastanhares Technique: subtle elevation with an almost invisible scar;
Vinhas Technique: indicated for specific cases of lateral ptosis;
Nike Technique: so named for the shape of the incision, provides elegant elevation of the tail of the eyebrow.

These techniques produce lasting results because they create a real structural fixation, not just a temporary suspension. The scar is hidden at the upper edge of the eyebrow and becomes imperceptible in a few weeks.

Are you a good candidate for blepharoplasty?

Blepharoplasty can benefit both young and mature patients, as long as the indications are correct. You may be a good candidate if:

You have heavy or drooping upper eyelids;
You have fat bags on the lower eyelids;
You suffer from deep dark circles that do not improve with topical treatments;
You notice that your eyes look permanently tired;
You are in good overall health and have realistic expectations.

On the other hand, there are conditions that require special evaluation, such as severe dry eye, thyroid diseases (especially Graves' disease), glaucoma, or other ocular pathologies. In these cases, I work together with ophthalmologists to ensure the safety of the procedure.

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Pre-operative blepharoplasty

The consultation: individualised planning

Each pair of eyes is unique, and the consultation is the moment to understand exactly what you desire and what is possible to achieve. I dedicate time for a complete evaluation, which includes:

Analysis of the upper eyelids

I assess the amount of excess skin, the position of the eyebrow, the presence of medial fat herniation, and the function of the eyelid elevator muscle. If there is true eyelid ptosis (eyelid that does not open completely), an additional technique may be necessary to correct this problem.

Analysis of the lower eyelids

I examine the size of the fat bags, the depth of the dark circles, the tone of the orbicular muscle, and the quality of the skin. I also check the elasticity of the lower eyelid, as in some cases there may be laxity that needs to be treated to avoid complications.

Evaluation of facial volume

The eyes do not exist in isolation. I assess the volume of the cheekbones, the presence of a deep nasojugal groove, and the relationship between the different structures of the midface. Often, restoring volume in these areas is as important as treating the eyelids.

Position of the eyebrows

I check for eyebrow ptosis that is contributing to the apparent excess skin. If present, we discuss the possibility of eyebrow elevation as part of the procedure.

Quality of the periorbital skin

I analyse fine wrinkles, elasticity, pigmentation, and texture of the skin around the eyes. These factors influence both the surgical technique and the complementary treatments that may be indicated.

Basic ophthalmological examination

I check tear production, the presence of dry eye, and other conditions that may influence the surgery. In specific cases, I request an evaluation with an ophthalmologist before the procedure.

Pre-operative tests

I request the following tests before blepharoplasty:

Complete blood count;
PAT with INR + APTT;
Creatinine;
Urea;
Fasting blood glucose;
Total proteins and fractions;
Urine I;
Electrocardiogram;
Surgical risk (evaluation with a cardiologist).

Type of anaesthesia

I perform blepharoplasty preferably under general anaesthesia. Although many surgeons perform it with local anaesthesia and sedation, I believe that general anaesthesia offers important advantages: you will not feel anything at all, you will not have unpleasant memories of the procedure, and I can work with total tranquillity and precision, especially when associating fat grafting or eyebrow elevation.

Pre-operative recommendations

Discontinue medications that increase bleeding (aspirin, anti-inflammatories, vitamin E, omega 3) for fifteen days;
Do not smoke for at least thirty days before the surgery;
Avoid supplements such as ginkgo biloba, arnica, and garlic;
Inform about any continuous medication;
Provide sunglasses for the post-operative period;
Organise the first week post-surgery for adequate rest.

How I perform blepharoplasty

One of the most important advances I have incorporated into my blepharoplasty practice is fat grafting to treat dark circles. Traditional approaches used hyaluronic acid fillers to camouflage the hollow groove beneath the eyes, but these fillers are temporary, lasting at most eighteen months, and can migrate or cause a bluish discolouration known as the Tyndall effect. The fat I harvest from the patient's own body and process into nanofat offers a permanent solution. This nanofat is rich in adipose-derived stem cells that regenerate the thin, darkened skin of the periorbital area from within, improving both the depression and the pigmentation simultaneously. When combined with blepharoplasty, the fat graft transforms the entire eye region, restoring a youthful fullness that skin removal alone cannot achieve. At my clinic in Londrina, I offer this combined approach as the gold standard for periorbital rejuvenation, drawing patients from across Brazil and internationally.

The technique varies according to the needs of each patient, but I can describe the general principles that guide my approach:

Upper eyelids

I start with precise marking of the skin to be removed. This marking is done with you sitting, as the lying position alters the distribution of tissues. The incision follows the natural crease of the eyelid, becoming practically invisible after healing.

I remove the marked strip of skin and, when indicated, a small portion of the orbicular muscle. If there is medial fat herniation, I can remove it or reposition it to fill depressions. In cases of sunken eyes, I perform micro-fat grafting to restore the lost volume.

If there is an indication for eyebrow elevation, I perform an additional incision in the lateral third, applying the most appropriate technique for each case (mini-lifts, vines, or Nike). This step is fundamental for patients with eyebrow ptosis, as simply removing skin does not adequately correct the problem.

Lower eyelids

For the lower eyelids, I preferably use the transconjunctival approach: the incision is made from inside the eyelid, with no visible external cut. This approach allows for direct and safe access to the fat bags.

Depending on the case, I may remove, redistribute, or combine the fat from the bags with additional grafting. When there are deep dark circles, I perform nanofat grafting in this region, filling the depression and improving the dark colouration.

If there is significant excess skin on the lower eyelid (more common in older patients), I may associate a small incision just below the eyelashes to remove this excess. The scar remains extremely discreet.

Fat grafting

When the plan includes fat grafting, I start the procedure with liposuction from a donor area, usually the abdomen or inner thighs. The fat is carefully processed to separate the viable cells.

For the nanofat for dark circles, the processing is even more refined, filtering until achieving an almost liquid consistency, rich in adipose stem cells. This fraction is injected with special micro-cannulas, creating a smooth and natural filling.

The fat graft not only fills; it regenerates. The stem cells present in the fat stimulate collagen production, improve skin quality, and promote neovascularisation. Over time, the treated area shows progressive improvement that goes beyond simple filling.

Surgical time

A simple blepharoplasty, just of the upper eyelids, lasts approximately one hour. When I associate lower eyelids, eyebrow elevation, and fat grafting, the procedure can last between two and three hours. I prefer not to rush; each step deserves meticulous attention.

About complications

In over twenty years performing blepharoplasties, I have developed a technique that prioritises safety above all. The complications described in the literature, such as retrobulbar haematoma, ectropion, or significant asymmetry, are extremely rare when the procedure is performed by an experienced surgeon with the appropriate technique.

My history reflects this commitment to safety. I attribute my consistent results to the combination of careful indication, detailed planning, refined technique, and rigorous post-operative follow-up.

Scars

The scars from blepharoplasty are remarkably discreet:

Upper eyelid: the scar is hidden in the natural crease, becoming practically invisible in a few weeks;
Transconjunctival lower eyelid: there is no external scar;
Eyebrow elevation: the scar is at the upper edge of the eyebrow, camouflaged by the hairs;
Fat donor area: small incisions of three to four millimetres that heal without leaving a visible mark.

Post-operative: what to expect

Recovery from blepharoplasty is one of the gentlest among all facial surgeries. I instruct my patients to apply cold compresses consistently during the first forty-eight hours, which is the single most effective measure to minimise swelling and bruising. The stitches are removed between five and seven days, and by then most patients already notice a significant improvement in their appearance. Any bruising typically fades within ten to fourteen days, progressing through shades of purple, green, and yellow before disappearing completely. I advise avoiding direct sun exposure during the first month and using quality sunscreen to prevent hyperpigmentation of the delicate eyelid skin. The final result of blepharoplasty becomes fully apparent between three and six months, when all residual swelling resolves and the fat graft integration is complete. At my clinic in Londrina, I follow each patient personally throughout recovery, ensuring the healing process stays on track towards the rejuvenated, natural look we planned together.

The recovery from blepharoplasty is more straightforward than most patients imagine. I will be honest about each phase:

First 48 hours

Swelling and bruising (purple) are most evident during this period. Cold compresses are essential: I recommend applying for fifteen minutes every hour while awake. Keep your head elevated, even while sleeping. You may experience tearing and a sensation of "sand in the eyes," which are normal.

First week

The swelling begins to decrease from the third day. Bruises, when present, go through a colour evolution (purple, green, yellow) before disappearing completely in one to two weeks. The stitches are removed between five and seven days. Avoid physical exertion and anything that increases pressure in the area.

Second to fourth week

Most of the swelling has subsided. You can resume light activities and use makeup to camouflage any residual discolouration. The scars may still be slightly pink, but this is temporary.

One to three months

At this stage, the result is already well defined. The scars mature and become increasingly discreet. If fat grafting was performed, it is during this period that the integration is completed and you will be able to appreciate the final result of the filling.

Final result

The complete result of blepharoplasty appears between three and six months. From then on, you will enjoy a rejuvenated look for many years. Natural ageing continues, but from a much more favourable baseline.

Important post-operative care

Cold compresses in the first 48 hours;
Head elevated while sleeping for two weeks;
Lubricating eye drops as prescribed;
Avoid physical exertion for three weeks;
Protect your eyes from the sun with sunglasses;
Do not wear contact lenses for two weeks;
Avoid makeup in the area for ten days;
Do not smoke for at least thirty days after the surgery.

Blepharoplasty Associated with Other Procedures

Frequently, blepharoplasty is performed alongside other facial surgeries for a more complete and harmonious result:

Blepharoplasty + Facelift

The most common combination. While blepharoplasty rejuvenates the eye area, the deep plane facelift addresses the sagging of the middle and lower thirds of the face. The result is a global and balanced rejuvenation. For those seeking a less invasive option, the mini facelift can also be combined with blepharoplasty.

Blepharoplasty + Rhinoplasty

In some patients, a large or disproportionate nose diverts attention from the eyes. Correcting both in the same surgery creates a facial harmony superior to isolated treatment.

Blepharoplasty + Non-Surgical Treatments

Botulinum toxin for expression wrinkles and facial fillers with hyaluronic acid can complement the results of blepharoplasty, treating areas that the surgery does not directly address.

Correction of Failed Blepharoplasty

I receive patients who have undergone blepharoplasty with other professionals and are not satisfied. The most common problems are:

“Rounded” or startled eyes: usually due to excessive skin removal;
Ectropion: lower eyelid turned outward;
Sunken eyes: excessive fat removal;
Asymmetry: one eye different from the other;
Visible scars: poor suture technique or healing complications.

The correction of failed blepharoplasties is one of the most challenging procedures in facial plastic surgery. Each case requires careful evaluation and individualised planning. Frequently, fat grafting is essential to restore lost volume and improve the quality of damaged skin.

If you are not satisfied with a previous blepharoplasty, book a consultation. I will conduct a complete evaluation and honestly present the possibilities for improvement for your specific case.

Frequently Asked Questions about Blepharoplasty

Does blepharoplasty hurt?

No. During the surgery, you will be under general anaesthesia and will not feel anything. In the postoperative period, discomfort is minimal, easily controlled with common painkillers. Most of my patients describe more of a “weight” or “swelling” sensation than actual pain.

How long does the result of blepharoplasty last?

The result of blepharoplasty is long-lasting. The skin removed does not return, and the repositioned or grafted fat tends to remain stable over the years. Natural ageing continues, but you will always look younger than you would without the surgery. In my experience, many patients enjoy the results for ten, fifteen years or more.

Can I have blepharoplasty if I wear glasses?

Yes, wearing glasses does not contraindicate the surgery. In fact, prescription or sunglasses are useful in the postoperative period to protect the operated area and camouflage any bruising during recovery. I recommend that my patients have sunglasses ready for the day of the surgery.

Can the surgery correct wrinkles around the eyes (crow's feet)?

Blepharoplasty primarily addresses the eyelids. For dynamic wrinkles like "crow's feet", botulinum toxin is the most indicated treatment. Many of my patients combine blepharoplasty with botulinum toxin application for a more complete and harmonious result.

What is the difference between nanofat and hyaluronic acid for dark circles?

Both fill the area of dark circles, but with important differences. Hyaluronic acid is an industrialised product that needs to be reapplied periodically and can cause the Tyndall effect, an undesirable bluish discolouration in the thin skin of this area. Nanofat is tissue from the patient itself, integrates permanently, carries stem cells that rejuvenate the skin, and does not cause the Tyndall effect. In my practice, I prefer nanofat for dark circles for these reasons.

Can I have blepharoplasty if I have dry eye?

It depends on the severity. Mild to moderate dry eye does not contraindicate the surgery, but requires special care in the postoperative period, such as frequent use of lubricating eye drops. Severe cases need to be treated before blepharoplasty. I evaluate each situation individually and, when necessary, request an opinion from an ophthalmologist.

Is it possible to do only the upper or lower eyelid?

Yes. Many patients need treatment only on the upper eyelids or only on the lower ones. During the consultation, I assess your specific needs and propose the most appropriate treatment, without performing unnecessary procedures.

When can I return to work after blepharoplasty?

Most patients return to professional activities in one to two weeks, depending on the type of work and the extent of the surgery. For activities that require a flawless appearance, I recommend waiting two to three weeks for any residual bruising to completely disappear.

What is transconjunctival blepharoplasty?

It is the technique I prefer to use for the lower eyelids. The incision is made through the inner surface of the eyelid (conjunctiva), with no visible external cut. This allows for precise access and treatment of fat bags, resulting in faster recovery and no visible scarring. It is the preferred approach worldwide for patients who need to treat bags without significant excess skin.

Can blepharoplasty be combined with laser?

Yes. In selected cases, fractional CO2 laser can complement blepharoplasty to improve skin texture, stimulate collagen production, and treat fine wrinkles around the eyes that the surgery alone does not address. I evaluate this indication on a case-by-case basis during the consultation.

Does blepharoplasty leave visible scars?

The scars from blepharoplasty are remarkably discreet. On the upper eyelid, the incision is hidden in the natural crease and becomes practically invisible within a few weeks. On the lower eyelid, when I use the transconjunctival approach, there is no external scar. Even when an incision is necessary just below the eyelashes, the mark becomes imperceptible over time.

What type of anaesthesia is used in blepharoplasty?

Do you want to rejuvenate your gaze?

If you identify with the problems described on this page and desire a more rested and rejuvenated look, the first step is to book a consultation. During our meeting, I will conduct a complete evaluation of the periorbital area, understand your expectations, and explain in detail what blepharoplasty can do for you.

Each patient is unique, and my approach is always personalised. There is no "standard blepharoplasty"; there is the right blepharoplasty for each person. Let’s discover together what yours is.

Learn more about how the first consultation works, understand the investment, and see guidelines on pre-surgical preparation and post-operative recovery. For specific cases of lower eyelids, learn about lower blepharoplasty.

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To learn more about blepharoplasty and other types of plastic surgery that Dr. Walter Zamarian Jr. performs in Londrina, Brazil, please contact the Zamarian Clinic and book a consultation.

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+55 43 99192-2221

Dr. Walter Zamarian Jr.

Plastic Surgeon in Londrina, Brazil

Rua Engenheiro Omar Rupp, 186
Londrina, Brazil
ZIP 86015-360
Brazil

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You can renew your gaze with blepharoplasty.