# Blepharoplasty in Brazil Lighter-looking eyes start with understanding what is weighing down your eyelids. [Explore my options](https://wa.me/16402248116?text=Hi%21%20I%20came%20from%20the%20blepharoplasty%20page%20and%20would%20like%20to%20know%20if%20it%20is%20right%20for%20me.) Explore At a glance ## Blepharoplasty in Londrina, Brazil: at a glance ### What is blepharoplasty? Blepharoplasty is plastic surgery of the upper eyelids, the lower eyelids, or both, to treat excess skin and bulging fat, preserving, repositioning, or removing tissue according to your anatomy. It does not correct eyelid ptosis, a low brow, pigmented dark circles, or every wrinkle around the eyes. - Who it’s for: heavy skin on the upper eyelids and lower-lid bags; dry eye and previous surgery are part of the evaluation. - Technique: on the upper lids, an incision in the natural crease and repositioning of the orbicularis muscle; on the lower lids, a transconjunctival approach or an incision just below the lashes. - Anesthesia: total intravenous anesthesia; without a facelift, you can go home the same day. - Recovery: bruising and swelling usually last 10 to 14 days; final healing takes months. - Risks: dry eye, asymmetry, and ectropion; hemorrhage with permanent vision loss is very rare, about 1 in 22,000. - Results: long-lasting, not guaranteed, and they don’t stop aging; follow-up visits for one year. By [Dr. Walter Zamarian Jr.](https://www.walterzamarianjr.com/us/walter-zamarian/) · CRM-PR 17.388 · [RQE 15.688](https://www.walterzamarianjr.com/us/credentials/) Your eyes ## What would you like to see in your eyes again? Maybe your makeup has started to settle into the eyelid crease. Maybe the bags show up even after a good night’s sleep. Or maybe your eyes look more tired than you actually feel. These are different concerns, and I want to hear each one carefully. Before I recommend removing skin, I look at how your eyelids open and close, where your brows sit, how volume is distributed, and the health of your eyes. My goal is to relieve what bothers you while preserving your expression. You should recognize your own eyes in the result we aim for, not have to adjust to a shape chosen without regard for who you are. Diagnosis ## Not everything that looks like extra skin has the same cause ### Upper-eyelid skin An extra fold of skin can hang over the natural crease. I assess how much can be treated while still letting your eyes close properly. ### Brow position A low brow can add to the feeling of heaviness. Removing eyelid skin is no substitute for correcting the brow position. ### Eye opening Eyelid ptosis is not the same as excess skin. Eyelid function needs its own evaluation. ### Lower-lid bags and hollows A bulge next to a hollow can make the transition look sharper. Removing all the fat isn’t the answer in every case. Upper and lower ## Upper and lower eyelids: separate plans for different needs On the upper eyelid, the incision usually follows the natural crease. When planning the incision, I consider how much skin there is, where the brow sits, and whether fat can be preserved or adjusted. I try to avoid a correction that leaves the area hollow or interferes with closing the eye. On the lower eyelid, the approach may be through the conjunctiva, on the inner surface of the eyelid, or may involve an incision just below the lashes, depending on what is indicated. The transconjunctival approach allows fat to be treated, but excess skin cannot be removed through it. [The ASPS explains the approaches](https://www.plasticsurgery.org/cosmetic-procedures/eyelid-surgery/procedure). You may need only the upper eyelids, only the lower ones, or both. I don’t include all four eyelids in the plan as a matter of routine. For the specific care involved in the area under the eyes, see the guide to [lower blepharoplasty](https://www.walterzamarianjr.com/us/face/lower-blepharoplasty/). The [transconjunctival blepharoplasty](https://www.walterzamarianjr.com/us/face/transconjunctival-blepharoplasty/) page explains the approach through the inside of the eyelid. ### Would you like to talk about what feels heavy around your eyes? I’ll examine your eyelids, listen to what you want to preserve, and explain what changes surgery can aim for. [Explore my options](https://wa.me/16402248116?text=Hi%21%20I%20came%20from%20the%20blepharoplasty%20page%20and%20would%20like%20to%20know%20if%20it%20is%20right%20for%20me.) Dark circles ## “Dark circles” is a description, not a diagnosis Darkness under the eyes can be related to pigment, blood vessels, a shadow cast by a hollow, or a combination of these. A bag can also cast a shadow. That’s why two people with “dark circles” may be given different advice. When there is volume loss, I discuss whether fat grafting makes sense. For lower-lid bags, I remove the excess fat and use nanofat. I repositioned fat in the past, but in my practice the results were not as good, so I stopped doing it; that is my own experience, not a judgment of surgeons who reposition fat. When pigmentation is the main issue, surgery may not meet your expectations. Nanofat is being studied for skin quality, but I don’t present it as a structural volume replacement or as a guaranteed solution for discoloration. Malar bags, which sit lower, below the eyelid, also need to be recognized. I don’t promise that conventional blepharoplasty will correct every bulge or all the puffiness in this area. Preservation ## Preserving is a surgical decision too Removing more tissue doesn’t mean looking younger. At the consultation, I assess what should stay in place to support balanced-looking eyes. The relationship between the eye and the cheek matters as much as the eyelid crease. If your brows are part of the concern, we can discuss a [brow lift](https://www.walterzamarianjr.com/us/face/brow-lift/). If there is hollowing, the conversation may include [fat grafting](https://www.walterzamarianjr.com/us/face/fat-grafting/). Each combined procedure needs its own reason, even when it is done in the same operation. I explain the purpose behind these choices and listen to what you have in mind. I don’t use a photo of someone else as a template your eyes have to match. Evaluation ## What I need to know before planning Let me know if your eyes burn, if you use eye drops or contact lenses, if you’ve had eye surgery, if you have thyroid disease, or if you have trouble closing your eyelids. Previous procedures, fillers, and scars also affect the plan. Dry eye and other eye conditions may require an evaluation by an ophthalmologist. Tests and medications are arranged according to your history and the extent of the surgery. Don’t stop an ongoing treatment without medical guidance. In my practice, I perform this surgery in a hospital, under total intravenous anesthesia. When other procedures are combined, I explain how they change the operating time, the recovery, and the follow-up visits. A retrospective series of 892 cases by Prischmann and colleagues underscores the importance of checking for dry eye and specific eyelid features before surgery. Because it reflects one surgeon’s experience, it doesn’t provide an individual prediction, nor does it make every case of dry eye a contraindication. [Study on dry eye and chemosis](https://pubmed.ncbi.nlm.nih.gov/23329270/). Surgery ## Anesthesia, incisions, and the day of surgery On the upper eyelid, the incision follows the natural crease, and its outer end tends to blend into the natural lines at the outer corner of the eye. Following the markings made before surgery, I remove the skin weighing the eyelid down and reposition the orbicularis muscle upward and outward. This reduces the heaviness and fullness below the tail of the brows and lowers the risk of the brows dropping once skin is removed. Whether any fat adjustment makes sense is something I decide case by case. [The American Academy of Ophthalmology describes this approach](https://www.aao.org/eye-health/treatments/upper-eyelid-blepharoplasty). I use total intravenous anesthesia (TIVA) for almost all my surgeries, in a hospital setting. In my hands, eyelid surgery takes about 1 hour on average: around 45 minutes when I operate on two eyelids and around 1 hour 15 minutes when I operate on all four; combined procedures add to this time, and I give you an estimate after the exam. When blepharoplasty is done without a facelift, you can go home the same day if you wish: since I schedule these cases for the afternoon, discharge is at around 10 p.m. When there is excess skin on the lower eyelid, the incision is usually placed slightly below the lashes, not right at the lash line; when only the bags need treatment, the approach can be from the inside. These choices are explained in detail on the [lower blepharoplasty](https://www.walterzamarianjr.com/us/face/lower-blepharoplasty/) and [transconjunctival blepharoplasty](https://www.walterzamarianjr.com/us/face/transconjunctival-blepharoplasty/) pages. Recovery ## The first few days call for careful eye care Swelling, bruising, irritation, and a feeling of dryness may occur. For the first few days, I recommend cold compresses and sleeping with your head elevated; lubrication and incision care are tailored to each case. The ASPS also stresses sun protection and specific instructions for follow-up visits. [Blepharoplasty recovery](https://www.plasticsurgery.org/cosmetic-procedures/eyelid-surgery/recovery). For reference, the [American Academy of Ophthalmology](https://www.aao.org/eye-health/treatments/upper-eyelid-blepharoplasty) reports that bruising and swelling after upper blepharoplasty usually last 10 to 14 days, that light everyday activities are often resumed within 24 to 48 hours, and that eyelid numbness tends to fade within two to four months. The ASPS notes that most people look presentable within 10 to 14 days and that final healing can take a few months. [Results according to the ASPS](https://www.plasticsurgery.org/cosmetic-procedures/eyelid-surgery/results). Your time off work is set at a follow-up visit, depending on what was operated on. Light exercise is allowed at 1 month; any physical activity, including contact sports, at 2 months. Arrange for help during the first few days, and don’t schedule an important event assuming every sign will be gone by an exact date. I remove the stitches at 7 days, and from then on you are cleared to travel; if you live within about 300 km (190 miles), you can go home after 2 days and come back on day 7 to have them removed. Makeup and contact lenses should only be resumed as instructed. Scars change in appearance as they mature. Follow-up, with visits over one year, lets us assess not only how your eyelids look but also how comfortable they are and how well they work. When blepharoplasty is part of a facelift, we follow the [recovery schedule for the combined surgery](https://www.walterzamarianjr.com/us/patient-journey/). Risks ## Your eyes deserve a straightforward conversation about risks Asymmetry, unfavorable scars, difficulty closing the eyes, persistent dry eye, and changes in the position of the lower eyelid, including ectropion, can occur. There are also risks of bleeding, infection, the need for revision, and changes in vision; vision loss is a very rare but serious complication. [Risks described by the ASPS](https://www.plasticsurgery.org/cosmetic-procedures/eyelid-surgery/safety). Some numbers help put these risks in perspective. In a survey of surgeons published by Hass and colleagues, orbital hemorrhage after cosmetic eyelid surgery occurred in about 0.055% of cases (roughly 1 in 2,000), and hemorrhage with permanent vision loss in about 0.0045% (1 in 22,000). Because it relies on the recall of the surgeons surveyed, it is an estimate. [Study on orbital hemorrhage](https://pubmed.ncbi.nlm.nih.gov/15599241/). In Prischmann’s series of 892 cases, dry eye symptoms and chemosis, a swelling of the conjunctiva, were recorded in 26.5% and 26.3% of patients, respectively, and were more frequent when the upper and lower eyelids were operated on together. Severe eye pain, a sudden drop in vision, or significant, rapid swelling around the eye requires immediate emergency care. Don’t wait for a reply to a message or for your next appointment to get help. I go over these points before you decide. A careful plan takes into account appearance, function, and the ability to respond quickly to a complication. Results ## Rested-looking eyes should still be your own When I assess the result, I look at how the eyelids relate to each other, how they close, the transitions, and your expression. A photo taken too early may show swelling rather than the settled result. That’s why I compare photographs and examine how you are healing at different points in time. The ASPS describes blepharoplasty results as long-lasting, noting that natural aging continues and that sun protection helps preserve them. Long-lasting doesn’t mean permanent or guaranteed: the skin, the brows, and facial volume keep changing over time. Surgery doesn’t stop aging or erase every line around the eyes. Expression lines and skin changes may remain and can be addressed separately. If you want to reduce heaviness or soften bags without losing the familiar look of your eyes, that conversation is worth having without rushing. I want to understand what you expect before suggesting what to remove, reposition, or preserve. Pricing ## When the answer lies elsewhere, and what determines the cost ### An eyelid that covers the pupil If the edge of the eyelid sits low, the problem may be the muscle that lifts it. I explain the difference on the [eyelid ptosis](https://www.walterzamarianjr.com/us/face/eyelid-ptosis/) page. ### A brow that has dropped A [brow lift](https://www.walterzamarianjr.com/us/face/brow-lift/) addresses the position of the brow. The techniques I use are mini-Castañares, modified Viñas, and Nike, chosen case by case. ### Skin texture and color Dark spots and fine lines may call for laser treatment or peels, which the [ASPS lists as complements](https://www.plasticsurgery.org/cosmetic-procedures/eyelid-surgery/procedure) to eyelid surgery. I don’t perform laser treatment or peels on the eyelids; when indicated, I use nanofat. ### Loss of volume A hollow around the eyes may call for [fat grafting](https://www.walterzamarianjr.com/us/face/fat-grafting/) rather than tissue removal. The cost depends on which eyelids are operated on, any combined procedures, operating time, anesthesia, and the hospital facilities. I only see private-pay patients; I don’t accept health insurance or Brazil’s public health system (SUS). On the [pricing](https://www.walterzamarianjr.com/us/pricing/) page, I explain how the quote is put together; the surgical fee is given after the evaluation. On WhatsApp, your first contact is with Bruna, my AI assistant, and the consultation can begin online. Questions ## Your questions deserve a careful answer. Does blepharoplasty lift the brows? That isn’t its main purpose. When brow position contributes to the heaviness, I evaluate it separately so I don’t try to make up for it by removing too much eyelid skin. Should every bag be removed? No. Depending on your anatomy, I may preserve or remove part of the fat and, when there is a hollow, use nanofat. The goal is a balanced transition that avoids excessive hollowing. Will surgery get rid of crow’s feet? Not completely. Wrinkles related to movement and skin quality may need a different approach. I explain this limit before surgery. Can I have surgery if I have dry eye? It depends on how severe it is and on the eye evaluation. In some cases, the condition needs to be treated, or the indication reconsidered, before surgery. Is the transconjunctival approach scarless? This approach doesn’t involve an external incision in the skin. That doesn’t mean there is no internal healing, and it doesn’t rule out risks or the need for another approach when there is excess skin. Can I combine it with a deep plane facelift? Yes, when both are indicated and the evaluation allows the combination. A facelift doesn’t replace an assessment of the eyelids, and blepharoplasty doesn’t treat the whole face. How soon can I go back to work after blepharoplasty? It depends on what was operated on and the kind of work you do. In the literature, bruising and swelling usually last 10 to 14 days, and light everyday activities resume sooner. I clear you to return to work at the follow-up visits, based on how you are healing; light exercise at 1 month, and any physical activity at 2 months. Are blepharoplasty results permanent? They are long-lasting, but not permanent. Aging continues, and the skin, the brows, and facial volume keep changing. I don’t guarantee a specific result. I want to understand what has changed in your eyes and examine your eyelids with attention to your expression and the comfort of your eyes. [Explore my options](https://wa.me/16402248116?text=Hi%21%20I%20came%20from%20the%20blepharoplasty%20page%20and%20would%20like%20to%20know%20if%20it%20is%20right%20for%20me.) References ## References and authorship By [Dr. Walter Zamarian Jr.](https://www.walterzamarianjr.com/us/walter-zamarian/) · CRM-PR 17.388 · [RQE 15.688](https://www.walterzamarianjr.com/us/credentials/) References reviewed on September 22, 2026. The sources below support the general information on this page. When I describe how I care for patients, I am referring to my team’s routine; the instructions for your surgery will be individual. - [ASPS. Eyelid Surgery Procedure Steps.](https://www.plasticsurgery.org/cosmetic-procedures/eyelid-surgery/procedure) - [ASPS. Eyelid Surgery Recovery.](https://www.plasticsurgery.org/cosmetic-procedures/eyelid-surgery/recovery) - [ASPS. Eyelid Surgery Risks and Safety.](https://www.plasticsurgery.org/cosmetic-procedures/eyelid-surgery/safety) - [Tonnard et al. Nanofat grafting: basic research and clinical applications. PRS, 2013.](https://pubmed.ncbi.nlm.nih.gov/23783059/) - [Prischmann et al. Dry eye symptoms and chemosis following blepharoplasty: a 10-year retrospective review of 892 cases in a single-surgeon series. JAMA Facial Plastic Surgery, 2013.](https://pubmed.ncbi.nlm.nih.gov/23329270/) - [American Academy of Ophthalmology (AAO). Upper Eyelid Blepharoplasty.](https://www.aao.org/eye-health/treatments/upper-eyelid-blepharoplasty) - [ASPS. Eyelid Surgery Results.](https://www.plasticsurgery.org/cosmetic-procedures/eyelid-surgery/results) - [Hass AN, Penne RB, Stefanyszyn MA, Flanagan JC. Incidence of postblepharoplasty orbital hemorrhage and associated visual loss. Ophthalmic Plastic and Reconstructive Surgery, 2004.](https://pubmed.ncbi.nlm.nih.gov/15599241/) ### Keep exploring - [Brow lift →](https://www.walterzamarianjr.com/us/face/brow-lift/) - [Fat grafting →](https://www.walterzamarianjr.com/us/face/fat-grafting/) - [Deep plane facelift →](https://www.walterzamarianjr.com/us/face/facelift/) [← All facial procedures](https://www.walterzamarianjr.com/us/face/)