Eyelid Surgery in Beverly Hills & Los Angeles
A More Refreshed Look Without Changing the Character of Your Eyes
Real Patients.
Real Transformations.
Meet Dr. Ardesh: Your Trusted Doctor for Eyelid Surgery
Dr. Ardesh is a double board-certified facial plastic and reconstructive surgeon with advanced experience in eyelid rejuvenation and periocular surgery. His approach evaluates the brows, upper and lower eyelids, facial volume, skin quality and eyelid support together so treatment can address the true source of a tired or heavy appearance while preserving natural eye shape and expression.
The Ardesh Refresh Approach to Eyelid Rejuvenation
Successful eyelid rejuvenation involves more than removing skin or fat.
The forehead, eyebrows, upper eyelids, lower eyelids and cheeks form an interconnected aesthetic region. A change in one area can affect how another appears.
Dr. Ardesh therefore evaluates:
- Brow position
- Upper eyelid skin
- Eyelid height and possible ptosis
- Lower eyelid bags
- Skin quality and fine lines
- Dark circles
- Tear trough hollowing
- Facial volume
- Lower eyelid support
- The transition between the lower eyelid and cheek
This broader evaluation helps distinguish between concerns that may look similar but require different treatments.
The goal is not to make the eyes look operated on. It is to determine what is creating the tired or heavy appearance and address those factors while maintaining normal expression.
Why Do My Eyes Look Tired?
There is rarely one answer that applies to every patient.
A tired appearance around the eyes may result from:
- Excess upper eyelid skin
- Descended eyebrows
- Eyelid ptosis
- Lower eyelid bags
- Tear trough hollowing
- Loss of cheek volume
- Dark circles or pigmentation
- Fine lines and changes in skin quality
- Weakness or looseness of lower eyelid support
Several of these changes can occur together. A patient may appear to have significant upper eyelid hooding when part of that heaviness is actually caused by a descended eyebrow. Another patient may have prominent lower eyelid bags together with hollowing beneath them.
Identifying the source of the concern is therefore an important part of selecting the appropriate treatment.
Why You Should Consider Eyelid Surgery
- Have drooping eyelids or sagging skin that affects their vision or appearance
- Experience puffiness or bags under the eyes due to excess fat.
- Are in good physical health and do not have significant circulatory disorders or cardiovascular disease.
- Have realistic expectations about the outcome of the surgical procedure
Upper Blepharoplasty
Addressing Heavy or Excess Upper Eyelid Skin
Upper blepharoplasty is designed to improve excess skin and appropriate fullness of the upper eyelids.
Patients often consider the procedure because their eyes appear heavy or tired despite feeling well rested. Others notice increasing hooding or find that applying eye makeup has become more difficult.
During surgery, an incision is positioned within the natural upper eyelid crease so that it is typically difficult to see after healing.
Excess skin is carefully removed. Depending on the patient's anatomy, treatment may also involve the underlying eyelid muscle or conservative reduction of prominent fat pockets.
Patients with more significant hooding toward the outer corner of the eye may require extension of the incision to adequately address skin in this area.
Fine sutures are used to close the incision and are generally removed approximately one week after surgery.
Functional vs. Cosmetic Blepharoplasty
Cosmetic blepharoplasty is performed to rejuvenate the appearance of the eyes by removing excess eyelid skin, reducing puffiness, and correcting hooded eyelids. The goal is to create a brighter, more refreshed appearance while maintaining natural facial expression.
Functional blepharoplasty may be recommended when excess upper eyelid skin obstructs the visual field or causes symptoms such as eye fatigue, forehead strain, or difficulty with daily activities. In these cases, eyelid surgery improves both vision and eyelid function while also enhancing appearance.
Cosmetic blepharoplasty is performed to rejuvenate the appearance of the eyes by removing excess eyelid skin, reducing puffiness, and correcting hooded eyelids. The goal is to create a brighter, more refreshed appearance while maintaining natural facial expression.
Functional blepharoplasty may be recommended when excess upper eyelid skin obstructs the visual field or causes symptoms such as eye fatigue, forehead strain, or difficulty with daily activities. In these cases, eyelid surgery improves both vision and eyelid function while also enhancing appearance.
During your consultation, a comprehensive evaluation will determine whether your concerns are cosmetic, functional, or a combination of both.
Do You Need Upper Eyelid Surgery or a Brow Lift?
A low eyebrow can push tissue downward and create apparent heaviness over the upper eyelid. Other patients have true excess upper eyelid skin with a well-positioned brow. Some have both.
Upper Blepharoplasty
Appropriate when true excess upper eyelid skin or fullness is contributing to heaviness.
- Addresses excess upper eyelid skin
- Can refine appropriate upper eyelid fullness
- Uses an incision positioned within the natural eyelid crease
- May be appropriate when the brow itself is well positioned
Brow Lift
Appropriate when a low or descended eyebrow is contributing substantially to upper-eyelid heaviness.
- Repositions descended brow tissues
- Addresses heaviness caused by low eyebrow position
- Improves the relationship between the brow and upper eyelid
- May be combined with upper blepharoplasty when both concerns are present
Upper Blepharoplasty
Appropriate when true excess upper eyelid skin or fullness is contributing to heaviness.
- Addresses excess upper eyelid skin
- Can refine appropriate upper eyelid fullness
- Uses an incision positioned within the natural eyelid crease
- May be appropriate when the brow itself is well positioned
Brow Lift
Appropriate when a low or descended eyebrow is contributing substantially to upper-eyelid heaviness.
- Repositions descended brow tissues
- Addresses heaviness caused by low eyebrow position
- Improves the relationship between the brow and upper eyelid
- May be combined with upper blepharoplasty when both concerns are present
Dr. Ardesh evaluates the relationship between the forehead, eyebrow and eyelid before recommending treatment. The procedure should follow the anatomy rather than the assumption that every heavy-looking upper eyelid requires the same operation.
Skin, Muscle, and Fat: The Key Components of Blepharoplasty
Successful blepharoplasty (eyelid surgery) involves much more than simply removing excess skin. Natural-looking blepharoplasty results depend on carefully evaluating the skin, muscle, and fat around the eyes to restore a refreshed, youthful appearance while preserving normal eyelid function.
Skin
As collagen and skin elasticity naturally decline with age, the upper eyelids can begin to droop, creating a tired or heavy appearance. During upper eyelid surgery, excess skin is carefully removed to improve eyelid contour, reduce hooding, and restore a brighter, more youthful look while maintaining natural eyelid function.
Muscle
The orbicularis oculi muscle plays an important role in eyelid movement and facial expression. Depending on your anatomy and aesthetic goals, selective muscle refinement may be performed during blepharoplasty surgery to improve eyelid contour while preserving natural movement and expression.
Fat
Aging can cause the eyelid fat pads to become more prominent, leading to puffy upper eyelids or under-eye fullness. Rather than removing excessive fat, a conservative approach using fat repositioning or selective reduction is often performed during eyelid surgery to create smoother, long-lasting, and natural-looking results.
Botox, Brow Position and the Upper Eyelids
Botox can be useful for treating forehead lines and crow's feet, but its relationship with eyebrow position needs to be considered.
The forehead muscles help influence the position of the eyebrows. In patients who already have heavier or lower brows, aggressive relaxation of these muscles may allow the eyebrows to descend further.
This does not mean Botox and eyelid rejuvenation are incompatible.
Depending on the patient's anatomy and concerns, Botox, brow lift surgery and upper eyelid surgery can have different and sometimes complementary roles. Dr. Ardesh determines which approach—or combination of approaches—is most appropriate for maintaining a natural balance across the upper face.
What does an eyelid procedure look like?
The procedure is usually done under local anesthesia with sedation; general anesthesia may be used for more complex cases.
A small incision is made in the upper eyelid's natural crease to remove excess skin, fat, and muscle, smoothing the area for a youthful contour.
The underlying muscles and fat are adjusted to enhance the eyelid shape, reducing fine wrinkles and sagging.
Incisions are closed with fine sutures for minimal scarring. Cold compresses may be applied to reduce swelling and aid recovery.
Eyelid Ptosis Is Different From Excess Eyelid Skin
Eyelid ptosis occurs when the eyelid itself sits lower than it should.
This is different from having excess skin draped over the upper eyelid, although patients frequently confuse the two conditions and they can occur together.
Ptosis commonly develops when the attachment of the levator muscle responsible for lifting the eyelid becomes weakened.
For selected patients seeking temporary non-surgical improvement, Upneeq eye drops may help elevate the eyelid.
When surgical correction is appropriate, ptosis repair may be performed internally without a visible external scar or through an incision concealed within the upper eyelid crease.
Ptosis surgery may also be combined with upper blepharoplasty or brow lift surgery when more than one structure is contributing to the appearance of the upper eye.
What Is Ptosis?
Ptosis is a condition in which the upper eyelid droops due to weakness of the levator muscle rather than excess skin alone. Because ptosis and hooded eyelids can appear similar, an accurate diagnosis is essential before treatment. When present, ptosis repair may be recommended alongside blepharoplasty to improve both eyelid function and cosmetic outcomes.
Blepharoplasty and Brow Lift
In some patients, heavy or hooded upper eyelids are primarily caused by drooping eyebrows (brow ptosis) rather than excess eyelid skin. In these cases, combining blepharoplasty with a brow lift can restore upper facial balance, open the eyes more effectively, and achieve longer-lasting, natural-looking facial rejuvenation.
Upneeq Eye Drops
Upneeq is a prescription eye drop that can temporarily lift the upper eyelid in selected patients with mild acquired ptosis. While it may provide a non-surgical improvement in eyelid position, it does not treat excess eyelid skin or replace blepharoplasty or ptosis repair when structural correction is required. During your consultation, Dr. Ardesh will carefully evaluate your eyelid anatomy, diagnose the underlying cause of eyelid drooping, and recommend the most appropriate treatment to achieve the best functional and aesthetic outcome.
Lower Eyelid Rejuvenation
Looking Beyond Under-Eye Bags
Lower eyelid bags are a common reason patients seek facial rejuvenation. They can make the face appear tired, stressed or older even when the patient feels otherwise.
Simply removing fat, however, is not always the appropriate solution.
Dr. Ardesh evaluates the lower eyelid in relation to:
- Fat pockets
- Excess or crepey skin
- Tear trough hollowing
- Cheek volume
- Eyelid support
- Fine lines
- Pigmentation
- The contour between the eyelid and cheek
The objective is to create a smoother transition from the lower eyelid into the cheek rather than simply making the lower eyelid flatter.
Lower Blepharoplasty
Lower eyelid surgery can be performed through different approaches according to the structures requiring treatment.
Internal Lower Eyelid Approach
Transconjunctival Lower Blepharoplasty
An internal, or transconjunctival, approach places the incision on the inside of the lower eyelid. Because there is no external skin incision, this approach avoids a visible external scar and may be appropriate when lower eyelid bags are the primary concern.
External Lower Eyelid Approach
Access for Skin, Bags and Support
An external incision can be positioned just beneath the eyelashes. This approach provides access when treatment needs to address excess skin, wrinkles, lower eyelid bags or support structures in addition to internal fullness.
Skin Pinch
Limited Treatment for Excess Lower Eyelid Skin
When the primary concern is a relatively small amount of excess lower eyelid skin, a more limited skin-removal procedure may be performed, commonly referred to as a skin pinch.
The appropriate technique depends on the patient's anatomy rather than using one lower blepharoplasty method for every eye.
Fat Repositioning and Tear Trough Correction
Lower eyelid aging is not always caused by having too much fat. Sometimes the problem is where that volume sits in relation to surrounding areas.
Many patients develop a hollow beneath the lower eyelid known as the tear trough. When prominent lower eyelid fat sits directly above this hollow, the contrast between the two can make under-eye bags appear more noticeable.
In selected patients, Dr. Ardesh may reposition existing lower eyelid fat rather than simply removing it.
Repositioning can help soften the transition between the lower eyelid and cheek while preserving appropriate volume.
The aim is a smoother contour rather than creating an overly hollow lower eyelid.
When Is Fat Transfer Considered?
Some patients have broader volume loss that cannot be addressed through eyelid fat repositioning alone.
Fat transfer may then be considered as part of facial rejuvenation.
Fat can be collected from another area, such as the abdomen or beneath the chin, and processed before being strategically placed in areas requiring volume restoration. Depending on its intended use, it may be prepared as microfat or nanofat.
Treatment planning considers the lower eyelids in relation to the cheeks and surrounding face so that volume restoration supports overall facial harmony.
Can Filler Replace Lower Eyelid Surgery?
Not necessarily.
Filler may help selected patients when volume loss along the upper cheek or surrounding area contributes to under-eye hollowing.
It cannot, however, correct every cause of lower eyelid aging.
Significant lower eyelid bags may remain despite filler because the underlying problem is structural rather than simply a lack of volume. In some patients, placing filler directly into the lower eyelid region may increase puffiness or create an unnatural contour.
For this reason, the decision between filler, fat repositioning, fat transfer and lower blepharoplasty should be based on the specific anatomy responsible for the concern.
Non-Surgical Treatment for Early Lower Eyelid Changes
Not every patient with aging around the eyes requires surgery.
Fine lines, crepey skin, pigmentation and early skin-quality changes may respond to non-surgical treatment.
Depending on the concern, options may include:
- Retinol-based skincare
- Eyelid firming products
- Medical-grade skincare
- Chemical peels
- TCA-based peels or other appropriate formulations
Dark circles require particularly careful assessment because they can have several causes.
Pigmentation, skin quality, volume loss, allergies, sinus congestion and facial anatomy can all contribute to darkness beneath the eyes. A treatment that helps one cause may therefore have little effect on another.
Supporting a Loose Lower Eyelid
The lower eyelid requires adequate structural support to maintain its position against the eye.
Some patients develop significant looseness that contributes not only to appearance but also to symptoms such as tearing, irritation or lower eyelid drooping.
Canthopexy
Canthopexy reinforces the lower eyelid using specialized sutures to improve support.
Canthoplasty
Canthoplasty involves repositioning and tightening the lower eyelid when a greater degree of structural support is necessary.
Canthopexy
Canthopexy reinforces the lower eyelid using specialized sutures to improve support.
Canthoplasty
Canthoplasty involves repositioning and tightening the lower eyelid when a greater degree of structural support is necessary.
Either procedure may be combined with lower blepharoplasty when both rejuvenation and eyelid support need to be addressed.
Reconstructive Eyelid Surgery
Eyelid surgery is not limited to cosmetic rejuvenation.
Dr. Ardesh also performs reconstructive eyelid surgery for defects or changes resulting from:
- Skin cancer removal
- Mohs surgery
- Traumatic injury
- Previous surgery
- Scar contracture
Reconstruction around the eye requires attention to both appearance and function because the eyelids play an important role in protecting the eye and maintaining normal closure and support.
Depending on the nature and extent of the defect, reconstruction may involve local flaps, eyelid-cheek advancement flaps, skin grafts, cartilage grafts, staged reconstruction or specialized eyelid support procedures.
Dr. Ardesh's background includes advanced fellowship training in Facial Plastic and Reconstructive Surgery at the University of Washington, followed by serving as Director of Facial Plastic and Reconstructive Surgery at Loma Linda University with appointments involving Head and Neck Surgery, Dermatology and Ophthalmology.
This experience informs his approach to complex periocular reconstruction where preservation of both natural eyelid anatomy and function is important.
Your Upper Eyid Surgery Journey: What to Expect
The Consultation
A consultation with Dr. Ardesh will include a thorough review of your medical history, including any eye conditions and use of blood thinners. This helps determine if you're a good candidate for upper eyelid surgery and if other procedures, like a brow lift or lower eyelid surgery, would be beneficial to achieve your aesthetic goals.
The Procedure
The procedure is typically done under local anesthesia with sedation, or general anesthesia for complex cases. A small incision in the upper eyelid’s natural crease allows Dr. Ardesh to remove excess skin, fat, and muscle while repositioning underlying tissues to enhance the eyelid shape. Incisions are closed with fine sutures for minimal scarring, and cold compresses may be applied to reduce swelling.
Post-Op Care
Dr. Ardesh provides comprehensive aftercare instructions, including how to manage bruising and swelling and what to expect during your recovery. Cold compresses are recommended to reduce swelling around the eyelids.
What Is Eyelid Surgery Recovery Like?
Recovery depends on whether treatment involves the upper eyelids, lower eyelids, ptosis repair, eyelid support procedures or a combination of treatments.
Temporary swelling and bruising are expected after many eyelid procedures, although the extent varies according to the operation and individual healing.
Following upper blepharoplasty, very fine sutures are generally removed at approximately one week.
Lower eyelid recovery varies more substantially according to whether treatment involves an internal or external incision, skin removal, fat repositioning or additional structural support.
Dr. Ardesh provides postoperative instructions according to the procedure performed and monitors healing throughout recovery.
What are the healing stages of a Blepharoplasty?
After upper eyelid surgery, you may experience mild swelling and bruising, but these symptoms typically subside within one to two weeks. Here's what to expect during the recovery process
- Apply cold compresses to the area surrounding the eyes to reduce swelling and bruising.
- Keep your head elevated to minimize discomfort and promote healing.
- Avoid strenuous activities and contact lenses for at least two weeks.
- Scarring is minimal, as the incision is made within the natural crease of the upper eyelid.
- Most patients can return to normal activities within 10-14 days.
Dr. Ardesh will schedule follow-up appointments to monitor your progress and ensure optimal healing. Any concerns about possible complications like bleeding, numbness, or infection will be addressed immediately.
Why Choose Dr. Ardesh
Dr. Ardesh, a double-board certified facial plastic and reconstructive surgeon, has delivered over 7,000 natural results with expertise and empathy. His focus is on creating a refreshed look—never a “worked on” appearance—which should always be a surgeon’s objective. With advanced training in minimally invasive techniques, Dr. Ardesh ensures minimal scarring, less pain, and shorter recovery times. Beautiful outcomes are achieved through careful listening, open communication, and a commitment to patient safety and comfort. His goal is to help you achieve your desired look that inspires confidence and joy.
Schedule an Eyelid Surgery Consultation in Beverly Hills
If your eyes look tired, heavy or older than you feel, the first step is determining why.
Excess upper eyelid skin, brow descent, ptosis, lower eyelid bags, tear trough hollowing, volume loss and changes in eyelid support can produce overlapping concerns but may require very different treatment approaches.
Dr. Farhad Ardesh evaluates the entire eye region rather than assuming that blepharoplasty alone is appropriate.
A consultation allows him to assess your forehead, brows, upper and lower eyelids, skin quality, facial volume and eyelid support before determining whether upper blepharoplasty, lower blepharoplasty, ptosis repair, brow lift surgery, non-surgical treatment or a combination of approaches may best address your individual concerns.
Request Your Consultation Today.
