Blepharoplasty in Uberlândia, Brazil

Upper blepharoplasty addresses the upper eyelid: it removes the excess skin — and, where present, the fat pocket — that weighs on the eyes and which, in some cases, begins to obstruct the visual field. Lower blepharoplasty addresses the lower eyelid, where the concern is usually the fat pocket and the excess skin that create a tired look. The two can be done together or separately, depending on the assessment, and the surgical approach differs: in the upper lid the incision sits in the natural eyelid fold; in the lower lid, along the lash line.

The CO2 laser is a cutting instrument, not a different operation. It emits light at 10,600 nm, absorbed by the water in tissue: it cuts by vaporizing that water and, in the same pass, seals the eyelid's fine vessels. The plan does not change: marking is done with the patient seated and awake, before any anesthetic, and skin and fat pocket are treated in the same way. In the lower lid the incision sits along the lash line. The literature is modest, and it compares instruments rather than operations. In a randomized trial of 78 patients undergoing lower blepharoplasty, the CO2 laser was compared with electrocautery — not with a blade: there was less heat sensation during the procedure and less conjunctival swelling afterwards, with no difference in operating time, pain, bruising or satisfaction. In the studies that compared the laser with an electrocautery needle and with a blade, there was no difference in scar or aesthetic outcome. It is a choice of instrument, weighed case by case.

Non-surgical blepharoplasty is a commercial label for procedures applied to the surface of the eyelid skin — plasma devices, ablative fractional lasers and radiofrequency microneedling — which are not surgery. They are not the same as skin-tightening technologies applied beneath the skin in association with surgery, which have their own indication and purpose. Acting on the surface, they produce tightening and collagen remodeling and tend to give a discreet improvement in mild laxity, over several sessions. They do not excise a strip of skin and do not treat the fat pocket, which are the two things blepharoplasty does. The evidence for eyelid use is limited: the published studies are small — 10, 17, 20 and 21 patients — most without a comparison group and with review between 4 weeks and 8 months, and the reviews reserve these methods for milder grades of laxity, keeping surgery as the option of choice in pronounced cases. If you read 3 sessions a month apart, what is being described is not blepharoplasty: the surgery is a single operation.

Yes, this is a common combination — feasibility is assessed individually at the consultation.

It typically takes a few hours, but the exact duration depends on the technique used and the extent of the procedure planned for each case.

Blepharoplasty is surgery, and the setting follows from the anesthetic. Where sedation is used — most often — a licensed operating room or outpatient surgical unit is needed, with monitoring, an anesthesiologist and equipment for any adverse event; that is how Dr. Lorena performs the operation. Under local anesthesia alone, upper blepharoplasty may be performed in a properly equipped procedure room with defined emergency backup. Admission is not needed: the approach is outpatient, with discharge a few hours after the operation and always accompanied. An overnight stay comes in when blepharoplasty is combined with larger operations, when general anesthesia is chosen and recovery calls for observation, or when a medical condition makes it advisable. Where the operation will take place, who will administer the anesthetic and what structure is available for an adverse event are fair questions at the consultation — worth asking. Whether you go home the same day or stay overnight is always assessed case by case, according to the extent of the surgery, the anesthesia, whether other procedures are combined and your pre-operative assessment — and it is defined before the surgery, not on the day. That same decision determines the venue: procedures with same-day discharge are performed in the operating theatre of Healme Clinic itself, and those requiring admission in the operating theatre of the UMC Hospital — in the same complex, with no travel between sites.

Yes, and it is not a formality: the assessment is carried out by an ophthalmologist, and what it finds can change the surgical plan. It covers dry-eye complaints or frequent use of drops, recent refractive or ocular surgery, glaucoma under follow-up, active blepharitis or infection, recurrent herpes around the eyes and thyroid changes with ocular involvement; laxity of the tendon that supports the lower lid is assessed at the surgical consultation itself. Any of these findings may lead to reducing the resection, adding a support measure for the lower lid, treating first with the specialist who manages the condition, or postponing surgery. To the routine preoperative tests and the preparation described under Preparation, procedure and recovery on this page, two items specific to this operation are added: antiplatelet drugs and recent use of isotretinoin.

It's usually performed under local anesthesia with sedation, though general anesthesia may be used when combined with other procedures — the choice is made together with the anesthesiology team.

The point of the anesthetic is precisely that no pain should be felt during surgery: blepharoplasty is usually performed under local anesthesia with sedation, and the stinging moment is the injection of the anesthetic, already under sedation. Pressure and pulling may still be felt, and more anesthetic is added when needed. Afterwards the usual complaint is not pain but heaviness, tightness and a gritty feeling in the eyes, along with itching as the incision begins to close — discomfort generally managed with simple analgesics over the first 2 to 3 days. Choosing a CO2 laser instead of a blade does not change the need for anesthesia, nor does it remove that discomfort. Severe or increasing pain, or pain with worsening vision, is not expected and should be reported to the team immediately.

Most swelling and bruising reduce within the first two weeks, varying by patient.

Relative rest is recommended during the first few days, avoiding exertion and keeping the head elevated — the exact guidance is individualized by the medical team.

This varies depending on the type of activity and how swelling progresses — desk-based work is usually resumed before more demanding roles, always with medical clearance.

It depends on visual recovery and how eyelid swelling subsides, since vision may be temporarily affected — this clearance is assessed on an individual basis.

Light activity is usually reintroduced gradually, while more intense or high-impact exercise generally waits longer — clearance is individualized.

Cold compresses are commonly recommended in the first days to reduce swelling, along with lubricating ointments or eye drops — specific instructions are given during post-operative follow-up.

The guidance is to sleep on your back with the head raised at roughly 30 to 45 degrees — two pillows, or the head of the bed lifted — for the first 1 to 2 weeks. Elevation helps drainage and reduces the swelling you wake up with; lying completely flat tends to make morning swelling worse. Sleeping on your side or face down is what to avoid in the early days, because of direct pressure on the operated lid, which can leave one side more swollen than the other. Sleeping sitting up is not necessary. If you turn over during the night, pillows on either side of the body help. Night-time ointment and drops blur vision for a while, which is expected.

Swelling usually peaks between day 2 and day 3 and then begins to settle; bruising changes color and fades, on average, between 10 and 15 days. Stitches in the upper lid generally come out between day 5 and day 7. Most of the social recovery happens within 2 to 3 weeks, and the fine residual swelling, with the crease still settling, can take 3 to 6 months to resolve. Worth knowing: the two sides do not settle at the same rate, so asymmetry during that period is common and does not by itself indicate an asymmetric result. The lower lid usually follows a longer calendar than the upper. Swapping the blade for a laser does not shorten that calendar.

Incisions are planned along natural eyelid folds or the lash line, becoming quite discreet over time.

It tends to become progressively less noticeable over the following months, though the maturation process varies from person to person and can take time to reach its final appearance.

In the upper lid the stitches usually come out between day 5 and day 7, in the office, in a few minutes: the suture is very fine and the sensation is a light tug, with no anesthetic needed in most cases. Removing them early is deliberate — a suture left too long in the thin skin of the eyelid can leave a mark of its own. In some cases an absorbable suture is used, which does away with removal, with no difference in healing described compared with a non-absorbable one. Right after removal the incision line looks pink and slightly firm: that is a normal stage of healing and tends to fade over the following months.

Keloid on the eyelid is rare: the skin there is the thinnest on the body and the incision sits in an area of little tension, which works against an exuberant scar. What does happen with some frequency is a transient hypertrophic phase — a reddened, firm and sometimes raised line in the first months, most often in the outer portion, where the incision leaves the natural crease. A history of keloid or hypertrophic scarring elsewhere does not automatically rule it out, but it changes the follow-up: strict sun protection, silicone gel or sheeting, massage once cleared and, in some cases, specific scar treatment. The honest limit is this: the incision does not disappear. It tends to become discreet within the crease, and may still be noticeable close up.

It's a possible effect, generally temporary, especially in the first days — along with mild difficulty fully closing the eyes, which tends to improve as recovery progresses.

It is a small-scale operation, done on an outpatient basis and almost always under local anesthesia with sedation — conditions that place it among the lower-risk procedures in plastic surgery. Lower risk is not zero risk: any anesthetic and surgical act carries a risk of medical complication, which is why preoperative assessment is requested, along with tests appropriate to age and existing conditions and, in some cases, clinical or cardiology clearance. Venous thrombosis is described mainly after long, large operations; eyelid surgery is short and the patient walks on the same day, which lowers that risk without erasing it.

Vision loss is the most feared and also the rarest complication of eyelid surgery, and it is almost always linked to retrobulbar hematoma — bleeding behind the eyeball that compresses the optic nerve. In the largest published series, orbital hemorrhage occurred in about 1 case in 2,000 and permanent vision loss in about 1 in 22,000. Most of this bleeding happens in the first hours and the risk falls markedly after the first 24, although later cases are described. Hence the preparation: a planned pause of anticoagulant and antiplatelet drugs, agreed with the doctor who prescribes them, blood pressure control and careful review of bleeding at the end of the operation. And hence the guidance for that first period: someone with you the first night, rest with the head raised, no straining, bending or lifting, and tell the team about nausea, vomiting or raised blood pressure. The warning sign is severe, progressive eye pain with rapidly increasing swelling and failing vision: that is an emergency, it needs immediate care and it is not a matter of waiting for the scheduled visit. Blurred vision in the first days, from swelling and from ointment and drops, is a different matter and is expected.

The commonest events are the reversible ones: swelling and bruising for some weeks, slight asymmetry between the two sides while swelling settles, and a dry-eye sensation with difficulty closing the lid completely — strongest in the first weeks and, in some patients, still present months later. In series that measured the tear film after upper blepharoplasty, the discomfort and the film instability were still detectable at 6 months, usually managed with prescribed lubrication. Those that may call for a second operation are less frequent: too little or too much skin removed, a change in the height of the eyelid crease, a widened scar and, in the lower lid, retraction — the margin drops and exposes the white of the eye while still lying against the globe — and ectropion, a separate situation in which the margin turns outward, away from the eye. Each has its own correction. The uncomfortable part deserves saying: skin removed in excess is the hardest problem to solve, whereas skin left behind can be adjusted. Revisions usually wait for scar maturation, around 6 to 12 months.

It does, and they belong to the instrument rather than to the eyelid. The beam can injure the eye, so metal shields are placed over the corneas for the whole time the laser is active, with protective eyewear for the team, damp gauze around the field, surgical smoke evacuation and control of the oxygen delivered by anesthesia, because of the ignition risk. Two trade-offs are recorded in the literature: the edge of the incision sustains more thermal injury than one cut with other instruments — in a trial comparing the laser with an electrocautery needle, histological thermal damage was greater on the laser side, though without clinical consequence over follow-up — and that same heat degrades the reading of a pathology specimen, so where a suspicious skin lesion needs to be examined under the microscope, a blade is preferred. None of this makes the laser unsafe — it shows that it has trade-offs.

Venous thromboembolism prophylaxis is used in every patient, not only in those at higher risk. It has two parts. The mechanical one is routine: anti-thrombosis compression stockings and intermittent pneumatic compression of the legs, used during the operation and in the immediate postoperative period, until early ambulation — the third pillar, and the reason the team insists on short, frequent walks from the first hours. The chemical part is individualised: how long enoxaparin is used is defined by the Caprini score, a validated instrument that adds up factors such as age, body mass index, expected length of surgery, hormone use, smoking and personal or family history of thrombosis. None of these measures eliminates the risk, which is why asymmetrical pain or swelling in a leg, shortness of breath and chest pain need immediate assessment, not waiting.

Permanent is not a word to use here. Removing skin and treating the fat pocket of the upper lid tends to give a long-lasting result — the literature describes many years of stability and low reoperation rates. The lower lid tends to need longer follow-up, because it depends on the support dynamics of the lid itself. In neither does aging stop: the skin keeps losing elasticity and the fat of the orbit and midface keeps reorganizing, so the look of the eyes goes on evolving over time. When a surface treatment for skin texture is added, that component is less lasting and tends to fade over the years. Durability comes from the surgery, not from the instrument used to cut.

No. The operation treats excess skin and the fat pocket, and that is what it sets out to correct. Dark circles, when they come from pigment or vessels showing through thin skin, are not removed by taking skin away. A deep tear trough and lost midface volume are not filled by the surgery. Brow position depends on the forehead, not on the eyelid: a descended brow calls for different planning, and removing more skin in that situation tends to make the whole worse. Lines around the eyes remain, because they depend on muscle contraction. And an eyelid that droops because of a change in the muscle that lifts it is a separate situation, one that has to be identified at assessment, because blepharoplasty alone does not correct it. None of this can be measured in years: what changes is the tired look.

Blepharoplasty is a surgical intervention — anesthesia, an operating room and postoperative follow-up — and medical regulation treats it as such: planning, performing and following up the operation are the responsibility of a doctor registered with the CRM. In practice the check that falls to you is simple and public: confirm the CRM license number and the specialist registration in plastic surgery, the RQE, in the public register of the Federal Council of Medicine. It is also worth asking where the operation will take place, who will administer the anesthetic and what the follow-up includes. Non-surgical procedures advertised under the blepharoplasty name follow different practice rules; in any setting the eye region tolerates little error, and ocular complications of eyelid procedures are described in the literature — which is why who performs it, where, and with what safety structure are fair questions to ask.

Yes — eyelid surgery is among the operations most sought by men, often for a tired-looking gaze or for excess skin that weighs on the visual field. The plan changes in details that matter: the male eyelid crease sits lower and is less defined, and resection tends to be more restrained, so the eye is not left excessively open and the expression is not feminized; the male brow is lower and straighter, so excess skin in the outer portion is handled cautiously, to avoid lifting the tail of the brow. Male skin tends to be thicker and better vascularized, which can make bruising more evident in the first days. Risks and recovery are the same.

Surgical fees are always private — Dr. Lorena does not operate through health insurance. What is possible, when a genuine, documented medical indication exists — such as excess upper-eyelid skin that begins to obstruct the visual field —, is to guide the patient and attempt to have the health plan cover part of the hospital admission, which may include the operating room, the hospital stay and materials, according to the terms of her policy. Authorisation is the insurer's decision and cannot be guaranteed; the team advises on the documentation required and on how to proceed.

Yes, where there is a reconstructive or functional indication — for example excess upper-eyelid skin that begins to compromise the visual field. Surgery for purely aesthetic purposes is not covered by the SUS. Dr. Lorena is a plastic surgeon appointed by public examination to the Hospital de Clínicas of the Federal University of Uberlândia (HC-UFU) and preceptor of its plastic surgery residency, and she operates on SUS patients there. The route, however, does not run through this site or the private practice: the patient must register at the primary care unit (Unidade Básica de Saúde) nearest to where she lives, be assessed by a doctor there and, if there is an indication, be placed in her municipality's regulation queue. The surgeon cannot choose who is operated on through the SUS — the order follows the queue and the rules of the system strictly.

We do not publish isolated before-and-after pairs. Resolution 2,336/2023 of the Brazilian Federal Council of Medicine allows results to be demonstrated, but only within a set that also includes unsatisfactory outcomes and the complications described in the literature, across different body types, age ranges and stages of healing, and with no editing of the images (art. 14, II). An isolated pair of photos does not meet those requirements and also implies a guaranteed result, which the same resolution prohibits (art. 11, XII). At the consultation the expected outcome is discussed from your own anatomy — what is reasonable to expect, what is not possible, and what the risks are.