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Eyelid Surgery


The surgery takes place at Marin Cosmetic Surgery Center, Dr. Delgado’s private surgery suite, located in his Marin County office on the Sutter Marin County Community Hospital campus. This allows Dr. Delgado to offer his patients private, concierge medical care, while providing the extra measure of safety and reassurance afforded by the surgery center’s contiguous location to the hospital.

Before anesthesia is given, the eyelids are marked to outline the surgical plan. A felt-tip marking pen, specially designed for this purpose, is used to mark the skin. Dr. Delgado takes great care with the marking in order to create the most natural and balanced shape possible.

The surgical procedure involves excising a tiny ellipse of skin from the upper eyelid. The incision is made in the upper eyelid’s natural crease so that when the incision line heals, it will be virtually invisible. A section of muscle underneath is also excised to create a clean upper eyelid crease and the fat distribution may be altered as well. The esthetics of Cosmetic Eyelid Surgery has changed over the years. It has evolved from fat removal to fat preservation. As the face ages, it loses the fat that gives the face its youthful appearance. Therefore, often the fat of the upper eyelid is preserved while the redundant skin is excised. The goal is to rejuvenate the eyelids and not create a deep-set or hollow appearance.

The Lower Cosmetic Eyelid Surgery is performed either through an incision inside the eyelid (transconjunctival blepharoplasty) or on the outside of the eyelid. The transconjunctival approach is especially ideal for younger patients when there is no skin or muscle laxity. Some people have puffy lower eyelids either prematurely or genetically and this approach serves their purpose well. The procedure is performed by retracting the lower eyelid. An incision is made from the inner side of the lower eyelid. The fat is dissected free and partially excised and only the correct amount of fat is removed. If it is necessary to tighten the skin below the eyelid, then an incision is made on the exterior of the eyelid below the eyelash line. Once the incision is made, the dissection is carried down to the fat layer which is trimmed, or in some cases, repositioned. The muscle which directly pulls the attachments of the overlying skin is tightened. The outer corner of the eyelid is anchored and then the excess skin is removed. The skin may be treated with a chemical peel or laser resurfacing to reduce creepiness.


Cosmetic Eyelid Surgery can be done with local anesthesia or IV sedation. It may be performed in conjunction with other procedures, such as a Face Lift or a Brow Lift. If multiple procedures are performed, general anesthesia is usually recommended. At Marin Cosmetic Surgery Center, anesthesia is administered only by a physician who is board-certified in anesthesia. Dr. Delgado and the anesthesiologist assist the patient in determining the best choice of anesthesia for his or her procedure. Additionally, the anesthesiologist calls the patient the night before surgery to review his/her medical history, confirm last minute instructions and answer any questions he/she may have related to the anesthesia.

After Eyelid Surgery

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