close-up of a woman's eye

Eyelid Surgery

Blepharoplasty surgery (eyelid tuck) is performed to cosmetically and functionally rejuvenate the eyelids and associated structures. By rejuvenating the eyelids, patients look more alert, awake and refreshed.

As we age, the skin and muscle associated with eyelids become loose and baggy. This produces a sad and saggy look that makes us look old and tired. In addition, tissues that separate the cushioning fat around the eyeball become weak and fat protrudes into the eyelids forming bags under the lower eyelids and making the upper lids appear thick.

Excess Tissue

Upper Eyelid Surgery, eyelids droop, Richmond VAThe excess tissue can also obstruct vision and by having cosmetic eyelid surgery, patients don’t only look better, but oftentimes see better as well. Aging changes of the eyelids can begin in the third decade and it is not uncommon to perform cosmetic eyelid surgery on patients in their 30’s and 40’s. Many people watch what they eat, they exercise and they pay attention to their appearance. Although they feel young, a complaint from many patients is when they look in the mirror they see a person that looks much older than they feel. Their friends are asking them if they are tired and they have lost that happy, refreshed look. Droopy and baggy eyelids simply make patients look older and tired.

When you pinch your excess eyelid skin and it stays pinched, it is time for eyelid surgeryWhen you pinch your excess eyelid skin and it stays pinched, it is time for blepharoplasty.

Eyelid Lift Educational Videos

In the videos below Dr. Niamtu discusses the essentials of safe blepharoplasty with natural results. Since a patient may only have this operation once in their life, investing some time and watching this video can be valuable to understand the procedures, dispel myths and make the correct decision when choosing a blepharoplasty surgeon.

The Art and Science of Cosmetic Eyelid Surgery
Lower Eyelid Blepharoplasty Important Facts You Need to Know
Upper Eyelid Blepharoplasty
Some Great Little Blepharoplasty Cases
Bloodless Radiowave Assisted Blepharoplasty
Canthopexy: Don't Do Lower Eyelid Blepharoplasty Without Watching This Video

Blepharoplasty Patient Photos

The patients below show improvement of eyelid aging after cosmetic blepharoplasty by Dr. Niamtu

The before and after photos below show selected patients with cosmetic eyelid surgery.

Some Blepharoplasty Patient Comments


 Fat protrusion of lower eyelids Fat protrusion of lower eyelids
 lower lid fat bags may be hereditary Some patients develop hereditary lower lid fat bags in their 20’s or 30’s. This patient is shown before and after surgery
 Mother and daughter with hereditary lower eyelid bags Mother and daughter with hereditary lower eyelid bags


Festoons are “boggy tissue” under the lower lids and and can sit on the upper cheek. Technically this is a process known as lymphedema where lymphatic fluid backs up in the tissues. Older treatments required surgical excision of the festoons, thus leaving a scar. CO2 laser technology has provided a 10 minute treatment (with about 7-8 days of recovery) that can dramatically improve this condition. The patients below were treated by Dr. Niamtu with CO2 laser resurfacing.

How is Eyelid Surgery Performed?

Blepharoplasty surgery is performed in our fully accredited office surgery center with light IV anesthesia. If desired, the surgery can usually be performed with local anesthesia as well. This surgery takes about 15 minutes per eyelid and the recovery time is usually about a week. During this time, the patient must refrain from any heavy activity and lifting. The eyes may swell or bruise for several days after surgery. Most patients that have eyelid surgery on Thursday or Friday can recover over the weekend and get out of the house by Monday or Tuesday with sunglasses to cover the surgery.

Dr. Niamtu uses the newest technologies of laser and radiowave surgery for eyelid surgery. This produces less bleeding and tissue damage which means faster recovery, less bruising, faster healing and less post operative pain.

Before and after lower eyelid surgery

Dr. Niamtu also uses the transconjunctival approach for lower eyelid surgery. This method allows the incision to be made inside the lower eyelid so there is no visible surgical scar. This approach is also less likely to cause a pulling down of the lower eyelid that is frequently seen with external incision techniques.

Older style external incisions (on the outside of the lower eyelid) can cause retraction of the lower eyelids and an unsightly pull down of the lower eyelid. This also causes exposure of the sclera (the white of the eye) and these changes are telltale signs of improper surgical technique. This can also result from excessive skin removal on the lower eyelid.

To avoid problems associated with lower eyelid malposition and excessive scleral show, Dr. Niamtu frequently treats the excess lower eyelid skin with laser resurfacing. This allows dramatic skin tightening without cutting away skin. No incisions are required. When performing laser resurfacing of the eyelid skin the patient will be red for a week and then pink for another several weeks. Makeup can be used to cover the pinkness until it resolves. For minor to moderate lower eyelid wrinkling, chemical skin peel can be performed and heals in about a week. The results are not quite as dramatic as the laser treatment, but the recovery is faster.

Types of Eyelid Surgery

Upper and Lower Eyelid Surgery

Upper and Lower Eyelid Surgery

upper and lower eyelid surgery
upper and lower eyelid surgery

View More Eyelid Surgery Cases

Festoon Treatment

Festoon Treatment

Festoons are the baggy pouches that some patients develop on the lower eyelids and cheeks. Dr. Niamtu treats many and out of state patients for festoon improvement. He has numerous lasers to take away festoons and years of aging.

Upper and Lower Eyelid Surgery
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Fat that normally cushions the eyeball protrudes and causes bags of the lower eyelids.  This can be a heredity condition and occur early in life.

“Skin Pinch”

“Skin Pinch”


For patients that do not desire laser or chemical peel skin tightening, Dr. Niamtu utilizes a conservative procedure called a “skin pinch”.  This small procedure is done with a mini incision hidden under the eyelashes and can tighten the wrinkles without adversely affecting the normal eyelid position.

View More Eyelid Surgery Cases


lower eyelid rejuvenation and cheek implants done at the same timeSimultaneous rejuvenation of the lower eyelids and the cheeks is a winning combination.

Click here to learn why cheek implants and lower eyelid surgery can double team facial aging.

Learn How

When considering cosmetic eyelid surgery it is important to inform your surgeon of any abnormalities of your eyes, vision, or general eye health. You should also schedule your surgery when you can relax for a week. Eyelid surgery is very safe but complications can occur when patients over exert themselves. When using laser and radiowave techniques like Dr. Niamtu does, patients often feel great shortly after surgery and can have a tendency to over due activities such as sports, gardening, exercise, etc. It is truly important to refrain from strenuous activities that require bending or lifting for a week after surgery to avoid complications. In addition, any drugs that increase bleeding such as aspirin, some vitamins and herbs and some over the counter medications need to be discontinued 2 weeks before surgery. The standard of care is to have minor blood work performed before eyelid surgery to make sure the patent’s clotting system is functioning properly.

The position of the forehead and eyebrows also effects upper facial aging. Endoscopic and mini open brow lifting are newer procedures that are used to address this problem. Brow position should always be considered before undergoing Blepharoplasty. If you consult a cosmetic surgeon for eyelid surgery and they do not mention brow position in the first minute, you should probably see another surgeon!

Dr. Niamtu has performed thousands of cosmetic eyelid procedures and it is one of his favorite procedures. Hundreds of Dr. Niamtu’s before and after pictures can be seen by viewing the before and after galleries.

...Feel and look like a celebrity...
5 out of 5 stars

Dr. Niamtu performed the best Blepharoplasty on my lower eyelids just two and a half months ago. I am so please with the results and I feel lifted both mentally and physically. As an African American woman, we often assume that we don't need cosmetic surgery but in my case, the natural milestones faced in later life had taken a toll on my appearance and dampened my feeling of well-being. Dr. Niamtu conquered all this with prompt, friendly and courteous service and his superior facial art works. During my initial consultation, the high level skill of Dr. Niamtu was apparent as he easily diagnosed and recommended treatment which included blepharoplasty, botox and smile line filers. The beauty of my two best female friends and colleagues (one Philippine and the other African American) are enhanced by Dr. Niamtu's skill as the both were his patience. They shared their immaculate satisfaction with Dr. Niamtu and all the staff. I must say that they all make you feel and look like a celebrity every time.

- Wanda Y


Very, very pleased
5 out of 5 stars

Dr Joe. Many thanks for the before after photos. As both of my daughters remarked, when I sent than photos before I saw than in person, that I was still me, but without all that excess 'baggage' I don't know what they were expecting, and for that matter, neither did I, but I am very, very pleased. Seeing the smiles on their faces 1 month post-op told me all that I needed to know. The care and attention given by you and your staff put me totally at ease, and for that I am most grateful.

- Anonymous


Amazing results!
5 out of 5 stars

Dr. Joe,Amazing results! I had been wearing glasses to hide my bags for years. After having them removed I feel more confident. Now I’m wearing contact lenses and eye makeup for the first time. 🙂 I don’t look tired anymore.You and your staff were wonderful. I couldn’t have asked for a better doctor.

- Kim


Insurance Coverage and Eyelid Surgery

Dr. Niamtu does not participate with insurance plans. He performs purely cosmetic eyelid surgery with attention to sculpting skin, muscle, fat and wrinkles. There can be a big difference between cosmetic eyelid surgery and insurance-covered procedures that simply remove some excess tissue to improve vision.