By Dr. Alexey Markelov
Few features betray age or fatigue as immediately as the eyes. Drooping upper lids and under-eye fullness tend to accumulate gradually, often driven by genetics as much as aging itself. Once these changes begin limiting peripheral vision or skincare stops making a visible difference, surgery often provides the most durable correction.
Dr. Alexey Markelov, a double board-certified plastic surgeon at AM Plastic Surgery in Tampa, brings more than a decade of facial surgery experience and hundreds of completed blepharoplasty procedures to every consultation. This blog walks through the full process, from candidacy and surgical technique to recovery and long-term results.
What Blepharoplasty Can Address
Blepharoplasty encompasses a range of procedures targeting specific structural changes around the eyes. It may involve the upper lids, lower lids, or both, depending on what each patient's anatomy requires. Common concerns include:
- Drooping or hooded upper eyelids that create a heavy, tired appearance
- Excess upper lid skin that partially obstructs peripheral vision
- Puffiness and fat protrusion beneath the eyes
- Loose or crepey skin along the lower lids
- A persistent fatigued look that does not respond to rest or skincare
The objective is proportional, natural-looking correction. Dr. Markelov customizes every surgical plan after a thorough anatomical evaluation, with proportion and refinement as the guiding standard.
Upper vs. Lower: How the Techniques Differ
Upper eyelid surgery begins with precise markings placed in the natural crease; measurements are taken while the patient is upright to account for how gravity affects tissue position. The incision follows this crease, allowing Dr. Markelov to remove redundant skin, conservatively adjust or reposition fat, and refine the underlying muscle when indicated. Because the scar heals within the natural fold, it becomes virtually imperceptible. Upper eyelid recovery typically runs seven to ten days.
Lower eyelid surgery is technically more nuanced. When skin tone is adequate but fat pads are prominent, the transconjunctival approach places the incision inside the lower lid, leaving no visible external scar. When skin laxity is also a factor, a fine incision just below the lash line allows for tissue removal alongside fat adjustment. In both approaches, Dr. Markelov repositions fat conservatively, preserving volume to avoid a hollowed contour. Recovery for lower blepharoplasty tends to run ten to fourteen days.
Many patients address both areas in the same session for a more complete result with a single recovery period.
What Happens the Day of Surgery
Anesthesia is confirmed during the pre-operative consultation based on the scope of the procedure. Upper blepharoplasty alone is often performed under local anesthesia with light sedation; most patients remain comfortable throughout without requiring general anesthesia. Combined upper and lower surgery may call for twilight anesthesia. The procedure itself takes one to two hours. Before discharge, antibiotic ointment is applied to the incision sites, and patients leave with detailed post-operative instructions and any necessary prescriptions.
The Recovery Timeline
Swelling and bruising peak in the first 48 hours, then begin to resolve steadily. Cold compresses, head elevation, and antibiotic ointment are standard during this phase. Non-dissolvable sutures, when used, are typically removed between days five and seven. By week two, most visible bruising has faded and many patients feel ready to return to work or social activities. Low-level residual swelling can persist for several additional weeks.
By the three-month mark, the final contour has typically settled. Eyelids look smooth, rested, and well-defined, with minimal to no visible scarring. Results from blepharoplasty often last 10 to 15 years; genetics, sun exposure, and overall skin health all play a role in how long results hold.
Precision Meets Artistry with Dr. Alexey Markelov
From the consultation room to the final result, blepharoplasty rewards careful planning and a surgeon who understands that small decisions in the operating room shape lasting results. Dr. Markelov completed his plastic surgery training at the University of Pittsburgh Medical Center, one of the country's top-ranked programs, and his general surgery training at Drexel University College of Medicine. His double board certification and years of dedicated facial surgery practice reflect the preparation this procedure demands. To learn more about eyelid surgery at AM Plastic Surgery, schedule a consultation today.