Subtle surgical artistry for a refreshed, refined appearance.
The aesthetic goal of surgery in the eye area is to transform a sad or tired appearance into an open and friendly look. As the eyes convey not only attention but emotion as well, a careful analysis is important. With any surgery of the eyelids, the artistic goals should consider the overall appearance of the position and shape of the eyelids and their relationship to the eyebrows. Dr. Edward Szachowicz performs upper and lower blepharoplasty, often called eyelid surgery, to help his Minneapolis-St. Paul patients look naturally refreshed and more youthful.
This is a 68 y/o woman who has skin excess in the upper eyelid region, which is weighing down her eyelids. She also has fatty protrusions under the eyes, giving her the appearance of dark circles. She has crepey texture to the eyelid skin which is a common finding associated with aging, sun exposure, and a decrease in collagen thickness.
Her images show the results of an upper blepharoplasty with removal of the excess of skin and a lower blepharoplasty with orbital fat re-positioning to soften the dark circles and relieve the bulging of the fat. After the surgery, she has Fraxel CO2 laser skin resurfacing of the upper/lower eye region (peri-orbital region) to treat the age-related changes to the thin eyelid skin.
Her result shows the eyebrow elevation from Botox, and her eye appear more open as the weight of the extra upper eyelid skin was removed. The lower eyelid fat re-positioning brings a softness to the under-eye region and no hollowing. The CO2 laser skin resurfacing around the eyes improves the skin quality and crepiness.
Dr. Szachowicz performs eyelid surgery at his Edina, MN, plastic surgery practice for Twin Cities women and men who want to address any of the following concerns:
When planning the procedure, Dr. Szachowicz considers a variety of factors including:
Asymmetry is common with the eyes and the eyebrows. It’s important to understand that some measure of asymmetry will remain after surgery. Most people are surprised to realize how the position of the eyebrows influences the amount of excess skin in the upper eyelid — the more the brow sags, the more excess skin accumulates around the upper eyelid. Many times, surgery on the upper eyelids and a brow lift (forehead lift) are performed at the same time for optimal results.
See real results from Dr. Szachowicz’s skilled artistry. Our gallery showcases natural-looking facelifts and complementary facial rejuvenation procedures—refined enhancements that restore harmony, definition, and confidence.
Every result reflects a personalized approach—shaped by your unique features and goals. Expect refreshed contours, smoother skin, and subtle improvements that look like you—just more rested and refined.
Upper eyelid surgery begins with marking the incision in the crease of the upper eyelid with the patient sitting in an upright position. Any protrusions of fat are outlined at this time as well.
The trans-blepharoplasty direct brow lift is a newer approach Dr. Szachowicz uses to elevate the outer eyebrow at the same time as the upper eyelid lift. This combination gives optimal rejuvenation to the eye area with the advantage of only one incision in the eyelid.
The incision in the upper eyelid is in the crease, the same as it usually is in surgery on the upper eyelid, and the procedure then includes a release of the eyebrow at the bony ridge above the eye. The eyebrow is elevated into the desired position and is then anchored in place to the brow bone with a bio-absorbable fixating device called an Endotine®. With the eyebrow now in a more youthful position, and the hooding removed by elevating the outer portion of the eyebrow, only the true excess of skin in the upper eyelid is removed. The incision in the crease of the eyelid is then closed normally using fine sutures.
The small Endotine implant holds the raised eyebrow in the desired position until healing is complete, and is then absorbed naturally by the body. This procedure is warmly accepted by people who already feel that they have too much skin on the upper eyelid and want a more complete rejuvenation of the eye area than just a routine blepharoplasty can offer. Recovery is similar to surgery on the eyelid alone.
This procedure is an excellent option for those with a high forehead or thinning of scalp hair, and it is preferred for the earliest signs of relaxation of the brow.
This is a 52 y/o woman who has “tired eyes.” Her eyebrows have lowered, and there is excess skin in the upper eyelid region with signs of ‘hooding’ on the outer corners of her eyes. The fatty pads of her lower eyelids are bulging.
Dr. Szachowicz performed a browlift, followed by an upper blepharoplasty to remove the skin excess of her upper eyelids and a lower blepharoplasty through a behind the eyelid incision and re-positioned the fat to soften the dark circles. Notive how she appears ‘brighter” and her whole upper face is more rejuvenated.
Dr. Szachowicz will make an individual assessment of the condition of the lower eyelid skin, the tone of the eyelid, and the fatty protrusions in the lower eyelid. If there is no excess skin, and there is good tone in the lower eyelid, then a “hidden incision” or transconjunctival blepharoplasty may be the best option. Dr. Szachowicz believes in preserving the fat around the eye, and chooses to reposition the fatty bulges into a smooth layer that softens the bony rim and gives a full, youthful result. This is the most common approach for rejuvenation of the lower eyelid. Most procedures on the lower eyelid look their best when combined with elevation of the cheek with a facelift procedure.
Transconjunctival surgery on the lower eyelids:
If any excess skin is present, a small “pinch excision” of skin is done along the margin of the eyelash. Any creped appearance of skin of the lower eyelid is best treated using Fraxel® laser resurfacing to thicken the thin, delicate skin of the eyelid.
This is a 43 y/o woman with a very common problem where the fat of the lower eyelid bulges forward, causing what appear to be dark circles. This condition called, pseudo-herniation of the orbital fat, is often an inherited trait that can be seen within your family tree.
This was treated with an incision behind the eyelids, and the fat bulging into the lower eyelid was re-positioned to make a smooth transition into the cheek. This technique does not result in a hollow eye after surgery.
If the lower eyelid has lost tone, tightening the muscle of the lower eyelid may help to re-suspend the eyelid. With this approach the excess fat is removed, and the muscle of the eyelid is tightened to support the eyelid.
This proceeds as follows:
Surgery on the upper and lower eyelids does require that you do no heavy lifting or strenuous activity for 1 to 2 weeks after the surgery to minimize the risk of bleeding around the eye. Swelling usually diminishes at 1 week. Residual bruising then fades thereafter. Dr. Szachowicz uses homeopathic arnica montana pellets and gel after surgery to accelerate healing. Fraxel laser resurfacing of the skin of the eyelid is usually planned any time after 6 weeks of healing.
Most people have no complications after eyelid surgery. Major risks such as visual loss are extremely rare. Infrequently, the shape of the eyelid or its position may change, and some fatty protrusions may re-occur. Dr. Szachowicz, an experienced facial plastic surgeon, will discuss the benefits and risks of surgery on the eyelid during your consultation.
“Dr. Szachowicz is a master at his craft. I would highly recommend him to everyone. I have been seeing Dr Szachowicz for over 5 years and I couldnt’ be happier with my treatments and results. He is extremely brilliant, knowledgeable, and honest. I have recommended him to many friends and will not go to anyone else. ”
“I feel so great about myself.
“Your aesthetic eye, attention to detail, overwhelming kindness and generosity are very much appreciated. Now, when I look in the mirror, I feel so great about myself. I realize how fortunate I am to have someone as wonderful as you to give me such a precious gift!””
“Thank you for being there to help me on my journey. Thank you for being such a professional. Thank you for helping me have nicer skin again. Thank you for being a kind and caring person who came through with flying colors. Thank you for being the person I always have thought you were. Thank you for being there to help me on my journey.”
“Dr. Szachowicz is a master at his craft. I would highly recommend him to everyone. I have been seeing Dr Szachowicz for over 5 years and I couldnt’ be happier with my treatments and results. He is extremely brilliant, knowledgeable, and honest. I have recommended him to many friends and will not go to anyone else. ”
