Blepharoplasty Surgery

Eyelid surgery is also known as a blepharoplasty, which can be performed on the upper eyelids, the lower eyelids, or both. The primary reason to perform upper eyelid surgery in Portland, Oregon is to rejuvenate the upper eyelids that is extra skin creating the hooded and tired look on the upper eyelids. The primary reason to perform lower eyelid surgery is to remove the excess fat bags creating the puffy look in the lower lids. An eyelid lift can accomplish rejuvenating the upper and lower lids for a refreshed and rejuvenated eyelid appearance.
Dr William Portuese is a Board Certified Facial Plastic Surgeon who performs upper and lower blepharoplasty, also known as eyelid surgery. A Portland, Oregon eyelid surgery procedure can improve the tired eyelid appearance and rejuvenate the upper and lower eyelids.

What is eyelid surgery?

Upper eyelid blepharoplasty procedure involves removing excess skin and fat from the upper lids. This procedure can be done for cosmetic purposes, or for functional vision purposes. The incision is located directly in the upper lid crease, and the eyelid lift procedure accomplishes re-freshening and rejuvenating the upper eyelids. Dissolvable sutures are placed in the upper eyelid crease and they fall out at approximately 7-10 days.
A Lower eyelid blepharoplasty procedure involves removal of fat bags in the lower lids through a trans-conjunctival approach located on the inside of the lower lids. There are 3 compartments of fat in the lower lids that partially removed to improve the lower lid aesthetics. If there is excess skin in the lower lids after the fat removal, then an external incision is made directly below the eyelash line and a pinch of skin is then removed. This incision is closed with Histocryl tissue glue. No sutures or stitches are used on the lower lids.

What eyelid surgery can treat.

Removal of the loose and inelastic skin and the fat bags on the inner corner of the upper eyelids is performed. Removal of the eye bags on the lower lids is performed in addition to skin tightening when needed. The excess skin in the lower lids is treated with a pinch technique.

Who is a good candidate for eyelid surgery?

Patients need to be in excellent health with no significant medical problems to be able to undergo local or general anesthesia for elective cosmetic eyelid surgery. Significant visual loss or hooding of the upper lids, and significant puffiness in the lower lids make patients a candidate for a cosmetic blepharoplasty procedure.

Where is the surgery performed?

In our practice, consultations and postoperative follow-up appointments can be performed in our Portland, Oregon office. All of the Eyelid surgery itself is performed in the Seattle office. The Seattle office contains our Medicare Certified and Washington State Licensed Ambulatory Surgery Center on the premises.

What type of anesthesia is used for an eyelid lift/eyelid surgery?

An upper blepharoplasty procedure can be performed under local anesthesia with patients wide awake, or under general anesthesia while patients are completely asleep. All lower eyelid surgery is performed under general anesthesia for patient safety and comfort. Most patients undergo the procedure under general anesthesia. Board certified physician anesthesiologists perform the general anesthesia and are in attendance during the entire surgical procedure.

What is recovery like after eyelid surgery/Blepharoplasty?

The lower eyelids tend to bruise more than upper eyelid surgery due to anatomy and gravity, however anticipate 2 weeks of visible bruising and swelling after any type of blepharoplasty or eyelid lift. Makeup can be applied after the dissolvable sutures and glue have fallen off.

What eyelid surgery will NOT do:

An eyelid lift or blepharoplasty accomplishes rejuvenating both upper and lower lids. It will NOT get rid of crow’s feet, dark discoloration of the skin, or eliminate fine lines from the upper or lower lids

How long does eyelid surgery last?

Properly performed upper and lower eyelid-lift surgery can last 10-15 years. It is important to have realistic expectations, and be an excellent health when undergoing elective eyelid cosmetic surgery. It is also best to be a non-smoker. Genetics, the aging process, and sun exposure will all determine the aging process around the eyelids.

How to prepare for upcoming eyelid surgery.

  • 1. Once patients have made the decision to undergo blepharoplasty, it is important to stop taking any aspirin, ibuprofen, vitamin E, and all herbal supplements for 2 weeks. This will allow optimal healing and minimize bruising.
  • 2. The day of the surgery, it’s important to have someone be responsible for driving the patient home after the anesthetic
  • Minimize any physical activity and exercise for 2 weeks after the surgery. Most patients refrain from going back to work for 2 weeks.
  • Minimize any physical activity and exercise for 2 weeks after the surgery. Most patients refrain from going back to work for 2 weeks.
  • 4. Fill all prescriptions for eyedrops and pain medication ahead of time prior to the surgery. We do not recommend ice packs placed across the eyelids however cool compresses may be helpful.
  • 5. Patients will receive a preoperative consultation 2-3 weeks before the upcoming surgery to go over pre-and postoperative instructions with one of our nurses

When does insurance cover upper eyelid surgery?

When patients have significant visual loss and severe hooding of the upper eyelids which is impairing vision and daily activities, medical insurance may participate in payment for an upper blepharoplasty procedure. Medical necessity must be documented which includes a full set of facial photographs, especially of the eyelids, the reflex distance measured at the doctor’s office which also includes the physical exam, and visual field obstruction test performed at an ophthalmologist’s office. All of that information is submitted to medical insurance for pre-authorization. Anticipate co-pays and deductibles associated with your medical insurance plan. For a list of insurance plans that our office participates in, please contact the office

What is the cost of upper and lower eyelid surgery?

The cost of Eyelid lift surgery is dependent upon 3 fees which include the operating room charges, time monitored under general anesthesia by an anesthesiologist and the surgeon’s fee for performing the procedure in addition to all the post-operative follow-up appointments. Our current price list is located on this website

Why should you choose Dr. William Portuese to perform your eyelid surgery/eyelid lift?

Dr. Portuese has extensive experience performing eyelid surgery for over 30 years. He is a Board Certified Facial Plastic Surgeon, and a Clinical Instructor in the Department of Otolaryngology, Head and Neck Surgery at the University of Washington. In addition, he is also a clinical instructor in the Department of Surgery, Division of Plastic Surgery at the University of Washington. He has been top doctor on Realself.com for many years. In addition, he received the Medical Leader of the year Award in 2008 and 2012 from the Washington Ambulatory Surgery Center Association.


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