My goal is to restore your eyelid contours to a natural state in harmony with your other facial features. Each patient’s eyelid anatomy differs, I use a customized facial balancing approach for a rested, relaxed, and refreshed result – one that makes you seem as if you are aging beautifully on your own – without obvious signs of having cosmetic surgery. – Anita Mandal, MD 

Your eyes are the first thing that people notice when they look at you. Because they are also one of the first areas to show signs of aging, many patients seek a plastic surgeon at an earlier age for eyelid surgery compared to a facelift. Beginning your facial rejuvenation journey with an eyelid lift —a procedure that offers a much easier recovery process with less downtime—can be highly rewarding. 

Cosmetic eyelid surgery can not only enhance the appearance of your eyelids through the removal of excess skin and fat caused by aging or genetics, but it can also make your entire face appear more rested and relaxed. Located in Palm Beach Gardens, Dr. Mandal has performed a high volume of eyelid surgery on patients from West Palm Beach, Palm Beach Gardens, and South Florida. Patients often seek out double-board-certified facial plastic surgeons with specialized training in blepharoplasty, such as Dr. Anita Mandal, for optimal results that appear natural.

As an artist and a surgeon, Palm Beach Plastic Surgeon Dr. Anita Mandal takes great care to restore your youthful eyelid contours to appear youthful and, most importantly, natural. Patients travel from all over Florida, across the country, and around the world for Dr. Mandal’s expertise in blepharoplasty. She is an active member of several professional societies, reflecting her commitment to excellence and her use of the most advanced techniques for eyelid rejuvenation. As a facial plastic surgeon with advanced training in facial plastic, cosmetic, and reconstructive surgery. Dr. Mandal is one of the top plastic surgeons for eyelid beautification. She always spends extra time precisely marking incision lines as a crucial step in achieving a rested and refreshed upper face, and avoiding an over-pulled, surprised look from blepharoplasty. Dr. Mandal is one of the few select facial plastic surgeons in the country who perform the majority of her blepharoplasties with straight local anesthesia – without the need for IV sedation – in her office surgical suites, significantly reducing the recovery and risks of surgery. Using her special anesthesia approach, patient have a safe and pain-free experience during their surgery.

What Sets Dr. Mandal Apart as the Premier Blepharoplasty Surgeon in Palm Beach Gardens?

• Dr. Anita Mandal is not only a double Board-Certified facial plastic surgeon but also an artist with over two decades of surgical experience. She has performed thousands of successful facial surgeries on both men and women, combining technical precision with her keen artistic eye.
• Dr. Mandal’s meticulous attention to detail, combined with her conservative approach, ensures natural-looking results that avoid the overly “done” or surprised appearance. 
• Dr. Anita Mandal has been consistently ranked as a Top Doctor in Palm Beach Gardens and South Florida. Year after year, she has been submitted for recognition in Castle Connolly’s Top Doctors for Facial Plastic Surgery and as a recipient of both the Patients’ Choice Award and Compassionate Doctor Recognition, and has been featured in several national publications for her outstanding work in facial cosmetic surgery.
• Dr. Mandal received her Doctor of Medicine (MD) degree from a prestigious U.S. medical school, followed by residency and fellowship training in Facial Plastic and Reconstructive Surgery. She trained under some of the most well-respected facial surgeons in the country and continues to advance her training every year to stay current with the latest surgical innovations.
• Dr. Mandal is regularly invited as faculty to lecture at national and international conferences to share her advanced facial plastic surgery techniques with her colleagues and peers.
• Dr. Mandal is double board-certified by the American Board of Facial Plastic and Reconstructive Surgery(ABFPRS) and the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS). She is also a Fellow of the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS).
• Dr. Mandal performs most blepharoplasty procedures in-office under local anesthesia, minimizing risk, cost, and recovery time. Her patients value the privacy, convenience, and personalized attention of her state-of-the-art surgical suite in Palm Beach Gardens. She utilizes advanced suture techniques so that the incisions are not obviously detectable. Her extra fine micro-surgical instruments minimize trauma, reduce downtime, and maximize results.

Blepharoplasty Quick Facts

• Surgery Time: 45 minutes to 2 hours, depending on whether upper, lower, or both eyelids are treated and the surgical approach 
• Price: starts at $6500 (Exact quote provided during consultation based on complexity and type of blepharoplasty) 
• Recovery: Bruising and swelling typically subside in 5–10 days. Patients can return to non-strenuous activities in 5–7 days.
• Goal of Results: Natural-looking, rested, refreshed, youthful appearance that lasts 7–10+ years. Some results may be lifelong depending on lifestyle and genetics.

Best Candidates for Blepharoplasty

• Loose or excess eyelid skin
• Protruding fat bags of the eyelids
• Low pre-operative risk factors
• Realistic expectations
• Overall good health
• Good skin elasticity
• Eyelid aging that makes you look tired or sad, or angry

Eyelid fullness can be noted as early as one’s 20s and 30s. When present at a young age, it is often due to genetic factors and is characterized by the accumulation of bulging fat. As you age into the ’40s and ’50s, the eyelid skin loses elasticity and becomes lax, crepey, and wrinkled. The fibrous tissue that supports the fat compartments inside the orbit (eye socket) also loosens, causing the orbital fat to protrude and appear as bulges or bags around the eyes. “Eye bags” are common in the inner corner of the upper eyelids, the outer corner of the lower eyelids, and along the central upper and lower eyelids. These changes can give a tired, sad, or angry look to the face. Crow’s feet, or fine lines at the outer corners of the eyes, are another common sign of aging around the eye area. The eyes can even appear smaller, slit-like, or droopy. Ptosis, or drooping upper lids, can also affect vision and may require surgical correction. Since everyone ages differently, heaviness above the eyes can sometimes be due to sagging eyebrows in addition to aging upper eyelids. In these patients, a browlift may be necessary in conjunction with blepharoplasty. 

Eyelid surgery can enhance the eyes and upper face by improving loose skin, puffiness, and excess fat, to restore a more youthful and rested appearance. Dr. Mandal can determine the proper cause of your eyelid fullness and customize treatment to your specific needs.

Male Vs. Female Blepharoplasty

Distinct differences exist between the male and female eyelids. Dr. Mandal’s approach to blepharoplasty takes into account gender differences when performing the procedure. Her goal is to preserve the natural balance between the masculine and feminine appearance of the eyelid.

Female Eyelid

• High-set brows
• Well-defined brow arch
• More visible upper eyelid height
• A deeper upper lid crease
• Thinner eyelid skin

Male Eyelid

• Low-set brows
• Flatter brow arch
• Less visible upper eyelid
• More shallow upper lid crease
• Thicker eyelid skin

*One of the most common mistakes made by many plastic surgeons is to feminize the male upper eyelid. A male upper eyelid retains its more natural, masculine appearance when slightly less skin is removed and more fat padding is left intact. A tight upper eyelid with a deep upper lid crease or a high-arched brow can give a man a more feminine appearance to the eyelids.

On the other hand, because women have thinner eyelid skin, it is essential to sculpt the outer corner of the upper lid, where one can be more aggressive with skin removal to reduce lateral hooding or overhang and minimize the appearance of a sad or droopy outer eyelid. At the same time, too much fat should not be removed in the central part of the upper eyelid to avoid hollowing, which can give the female eyelid a gaunt, more aged look.

Natural, youthful eyelid rejuvenation that respects inherent gender differences is best performed by a Board Certified Facial Plastic Surgeon who specializes in eyelid surgery. Dr. Mandal has an in-depth understanding of male and female surgical eyelid anatomy, a high level of technical expertise, and over 20 years of experience to achieve the desired eyelid rejuvenation for her patients.

Palm Beach Blepharoplasty

Palm Beach eyelid surgery, also known as blepharoplasty, is a surgical procedure in which loose skin, protruding fat, and/or muscle are removed from the upper and/or lower eyelids. Cosmetic eyelid surgery, also known as an eyelid lift or blepharoplasty, involves making small incisions hidden within the natural eyelid creases to remove excess skin, fat, and, in some cases, muscle, resulting in a rejuvenated appearance. 

Dr. Mandal employed several surgical approaches for eyelid lift surgery, tailored to each person’s unique aging and the amount of fat and/or skin to be removed. Only if excess baggy muscle exists, underlying muscles may be tightened or a skinny strip removed to enhance the aesthetic outcome and restore a youthful, firm appearance.

While any surgeon can perform Blepharoplasty using generic techniques, achieving a superior result that appears natural, rested, and refreshed while also minimizing complications and upholding the highest standards of patient safety requires my higher skill level. 

Upper Eyelid Surgery (Upper Blepharoplasty)

The aesthetic goals of upper eyelid surgery are to reduce lid fullness, make the upper lid more visible, and add depth as well as definition to the natural upper eyelid sulcus. The incision is well hidden in your natural upper eyelid crease. Excess skin and bulging fat are then removed. The incision is closed with a very fine suture using special hidden subcuticular stitches, which are taken out in 3 – 5 days. The final result reveals a more youthful, refreshed, and rested appearance.

Lower Eyelid Surgery (Lower Blepharoplasty)

The aesthetic goals of lower eyelid surgery are to smooth out wrinkles, remove excess skin, and reduce fat bags without creating a hollow appearance in the lower eyelid area. Surgery is performed using various methods, the choice of which depends on the degree of skin and/or fat removed. Unlike an upper eyelid lift, modern lower eyelid surgery involves no external skin incision as the eye bags are removed using a transconjunctival approach that more safely maintains the natural support of the lower eyelid. This transconjunctival Blepharoplasty is combined with CO2 laser resurfacing to tighten any loose skin and soften eyelid wrinkles. In rare cases, when a lower eyelid skin incision is still needed, it is hidden just under the lower eyelash line using a subciliary approach.

Pinch Blepharoplasty

This lower eyelid procedure can reduce excess, lax, or wrinkled eyelid skin. It is essential to note that pinch blepharoplasty is not intended to flatten or tighten the lower lid completely. It involves excising a smaller ellipse of lower eyelid skin without entering the fat or deeper muscle layers. Pinch blepharoplasty is a conservative upper or lower eyelid lift in which some, not all, of the laxity and wrinkles of the lid are improved to give modest eyelid tightening. There is less overall disruption to the eyelid tissues, thereby even having less risk than conventional eyelid surgery. The results reveal a more modest, natural improvement. Like all cosmetic procedures, patients must have realistic expectations when considering pinch blepharoplasty.

Standard Lower Lid Blepharoplasty

The standard lower eyelid lift is designed for patients with more significant loose skin and/or bulging fat of the lower eyelids. Compared to a pinch blepharoplasty, a standard blepharoplasty incision is longer, yet still well hidden just under the lower eyelash line. The skin and underlying muscle are elevated together as a flap to access the bulging fat, which is then removed. Excess skin and muscle are also excised. The incision is closed with very fine sutures. The stitches are removed 3 to 5 days later.

Transconjunctival Blepharoplasty

This tranconjunctival lower eyelid lift is the most commonly performed approach and is suitable for patients who primarily have bulging fat with lesser amounts of loose or excess skin. Unlike the skin incisions of a pinch or standard lower lid blepharoplasty, the transconjunctival incision is placed inside the eyelid, well hidden within the conjunctiva. The eyeball itself is protected during surgery. Because the incisions are internally placed, there are no sutures to remove and no externally visible scars in the skin. Eyelid muscle integrity and overall lid support are also better preserved. Transconjunctival blepharoplasty is not only very safe but also allows for fat removal without entering or disrupting the skin, muscle, and fibrous support layer of the lower eyelid. This procedure can effectively reduce eyelid “bags” with less tissue disruption, lower risk, and faster recovery.

Combined Transconjunctival and Pinch Blepharoplasty

Sometimes, transconjunctival lower lid blepharoplasty for fat removal is combined with a pinch blepharoplasty for skin removal of the lower eyelids when excess skin and fat bags are both present. One must be realistic and expect a modest improvement.

Combined Upper and Lower Lid Blepharoplasty

People often experience simultaneous aging in both their upper and lower eyelids. In such cases, both upper and lower lid blepharoplasty is performed at the same time to maintain a balanced appearance to the eyelids and face. 

When Do I Need A Browlift Instead of A Blepharoplasty 

Sometimes, upper lid fullness is due to sagging eyebrows rather than aging upper eyelids. In these situations, our Palm Beach Gardens & West Palm Beach eyelid surgery patients may opt for a brow lift. Upper eyelid fullness can be caused by excess upper eyelid skin and/or fat, sagging eyebrow,s or a combination of both upper eyelid and brow aging. An experienced plastic surgeon with a keen eye and sound judgment will recognize this presentation and may recommend a browlift alone or in combination with an upper eyelid lift. 

How Do I Prepare for My Blepharoplasty?

• Stop smoking at least 3–4 weeks prior to surgery.
• Avoid blood thinners, aspirin, and anti-inflammatory medications. However, if any medication is required by your primary medical doctor, it is important that you have written permission from him/her to go off these medications for a long enough period that your blood clotting ability is normal prior to the date of surgery.
• Avoid any supplements that contain blood-thinning agents for at least 2-3 weeks prior to surgery. 
• Arrange for a friend or family member to drive you home after your procedure. If you cannot obtain a ride, our office can make recommendations for drivers who only transport patients to/from medical offices.
• Fill all prescribed medications and over-the-counter products ahead of time
• Maintain good hydration and follow a healthy diet
• Inform Dr. Mandal of any eye conditions, allergies, or previous facial surgeries. 
• If you have eyes that are dry, watery, or itchy, depending on the severity of your condition, an ophthalmology clearance from your eye doctor may be required prior to surgery.
• If you have certain types of glaucoma or tear duct issues, an ophthalmology clearance from your eye doctor may be required prior to surgery.
• Blood work and other tests may be required prior to surgery and should be done within 30 days of your surgery date. 

Where Are the Incisions Placed?

Prior to surgery, the upper and lower eyelid skin is cleansed with disinfectant and precisely marked with the patient sitting upright, since the eyelid tissues shift position when the patient lies flat for surgery. This key step can avoid an overpulled or unnatural result. The patient is also asked to look in different directions to identify hidden fat pockets, which are removed during surgery to avoid fat protrusions post-operatively. Incisions are hidden in the natural upper eyelid crease or just under the lower eyelid eyelash line and closed with very fine sutures to assure a final appearance of scars that are not readily detectable once healed. 

Sutures are typically removed 3 to 5 days postoperatively. Incisions can be easily camouflaged with makeup until they fade. Dr. Mandal recommends the aggressive use of saline eye drops and non-antibiotic eye ointment postoperatively to keep the eyes well-lubricated until all postoperative swelling subsides, to avoid persistent dry eye symptoms. 

Technical Expertise With An Artistic Eye

Surgical skill, combined with an aesthetic eye, is key to achieving satisfying eyelid results for our Palm Beach eyelid surgery patients. Dr. Mandal gives special attention to specific details for a rested, refreshed, and natural-looking eyelid:

• Placement of incisions in precise locations where the scar is well camouflaged once healed.
• Preoperatively marking eyelid incisions with the patient in a sitting position to assure removal of very accurate amounts of skin to avoid a “surprised” look and eyelid closure problems.
• Use of very fine sutures with advanced suturing technique to enable more rapid healing of incisions and undetectable scars. 
• Use of local anesthesia, whenever possible, to reduce recovery and overall risk.
• Attention to lateral hooding of the upper eyelid to improve sad or droopy outer eyelids. Most surgeons fail to extend the upper lid incision properly to give the proper lift of this area. 
• Careful removal of only the necessary amounts of fat to prevent a hollowed appearance to the eyelid
• Identification of hidden fat pockets to avoid persistently visible fat pockets after surgery
• Recognizing when a brow-lift, upper eyelid, or combination brow/eyelid lift is needed. 
• Advising additional procedures for an overall balanced facial appearance

Pre-operative Risk Factors

While our Palm Beach blepharoplasty procedure is very safe, certain pre-operative conditions may increase the risks from blepharoplasty, including the potential for complications:

• Frequent or regular dry, irritated, or watery eyes
• A lower eyelid that does not have adequate tissue support and fails the lid retraction and snap-back tests 
• Excess scleral show (the white area of the eyeball between the lower lid and the pupil edge is much more visible than average)
• Bulging or protruding eyeballs (proptosis or exophthalmos)
• Certain types of glaucoma
• Exophthalmos or protruding eyeballs 
• Eyelid ptosis caused by muscle or nerve dysfunction instead of excess soft tissues 
• Smoking
• Poor health status 

Depending on the situation, your surgeon may recommend clearance from an ophthalmologist with a more detailed eye assessment prior to proceeding with surgery. An Ophthalmologist can help identify risk factors, assess for potential complications, and check visual field and dry eye testing. These risk factors are not necessarily absolute contraindications to blepharoplasty, but they should be taken into consideration in making a decision on whether to proceed and which approach to use for a safe and optimal outcome. A personalized consultation with Dr. Mandal can provide you with a thorough understanding of whether you are a candidate for blepharoplasty and what it can achieve for you. Dr. Mandal tailors the choice of eyelid and brow procedure to your lifestyle and individual needs.

Downtime & Recovery

Eyelid surgery, also known as blepharoplasty, performed by Dr. Mandal in Palm Beach Gardens, is an outpatient procedure. After surgery, patients are discharged to the comfort of their own homes. There are no postsurgical dressings. Because the eyelid skin is thin, bruising and swelling are to be expected, but typically minimal after one week and concealable with makeup. Your healing can be expedited with the application of naturally-derived topical healing factors intra-operatively.

Post-operative instructions are customized to each patient but include: 

• Head of the bed elevation
• Application of ice for 48 hours
• Booking several manual lymphatic massage treatments
• Aggressive application of saline eye drops and eye-lubricating gel

Bruising and swelling do not correlate with pain, as most patients experience minimal discomfort after eyelid surgery. While prescription pain medication is given, most patients switch to plain Tylenol or stop all pain medications within 1-2 days after surgery. Sutures are removed between 3 and 5 days postoperatively. Depending on the surgical approach, most patients feel comfortable being seen in public after one week. Most non-strenuous daily activities can also be resumed at this time. Straining, lifting, and exertional activity should be avoided for several weeks. Once healed, a more refreshed, youthful eyelid contour that can take 5-15 years off your face is revealed.

8 Tips for Recovery

1. Use cold compresses for the first 48 hours to minimize swelling

2. Elevate your head while sleeping to reduce fluid buildup

3. Apply saline drops and lubricating ointment as directed

4. Avoid bending, lifting, or strenuous activity for at least 2 weeks

5. Do not rub your eyes

6. Wear sunglasses when outside to protect sensitive eyelid skin

7. Follow up with all post-op visits for proper healing assessment

8. Avoid makeup on incisions for 7–10 days or until cleared by Dr. Mandal

Anesthesia

Dr. Mandal performs most of her upper and lower eyelid surgery under local anesthesia in her Palm Gardens surgical suite. Using advanced local anesthetic techniques, the patient remains awake throughout the entire procedure but experiences no pain. Oral sedatives are prescribed prior to surgery to help relieve anxiety if needed. Alternatively, blepharoplasty can be performed with intravenous sedation, also known as “twilight sleep”; general anesthesia is reserved for special situations. The use of local anesthesia not only reduces patient risk and downtime but is also more cost-effective.

Types of Anesthesia

• Local anesthesia – lowest risk, quickest recovery, shortest operating room time
• Twilight sleep or IV sedation
• General anesthesia

Additional Procedures

Additional procedures commonly performed to complement or enhance the results of blepharoplasty include:

• BOTOX® Cosmetic, Dysport®, Jeuveau™, Daxxify and Xeomin® for frown lines between the brows, laugh lines or crows feet around the eyes, wrinkle bunching under the eyes as well as forehead lines
• Laser resurfacing or chemical peels for fine lines around the eyes and slight skin tightening.
• Injectable fillers, such as Restylane®, nanofat, or Derma-PRP gel, to restore volume tothe  tear trough or lower lid under and help improve dark circles.
• Sculptra®, Radiesse®, Restylane®, Juvéderm®, RHA® Collection, or Bellafill® for temple depressions to make the eyes appear less narrow and more awake
• Genius™ RF /Infini™ RF, Ellacor dermal micro-coring, or Everesse for a non-surgical Brow Lift to improve upper eyelid fullness due to heavy eyebrows
• Surgical Brow or Forehead Lift to improve upper eyelid fullness caused by sagging brows rather than excess eyelid skin.

Frequently Asked Questions

Book Your Eyelid Surgery(Blepharoplasty) Consultation Today

As a Board-Certified Facial Plastic Surgeon, Dr. Mandal focuses on achieving results that are very natural-looking. When it comes to the face, patients prefer quality and excellence over price. They seek her skills from throughout Palm Beach County, across Florida, and from a range of national and international locations. To explore your options, schedule a consultation online or call us at 561-238-0040 from our Palm Beach Gardens office.