Upper & lower eyelid surgery performed by Dr. Robert Feinfield
Blepharoplasty — commonly called an eyelid lift — addresses drooping upper eyelids, under-eye bags, and excess eyelid skin that can impair both vision and appearance. At Berg-Feinfield, this procedure is performed by a physician who operates in and around the eye every day.
Blepharoplasty is a surgical procedure that removes or repositions excess skin, muscle, and fat from the eyelids. It can be performed on the upper eyelids, lower eyelids, or both — depending on each patient’s anatomy, concerns, and goals.
Upper blepharoplasty corrects heavy, hooded, or drooping upper eyelids caused by excess skin that accumulates with age. In many patients, this excess skin obstructs the superior visual field — a medical condition rather than purely a cosmetic one. Lower blepharoplasty addresses puffiness, bags, and loose skin beneath the eyes that create a chronically fatigued appearance regardless of how much sleep you get.
Because the eyelids are among the most delicate structures in the human body — and because the eye itself is immediately behind them — blepharoplasty demands surgical precision that comes from true familiarity with ocular anatomy. At Berg-Feinfield, Dr. Robert Feinfield brings decades of surgical experience operating in and around the eye to every blepharoplasty procedure.
Removes excess skin and, in some cases, herniated fat from the upper eyelid. Incision is hidden within the natural eyelid crease.
Addresses hooding, heaviness, and visual obstruction. Can be medically necessary when skin impairs peripheral vision. Scar heals within the eyelid fold and is effectively invisible.
Addresses under-eye bags caused by herniated fat, loose skin, or muscle laxity beneath the eyes.
Can be performed via external incision (just below the lash line) or transconjunctival incision (inside the eyelid, no external scar) depending on the degree of skin excess and anatomy.
Upper blepharoplasty occupies a unique position in medicine — it can be both a medically necessary procedure and a cosmetic one, depending on your degree of eyelid ptosis and visual field impairment. Understanding which category applies to you is the first step.
When excess upper eyelid skin droops low enough to obstruct the superior visual field, it becomes a functional impairment — not just a cosmetic concern. Patients describe difficulty seeing overhead objects, the need to raise their eyebrows constantly to see clearly, and fatigue from the effort of holding heavy lids open.
Functional blepharoplasty is documented with visual field testing that demonstrates the obstruction, and the degree of improvement with the eyelids manually elevated. When criteria are met, this may be covered by medical insurance.
Even when eyelid skin hasn’t crossed into functional impairment, many patients choose blepharoplasty to address the tired, aged, or heavy-lidded appearance that excess eyelid skin creates. The goal is a refreshed, alert appearance — without looking surgically altered.
Lower blepharoplasty is almost always cosmetic — addressing under-eye bags, hollowing, and skin excess beneath the eyes that make patients look perpetually fatigued. Both upper and lower cosmetic blepharoplasty are performed by Dr. Feinfield at Berg-Feinfield.
Upper blepharoplasty may be covered by medical insurance when it is medically necessary — specifically, when excess skin obstructs the superior visual field on visual field testing. Dr. Feinfield’s team will document your examination findings and assist with prior authorization. Lower blepharoplasty is generally classified as cosmetic and is not covered by insurance. We will clarify coverage before scheduling any procedure.
You may be a good candidate for upper blepharoplasty if you:
You may be a good candidate for lower blepharoplasty if you:
Often combined: Upper and lower blepharoplasty are frequently performed together at the same surgical session. Dr. Feinfield will recommend the most appropriate combination at your consultation.
Schedule a consultation →Dr. Feinfield examines your eyelids, assesses skin excess, fat herniation, and levator function. Visual field testing may be performed if a functional component is suspected. Photos are taken. He will outline a specific surgical plan and expected outcome for your anatomy.
You will receive specific instructions regarding medications to avoid before surgery (aspirin, NSAIDs, certain supplements), fasting requirements, and what to arrange for transportation and recovery at home. Most patients discontinue blood thinners 1-2 weeks prior.
Blepharoplasty is performed under local anesthesia with optional oral sedation. Upper blepharoplasty typically takes 45–60 minutes. Lower blepharoplasty or combined procedures take 1–2 hours. You go home the same day. Someone must drive you home.
Cold compresses and head elevation for the first 48 hours significantly reduce swelling. You will be seen the following day. Sutures are typically removed at 5–7 days. Most patients are comfortable and presentable within 10–14 days.
Residual swelling resolves gradually over 4–6 weeks. Incision lines continue to fade for several months. Final results are natural-looking, long-lasting, and in most cases permanent — though natural aging continues after surgery.
Blepharoplasty is not merely a cosmetic surgery — it is an eyelid surgery, performed millimeters from the globe of the eye. The anatomical precision it demands is precisely the kind of precision that ophthalmologists bring to the operating room every day.
Dr. Robert Feinfield, co-founder of Berg-Feinfield Vision Correction, has been performing surgery in and around the eye for decades. His background in ophthalmology — a specialty built on the meticulous, high-magnification surgery that the eye demands — gives him a depth of anatomical familiarity with the eyelid that is the foundation of safe, effective blepharoplasty.
Whether the procedure is a straightforward upper blepharoplasty for functional visual field obstruction, a combined upper and lower procedure for comprehensive rejuvenation, or a lower transconjunctival approach to address under-eye fat without an external incision, Dr. Feinfield approaches each case with the same surgical precision he brings to the rest of his practice.
The eyelid is the most complex and delicate structure adjacent to the eye. An ophthalmologist who operates on the eye itself — performing cataract surgery, laser procedures, and other ocular surgery at high magnification — brings an unmatched familiarity with the anatomy of the periorbital region. The margin for error in eyelid surgery is measured in fractions of a millimeter. That context is exactly what a physician who works at that scale every day provides.
Blepharoplasty done well looks natural — as if you’re well-rested, not as if you’ve had surgery. The goal is never an operated appearance, but a refreshed one.Dr. Robert Feinfield, MD — Co-Founder, Berg-Feinfield Vision Correction
Results shown are from an actual Berg-Feinfield patient. Individual outcomes vary based on anatomy, age, skin quality, and the specific procedure performed. Dr. Feinfield will discuss realistic expectations for your individual case at your consultation.
Individual results may vary. Photos represent actual patient outcomes and are used with permission.
Dr. Feinfield sees blepharoplasty consultation patients across all Berg-Feinfield locations. Call to confirm surgical scheduling at your preferred office.
Berg-Feinfield provides blepharoplasty consultations and surgery to patients throughout Los Angeles County. Communities served include Burbank, Glendale, Sherman Oaks, Encino, Studio City, North Hollywood, Van Nuys, Tarzana, Beverly Hills, West Hollywood, Bel Air, Brentwood, Santa Monica, Culver City, Arcadia, Pasadena, Monrovia, Temple City, Valencia, Stevenson Ranch, Santa Clarita, and surrounding communities throughout the greater Los Angeles metropolitan area.
Blepharoplasty addresses excess skin, fat, and tissue of the eyelids themselves. A brow lift addresses drooping of the eyebrow, which can pull upper eyelid skin downward as a secondary effect. In some patients, what appears to be upper eyelid excess is actually caused — or worsened — by brow ptosis. Dr. Feinfield evaluates the position of the brow relative to the orbital rim and eyelid to determine whether blepharoplasty, a brow lift, or both are the appropriate solution. Treating the wrong structure produces suboptimal results.
Upper blepharoplasty incisions are placed within the natural eyelid crease, which hides them remarkably well — the scar is effectively invisible to most observers once healed. Lower blepharoplasty performed via a transconjunctival approach (inside the eyelid) leaves no external scar at all. External lower blepharoplasty incisions are placed just below the lash line and fade significantly over 3–6 months. Proper surgical technique and adherence to post-operative wound care instructions produce the best possible cosmetic outcome of the incision lines.
Yes — and for many patients, a combination approach produces the most natural and comprehensive result. Blepharoplasty addresses structural excess of the eyelid itself. Botox addresses dynamic wrinkles — crow’s feet, forehead lines, and brow position. Dermal fillers can address hollowing in the tear trough region that blepharoplasty alone doesn’t correct. Dr. Feinfield evaluates each patient’s full periorbital anatomy at the consultation and recommends the combination most appropriate for their goals. Berg-Feinfield also offers Botox and dermal fillers through the Facial Aesthetics program.
Blepharoplasty results are long-lasting — for most patients, upper blepharoplasty results last 10–15 years or longer before any additional skin excess requires attention. Lower blepharoplasty addressing herniated fat is often permanent, as the fat compartments do not regenerate. However, natural aging continues after surgery — skin elasticity continues to diminish and soft tissue continues to change over decades. Some patients choose a touch-up procedure many years later. Sun protection and general skin care help maintain results.
The procedure is performed under local anesthesia — the operative area is thoroughly numbed before any incisions are made, so the procedure itself is not painful. Patients may feel mild pressure or movement but not pain. The immediate post-operative period involves swelling, tightness, and mild discomfort that is typically managed well with over-the-counter pain medication. Most patients describe the recovery as uncomfortable rather than painful. The eyelids are surprisingly forgiving — they heal quickly and with less post-operative pain than many other surgical areas.
Yes — they are different procedures, though they are sometimes confused or combined. Blepharoplasty removes excess skin and fat from the eyelid. Ptosis repair (levator advancement or other techniques) addresses drooping of the upper eyelid caused by weakness or stretching of the levator muscle — the muscle that lifts the eyelid. A patient can have eyelid ptosis without significant skin excess, or skin excess without true ptosis, or both simultaneously. Dr. Feinfield evaluates levator function at every consultation and recommends the appropriate procedure — blepharoplasty, ptosis repair, or both — based on the specific anatomy he finds.
Whether you’re concerned about functional vision impairment from heavy upper lids or simply want to look as alert as you feel, a consultation with Dr. Feinfield will give you a clear picture of your options and what to expect.
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