Your eyes are the main focal point of your face. Make them really shine with our eye rejuvenation techniques. Dr. Picerno and Dr. Cote have been providing blepharoplasty procedures and eye rejuvenation techniques to patients in the Denver area for years, and they are experts in this procedure.

Look younger and reenergized, and feel more confident in your appearance. Blepharoplasty or eye rejuvenation refers to surgery of the upper and lower eyelids and can be used to rejuvenate the laxity (droopiness and puffiness) due to the aging process and sun damage.

Your eyes are very sensitive, and any facial surgery is a complex matter. At FacesFirst, we always take a careful approach to surgery of your eyes, understanding they are delicate structures. Dr. Picerno or Dr. Cote will review your medical history and have you obtain a complete eye exam before proceeding with any surgery. We take the utmost responsibility in offering careful pre-operative planning and close follow-up after surgery to ensure that you feel confident in your treatment, our team, and your results. Call us today at 303.744.2300 with any questions!

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from our patients

Dr Picerno is amazing and I adore her!
-Ciana Wallace

I absolutely love this place! I have been going for years (oh wait did I just date myself, lol) From the moment you walk in to leaving you feel great! The staff and even the patients in the waiting room are friendly and awesome! 🙌🏼

-Melissa Gray

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What is Blepharoplasty?

Blepharoplasty is also known as “eyelid surgery” or an eyelid lift. The procedure is designed to reduce puffiness, sagging skin or folds, drooping eyelid skin, or wrinkles in the eyelid. An eyelid surgery candidate may choose to have an upper blepharoplasty, lower blepharoplasty, or a combination of upper and lower blepharoplasty depending on their preferences and needs. This is typically an outpatient surgery performed under local anesthesia. During a consultation for eyelid surgery in Denver, your plastic surgeon will make a recommendation regarding which techniques will best meet your goal results for rejuvenated eyelids and an overall more awake, alert, and youthful appearance.

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Eyelid Surgery at FacesFirst


3 Things to Know Before Undergoing Eyelid Rejuvenation


Upper Blepharoplasty

Upper blepharoplasty, or upper eyelid surgery, is a plastic surgery procedure that addresses the excess eyelid skin and muscle that is hanging low on the upper eyelids. This excess skin may be sitting on the eyelashes and causing you to unconsciously raise your eyebrows, leading to forehead wrinkles. It may also be “hooding” on the sides of your eyes, contributing to deeper shadows. Sometimes there is so much excess upper eyelid skin that it may be blocking your peripheral vision. Makeup doesn’t stay where you place it and ends up migrating onto the eyebrow skin in an unappealing fashion. Don’t suffer through these symptoms. Consider a blepharoplasty.

Upper blepharoplasty surgery can be performed safely at FacesFirst, with offices in Denver and Lone Tree, Colorado. You will be under local anesthesia and only a thin incision will be made, which is hidden in the natural crease at the top of the upper lids. Plus, there can be minimal downtime of less than a week. You will need a complete eye exam before your procedure.

Lower Blepharoplasty

Lower blepharoplasty is the term for lower eyelid surgery that addresses laxity and volume changes to the lower eyelid. Like upper blepharoplasty, lower eyelid blepharoplasty is often complemented by skin treatments with peels and volume treatments, such as fillers and fat transfers, to give you the best results possible. Like the upper lid, the lower eyelid is a complex structure that protects your eyes and is highly susceptible to the aging process. There are a number of aging changes that begin in your twenties and thirties that can affect the lower eyelid region. Avoid looking tired and weary through a multitude of approaches that can help you to achieve youthful, natural-looking results.

Lower blepharoplasty can be done in many ways depending on a physical exam. Transconjunctival blepharoplasty is performed with a hidden incision on the inside of the lower lids. This procedure is good for patients with good skin and muscle tone who have the appearance of “bags” under the eyes. This is deep eye fat that is revealed when you start losing the fat under your cheek skin in your thirties. Transcutaneous blepharoplasty is performed with a thin incision under the eyelashes, allowing access to the skin, muscle, and excess fat under the lids. This approach is preferred when there is droopiness to the skin or muscle and more aggressive lifting is needed. Because eyelid skin often heals so well, these incisions are typically imperceptible after the healing process is complete.

Like the upper blepharoplasty procedure, lower eyelid surgery can be done in our office under local anesthesia. Of course, more anesthesia options are always available. You should plan on 7-10 days of swelling and bruising. There is usually little pain and discomfort, though you will want to rest your eyes.

Who is a Candidate for Blepharoplasty?

Eyelid surgery candidates generally have sagging skin, fatty deposits, wrinkles, or puffiness in either the upper eyelid, lower eyelid, or both. Some eyelid surgery patients may also have some vision loss due to the upper eyelid sagging into their line of sight. However, they may simply be unsatisfied with the appearance of their upper and lower eyelid and choose plastic surgery to achieve a more youthful appearance and rejuvenated eyes.

In some cases, younger patients also choose the procedure to change the appearance of the upper eyelid and general eye shape. For example, patients may wish to have upper eyelid surgery to create an eyelid crease; this surgical procedure is known as “double eyelid surgery.” As with any type of plastic surgery, you should be generally healthy overall and a nonsmoker before eyelid surgery. During your consultation in our Denver plastic surgery office, your board-certified plastic surgeon will evaluate your health and goals to determine whether you’re a good candidate for eyelid surgery.

What is Recovery Like After Blepharoplasty?

After both upper and lower blepharoplasty, patients will experience swelling, bruising, and some discomfort. Patients should rest their eyes as much as possible and will be advised to take pain medication to remain comfortable. Most swelling and bruising should dissipate within about a week to 10 days after the eyelid surgery. Typically, after an eyelid surgery in Denver, patients require at least a week to two weeks of downtime before they return to work or other routines.

Frequently Asked Questions

Will I have a scar along the incision line?

Most upper eyelid blepharoplasty has a scar that is hidden in the natural crease of the eyelid. For lower blepharoplasty the scars maybe put inside the eyelid or sometimes under the eyelashes depending on what the surgeon thinks will provide the best results. Fortunately, eyelid scars heal very nicely and are often hard to see once they have healed and mature.

Can I apply makeup after eyelid surgery?

Appropriate makeup can be used to cover up bruising and swelling even during the first week after eyelid surgery. In the first week you should avoid any irritating make up near incision lines. In our practice we do have staff that are highly skilled at make up application and specific make up is designed for post surgery patients.

How can I hide my eyelid surgery?

The amount of swelling, bruising, and other noticeable side effects that are visible after a blepharoplasty varies from patient to patient. Usually, any remaining redness after your initial rest period can be covered with makeup.

When can I expect for the swelling to go down?

Blepharoplasty incisions, like any wound on your body, take time to heal and there is a natural process that will occur from immediate swelling to a mature scar. Since it is on your face it is going to be more obvious and apparent to you. In the first week, there are sutures in visible bruising and swelling. In the weeks following that swelling and redness will gradually go down. A scar may be pink even a month after surgery and will fade over many months up to a year.

Does eyelid surgery leave scars?

Most eyelid surgery has scars, but they are places in a way that hides their appearance. For example, an eyelid scar may be hidden in the upper eyelid crease or inside of the lower eyelid. Most eyelid skin heals very well and external scars may be thin or imperceptible.

How do you reduce bruising after eyelid surgery?

Keeping your head elevated will prevent blood from collecting in the treatment area and causing increased bruising. Applying a cold compress will also ease your discomfort and reduce the amount of bruising.

How much is an eyelid surgery?

The cost of each cosmetic surgery will differ among patients depending on their specific needs and aesthetic goals. We offer CareCredit as a financing option for patients to help them pay for their cosmetic surgery. We will give you specific cost in the office to help guide you in your decision-making.

How long does a blepharoplasty last?

The results from a blepharoplasty last 5-7 years, on average. After this time, normal signs of aging start to become visible again.

When can I wash my face after blepharoplasty?

Cleansing your face and eyelids after surgery is important for protecting from infection and you should begin this 24 to 48 hours after surgery as directed.

Can Botox lift droopy eyelids?

You can often get a very subtle lift of the eyebrow using Botox. This has to be strategically placed by a provider who understands the anatomy. You may see a small lift that occurs in a week or two and can last up to three months on average.

Can droopy eyelids cause blurred vision?

Excessive skin of the upper eyelid can block your vision, much like the shades of a window can block your view. Visual field testing can assess this type of vision problem. Upper blepharoplasty, surgery to remove excess skin of the eyelid, can help this problem.

Can I sleep on my side after eyelid surgery?

You should sleep on your back and in an elevated position after eyelid surgery. The skin around your eyes is very delicate and can easily be damaged from the friction of sleeping on your side. Starting arnica or bromelain which is an ingredient from pineapple before and after surgery can be helpful as well. This can not only impact your recovery but your results as well.

Can you go blind from blepharoplasty?

Blepharoplasty, eyelid surgery, has a risk of blindness, but it is very rare. That is why having it done by a qualified surgeon who follows you closely is so important.

How is upper eyelid surgery done?

An incision is made along the area where the new eyelid crease will be. Extra skin and fat are then removed and repositioned before the incision is closed with sutures. The scar is hidden within the new eyelid crease.

What can I expect after eyelid surgery?

The appearance of your eyelids may remain swollen and bruised for 1-3 weeks after your procedure. It may take a full 3 months to see the final results, but some people will be completely healed after just one month. Most individuals feel ready to return to work after 10-14 days.

Are you put to sleep for eyelid surgery?

Blepharoplasty surgery usually requires general anesthesia. This means that you will be asleep through the duration of your procedure.

Nicolette Picerno, M.D.

Dr. Nicolette Picerno is a double-board-certified facial cosmetic surgeon certified by the American Board of Facial Plastic and Reconstructive Surgery and the American Board of Otolaryngology. She received her medical degree from Hahnemann University, School of Medicine in Philadelphia, and completed her fellowship for the American Academy of Facial Plastic and Reconstructive Surgery at the Beeson Aesthetic Surgery Institute in Carmel, IN. She also completed the Cenegenics Physician Training and Certification in Age Management Medicine program in 2012 and became a certified BioTE provider in 2014. When not in the office, Dr. Picerno enjoys spending time with her family, hiking, skiing, playing tennis, and running her doggie daycare with her husband.

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