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Elegant, revitalizing holistic eye rejuvenation and blepharoplasty results that help preserve a youthful expression

Your eyes are the first thing people see when they look at your face. An immediate impression is formed about your age, level of energy and fatigue. The eyes are also the first part of the face to show the signs of aging.

Youthful eyes sparkle and look refreshed and alive, but aging causes a combination of changes that result in excess skin of the upper and lower eyelids, puffiness or bags of the lower eyelid, sagging of the corners of the eyebrows and loss of volume around the eyes, temples and cheeks. Our eyelid surgery in La Jolla can give you that bright and youthful look again.

As the skin thins in this region, fine lines and wrinkles start to form, further aging your appearance. This sagging, coupled with deflation, results in a hollow, sallow and fatigued look consistent with an aged appearance. These changes typically start in the mid-to-late 30s and progress rapidly throughout the 40s and 50s.

It is important to note that when people look at your eyes, they don’t just see the upper eyelids or lower eyelids, they see the entire region around your eyes. This includes the skin, the hollows and dark circles beneath the eyes and the sagging eyebrows. Gone are those sparkling windows to the soul, replaced by fatigued, morose and shaded eyes.

Our San Diego eye rejuvenation surgery may be one of the most high-impact methods of facial rejuvenation. Traditional approaches focus on blepharoplasty, or eyelid surgery in which skin, muscle and fat are removed in order to sculpt the eyes.

In reality, the results of this procedure often make eyes look older and simply different, not better. This misses the entire goal of eyelid surgery, which is to make the eyes look refreshed and revitalized.

Our preferred method is to take a comprehensive and holistic approach to the treatment of the various changes affecting this region.

The first step is a thorough assessment of the periorbital region. Aging of the eyes results from a combination of changes to different components around them. Careful evaluation of these changes is the first step toward a true and meaningful eye rejuvenation that will leave the eyes looking bright, healthy, fresh and natural.


Volume loss

When we lose the fat layer along the lower eyelid region and upper cheek, the eyes begin to look hollow, which gives the impression that we’re fatigued and aged. An important and highly-emphasized part of our eye rejuvenation philosophy is volume restoration with fat transfer.

Fat transfer

This is a treatment that complements our surgical procedures and is done with essentially every rejuvenation case (approximately 350 cases per year). It is used to restore the lost volume surrounding the eyes. Commonly filled areas are the temples, upper eyelid and eyebrows, along the lower orbital rim, tear troughs and upper cheeks. This results in long-lasting and natural volume restoration.

Adding volume is the most effective and important way to rejuvenate the eyes. Without it, the skin and sagging may look better, but the eyes will never have that refreshed and youthful look.


When excess skin is present, a conservative surgical procedure is required to remove it. The following procedures are used to treat the specific issues.

Upper eyelid blepharoplasty: The removal of excess upper eyelid skin.

Lower eyelid blepharoplasty: The removal of the fat pad (“bags”) and loose skin of the lower eyelid.

Lower eyelid skin pinch: The removal of loose lower eyelid skin only. This is done when there are no fat pads to remove, but only loose lower eyelid skin.

Lateral brow lift: Used to lift the outer brow, diminishing the hooding and heaviness of the upper eyelid region.

While men and women enjoy looking years younger and benefit from these procedures equally, the techniques are different for each sex. Dr. Karam’s experience and expertise allow him to successfully handle the nuances related to different ethnicities and sexes and to create a natural rejuvenation of the entire region with our eyelid surgery in La Jolla.

Is eye rejuvenation right for me?

Our comprehensive eye rejuvenation program can help alleviate many problem areas associated with aging. Eye rejuvenation is for those who want to:

  • Eliminate that aged, tired look
  • Look fresh and energetic
  • Improve dark circles
  • Remove bags under the eyes
  • Restore the plumpness of youth
  • Return the skin and brows to their original position
  • Recover the self-confidence of younger years

Advantages of comprehensive eye rejuvenation

  • Total rejuvenation of the entire region around the eyes
  • Balance and harmony of the eyes
  • Consistency and reliability
  • Low complication rate
  • Long lasting results (10+ years)
  • No change in eye shape or change in facial features
  • Performed under local anesthesia with IV sedation; no need for general anesthesia
  • Two-week downtime
  • Ideal balance between excellent and natural results, low risk and brief recovery


Perhaps one of the biggest advantages, from a safety standpoint, is that these procedures can be performed under local anesthesia with IV sedation. With this technique, patients are comfortable and moderately sedated. Most patients choose this method to avoid any of the risks associated with general anesthesia. For those patients who do prefer general anesthesia, our facility is fully-equipped for general anesthesia.

Procedures are performed in our accredited and certified (JCAHO) surgical center, Carmel Valley Surgical Center, located within the suite. The San Diego center offers the highest level of safety and state regulations for outpatient surgery.

Highly-trained and experienced surgical techs, medical assistants, nurses and a board-certified anesthesiologist all work together to create the safest and most comfortable experience possible.

Carmel Valley Surgical Center hosts two state-of-the-art surgical suites and a recovery center. The rooms are equipped with only the best equipment and instruments, and the center also has a separate entrance and exit from the main office, which allows our patients to undergo procedures in privacy. Your comfort is always our priority during these surgical procedures.

Post-procedure care

Following surgery, ointment is applied to the incisions. In cases where a lateral brow lift is performed, a gauze dressing is applied and wrapped around the head for one night. Patients return to the comfort of their home or hotel room, then come back for an in-office check the following day where the dressings are removed and the face is examined.

A cool compress is used to reduce swelling for the first two days following surgery. Lubricating drops are used during the day and ointment is used at night to help keep the eyes moist and protected from drying. Antibiotic ointment is applied to the incisions for one week.

At one week, sutures are removed in the office. At this point, swelling is starting to resolve rapidly. Follow-up appointments are made at one month, three months, six months and one year to monitor healing and make sure all questions are answered.


Recovery is primarily related to swelling. Bruising is not commonly seen in our patients, although it is a possibility. The typical recovery takes between 10 and 14 days.

We recommend planning two weeks off of work or social engagements to allow sufficient time to heal. Although healing is not completely finished by two weeks, most patients are sufficiently healed and can return to work and other social occasions.

Minor swelling continues to improve steadily for up to one year following the procedure. Exercise is resumed between three to four weeks following surgery, depending on the nature of the activity and the degree of swelling involved.

What to expect in terms of your results

There are a variety of positive results you can expect from your eyelid rejuvenation procedure, including:

  • A more youthful and natural-looking appearance
  • Elimination of hooding and heaviness in the eyelids
  • A full and healthy upper lid complex (no longer skeletonized, harsh or bony)
  • Eradication of under-eye bags
  • Long-lasting outcomes that mimic your genuine, younger self
  • The return of self-confidence

Why choose Dr. Karam for your San Diego eye lift procedure?

An average board certified facial plastic surgeon performs approximately 20 eyelid and brow procedures annually. Dr. Karam, on the other hand, performs over 350 every year (over 400 performed).

Dr. Karam is double board-certified by the American Board of Facial Plastic and Reconstructive Surgery and American Board of Otolaryngology. Extensive experience translates to more natural results, more consistency and less variability, plus a distinct knowledge of different ethnicities and facial types and how to change the techniques to best suit the particular facial structure. Dr. Karam’s careful and intentional approach ensures that no one changes their identity, but rather simply looks refreshed and youthful.

Dr. Karam’s comprehensive approach, which involves combining these procedures with others, results in synergistic effects. The entire face looks naturally and vibrantly youthful, rather than hosting a single, unnatural element.

In his text book, Rejuvenation of the Aging Face, Dr. Karam describes his approach to facial rejuvenation and eye rejuvenation in order to teach the ingenious techniques to other surgeons and colleagues.

Dr. Karam’s expertise in the subject has also prompted him to write a number of book chapters and scientific articles on facial plastic surgery topics, including upper and lower eyelid blepharoplasty, fat transfer and rejuvenation of ethnic-specific (for example, Asian) groups.

And perhaps most importantly, Dr. Karam’s caring demeanor, excellent patient communication skills and responsive and knowledgeable staff ensure you’re always comfortable and informed. It’s these particular attributes that have earned Dr. Karam the trust to perform these procedures on his medical colleagues and their families.

Planning your consultation

During the La Jolla blepharoplasty consultation, your expectations will be discussed and a personalized treatment plan will be proposed after careful examination and discussion of your goals.

The basic criteria for the timing of this procedure is dependent on two factors: First, whether there is enough sagging to justify the procedure, and second, the patient’s readiness to move forward.

The average patient defines the changes seen in their 40s as a point where comprehensive eye rejuvenation would make a positive difference. In general, the earlier the better. The advantages of performing the surgery sooner are that the changes are less dramatic and subtler, and the results last longer.

More and more patients are utilizing these procedures as a way to maintain their appearance and prevent aging. To discuss arranging your own San Diego blepharoplasty consultation, please call 858–259–3223 or send an email inquiry.

Before & After

Dr. Karam, who is board certified by the American Board of Facial Plastic and Reconstructive Surgery and American Board of Otolaryngology, offers services in San Diego County including San Diego, Del Mar, Carlsbad, Carmel Valley, Encinitas, Rancho Bernardo and La Jolla in Southern California.

If you are ready to schedule an appointment with Dr. Karam, contact us today.

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