What is pinch blepharoplasty and who is a candidate?

Pinch blepharoplasty is a conservative lower eyelid procedure that removes only a small, precisely measured strip of excess skin just beneath the lash line without disturbing the underlying fat pads or muscle structures. It is performed under local anesthesia in 30 to 45 minutes and is ideal for patients who have mild to moderate lower eyelid skin laxity and crepiness without significant fat prolapse or under-eye bags. Because it preserves deeper eyelid support, it carries a lower risk of lower lid retraction than more aggressive approaches. Dr. Karamanoukian at Kare Plastic Surgery in Santa Monica evaluates every lower eyelid patient to determine whether pinch blepharoplasty or a more comprehensive lower lid procedure is appropriate. Call (310) 998-5533.

How long do eyelid lift results last in Los Angeles?

Upper blepharoplasty results typically last 10 to 15 years or more before excess skin recurrence becomes noticeable. Lower blepharoplasty results can last a decade or longer with good sun protection and skin care. Because aging of the periorbital area continues after surgery, some patients choose a secondary touch-up procedure 10 to 15 years after their initial blepharoplasty. Dr. Karamanoukian at Kare Plastic Surgery in Santa Monica provides a realistic assessment of expected longevity based on each patient's skin quality, genetics, and sun exposure history at consultation. Call (310) 998-5533.

Natural Looking Eyelid Surgery Beverly Hills | Santa Monica

Kare Plastic Surgery & Skin Health Center · Santa Monica & Los Angeles

Eyelid Lift Los Angeles

Creator: Dr. Raffy Karamanoukian, MD, FACS
Published: 2026-06-09
Keywords: eyelid lift Los Angeles, blepharoplasty Los Angeles, upper blepharoplasty Los Angeles, lower blepharoplasty Los Angeles, pinch blepharoplasty, Foxtail eyelid lift, revision blepharoplasty Los Angeles

804 7th Street, Santa Monica, CA 90403 · Near Montana Avenue · (310) 998-5533

Upper and lower blepharoplasty, pinch blepharoplasty technique, Foxtail eyelid lift, and fractional CO2 laser resurfacing by UCLA-educated dual board-certified plastic surgeon Dr. Raffy Karamanoukian at Kare Plastic Surgery in Santa Monica

Call (310) 998-5533 Request a Consultation

Upper + Lower Blepharoplasty& Lower Blepharoplasty

Pinch BlepharoplastyBlepharoplasty Technique

Foxtail Eyelid LiftEyelid Lift

Eyelid Lift Los Angeles

The Eyes Reveal Everything. An Expert Eyelid Lift Restores What Age Has Taken.

Dr. Raffy Karamanoukian MD FACS — UCLA-trained dual board-certified plastic surgeon specializing in eyelid lift blepharoplasty at Kare Plastic Surgery Santa Monica Los Angeles

Dr. Raffy Karamanoukian Dual Board-Certified Plastic Surgeon Graduate, UCLA School of Medicine · Upper Blepharoplasty · Lower Blepharoplasty · Pinch Technique · Foxtail Eyelid Lift · Revision · CO2 Laser · Kare Plastic Surgery, Santa Monica

Blepharoplasty — the surgical refinement of the upper and lower eyelids — is among the most technically demanding procedures in facial plastic surgery, and among the most personally meaningful for patients who undergo it. More than 120,700 eyelid lifts were performed in the United States in 2024 alone, making it one of the most commonly requested facial cosmetic procedures in the country. The reason is straightforward: the periorbital area is the first region of the face where aging becomes visible and the most difficult area to address with non-surgical treatments alone. When excess skin folds over the upper eyelid crease, when fat pockets push forward as under-eye bags, when the lower lid skin becomes creped and the shadow beneath the eye deepens, patients look tired, older, and less like the person they feel they are. Blepharoplasty corrects all of these changes — when performed correctly.

At Kare Plastic Surgery and Skin Health Center at 804 7th Street in Santa Monica near Montana Avenue, UCLA School of Medicine graduate and dual board-certified plastic surgeon Dr. Raffy Karamanoukian, MD, FACS performs upper and lower blepharoplasty with the same governing philosophy that defines every procedure in his practice: the result should look completely natural. The eyes should appear more rested, more open, and more youthful, but should still look like the patient's own eyes. There should be no sign that surgery was performed. No skin pulled too tight. No hollow appearance from overly aggressive fat removal. No lower lid drooping from a technique that sacrificed support for skin excision. The goal is a result that patients can see immediately and that lasts for a decade or more.

120,700Eyelid lifts performed in the U.S. in 2024

10-15Years typical result duration

1-3 hrsProcedure time depending on scope

20 YrsDr. Karamanoukian experience

Eyelid Lift Services at Kare Plastic Surgery Santa Monica

Upper blepharoplasty — skin, muscle, and fat refinement via the natural eyelid crease
Lower blepharoplasty — fat repositioning or removal via transconjunctival or sub-lash approach
Pinch blepharoplasty — conservative lower lid skin removal preserving deeper structures
Foxtail eyelid lift — signature technique at Kare Plastic Surgery
Fractional CO2 laser resurfacing — non-surgical eyelid skin tightening
Revision blepharoplasty — correction of results from prior eyelid surgery
Quad blepharoplasty — upper and lower eyelid surgery at the same appointment
Combined eyelid lift with brow lift, facelift, or fat grafting
Functional blepharoplasty for visual field impairment from upper eyelid ptosis

Eyelid Lift and Revision Results at Kare Plastic Surgery

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Upper blepharoplasty before and after. Upload patient result to replace this placeholder.

Upper Blepharoplasty

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Lower blepharoplasty before and after. Upload patient result to replace this placeholder.

Lower Blepharoplasty

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Revision eyelid surgery before and after. Upload result to replace this placeholder.

Revision Blepharoplasty

Surgical Techniques

Upper Blepharoplasty and Lower Blepharoplasty — What Dr. Karamanoukian Does Differently

Upper Eyelid Lift in Los Angeles

Upper blepharoplasty addresses the excess skin, redundant muscle, and herniated orbital fat that accumulate on the upper eyelid as the levator complex weakens, the orbital septum loosens, and the overlying skin loses its elasticity over time. In mild cases this appears as a heavier, thicker-looking upper eyelid. In moderate cases the excess skin folds over the eyelid crease. In advanced cases the hanging skin contacts the lashes and begins to impair the superior visual field at which point blepharoplasty qualifies as a functional procedure with insurance coverage potential rather than purely elective cosmetic surgery.

Dr. Karamanoukian places the upper blepharoplasty incision within the natural pre-existing crease of the upper eyelid, following the anatomic line that the eyelid already possesses. The crescent of excess skin and orbicularis muscle is measured with great care and removed conservatively — taking enough to create a crisp, open-appearing eyelid without removing so much that the eye appears wide, startled, or hollow. This calibration is the technical skill that distinguishes an experienced blepharoplasty surgeon from one who operates by formula. At the lateral end of the incision, Dr. Karamanoukian curves the line upward rather than downward to lift the corner hood and create a natural outer canthus rather than depressing the lateral brow.

Lower Eyelid Lift and Pinch Blepharoplasty in Los Angeles

Lower blepharoplasty is technically more demanding than upper blepharoplasty and carries a higher risk of complications when approached aggressively. The lower eyelid depends on a complex balance of skin, muscle, orbital septum, and canthal support to maintain its position against the globe. Excessive skin removal, aggressive muscle disruption, or incorrect fat management can result in lower lid retraction, scleral show, or a hollow post-operative appearance that looks more operated than the presenting aging. These are the complications that motivate patients to seek revision blepharoplasty, and they are largely preventable with the right approach.

Dr. Karamanoukian's preferred lower blepharoplasty approach uses a transconjunctival incision placed on the inner surface of the lower lid where no external scar is created at all. From this hidden access point, the herniated orbital fat that creates under-eye bags is either removed conservatively or repositioned into the tear trough depression below it — filling the shadow that creates the dark circle appearance while reducing the fat pocket that creates the bag above it. Fat repositioning rather than aggressive fat excision is the modern standard because it addresses both problems at once and avoids the hollow, over-operated lower lid that results from taking too much fat.

Pinch Blepharoplasty — Conservative Lower Lid Skin Refinement

For patients whose primary lower eyelid concern is excess skin and fine wrinkling rather than fat prolapse or significant bag formation, Dr. Karamanoukian offers the pinch blepharoplasty technique. This targeted approach removes only a precise, measured strip of excess skin from just beneath the lower lash line without entering the deeper eyelid layers. The underlying fat pads and orbicularis muscle remain completely undisturbed. This preservation of eyelid support structures means the risk of lower lid retraction is substantially reduced compared to a full transcutaneous lower blepharoplasty, and the recovery is faster and more comfortable.

The pinch blepharoplasty is performed under local anesthesia in 30 to 45 minutes as a standalone procedure or combined with upper blepharoplasty on the same visit. The incision is closed with very fine sutures hidden beneath the lash line, which are removed at 5 to 7 days. It is an elegant, minimal-intervention solution for the patient who does not need a full lower lid surgery but wants measurable improvement in the skin quality and tone beneath the eyes. It is also an appropriate adjunct to the transconjunctival approach when fat repositioning addresses the bags but the patient has independent excess lower lid skin that benefits from the simultaneous pinch excision.

Upper Blepharoplasty

Incision in the natural eyelid crease. Conservative skin and muscle removal. Fat addressed conservatively. Lateral incision curved upward to lift the corner hood. Sutures removed at 5 to 7 days. Full result visible at 4 to 6 weeks as swelling resolves completely.

Transconjunctival Lower Blepharoplasty

Incision inside the lower lid with no external scar. Fat repositioning into the tear trough and conservative fat removal. No disruption of lower lid support structures. Preferred technique for patients with fat prolapse and under-eye bag formation. No visible incision in recovery.

Pinch Blepharoplasty

Small strip of excess lower lid skin removed just below the lash line. Deeper structures preserved. 30 to 45 minutes under local anesthesia. Ideal for skin laxity without significant fat prolapse. Faster recovery than full lower blepharoplasty. Can be performed standalone or combined with upper blepharoplasty.

Quad Blepharoplasty

Upper and lower eyelid surgery performed at the same appointment for comprehensive periorbital rejuvenation. Addresses the full eyelid complex in a single recovery. Dr. Karamanoukian plans quad blepharoplasty for patients with both upper and lower eyelid aging that is best corrected together for balanced, symmetric results.

"The most common mistake I see when patients come to me for revision blepharoplasty is too much skin removed from the upper eyelid or too much fat taken from the lower. Both result in a look that communicates surgery rather than youth. My philosophy is to take less than I think I need to take. I can always do more. I cannot put back what I have removed. Natural is the only standard."

— Dr. Raffy Karamanoukian · Kare Plastic Surgery, Santa Monica

Signature Techniques

The Foxtail Eyelid Lift and Fractional CO2 Laser Resurfacing at Kare Plastic Surgery

The Foxtail Eyelid Lift — Dr. Karamanoukian's Signature Technique

The Foxtail eyelid lift is a signature technique developed at Kare Plastic Surgery that addresses the lateral upper eyelid and the outer corner of the eye with a refined approach that creates a subtle upward angulation of the outer canthal area. The technique takes its name from the graceful upward sweep of the lateral eyelid that results from precisely directing the vector of the lift toward the outer and upper orbital rim rather than straight upward. For patients who have noticed that their outer eyelid corners have begun to descend, creating a tired or sad-eyed appearance even after standard upper blepharoplasty, the Foxtail technique addresses the specific anatomical change driving that outer canthal heaviness.

The Foxtail lift can be performed as a standalone procedure for patients with predominantly outer canthal heaviness and adequate upper eyelid skin tone, or combined with a standard upper blepharoplasty for patients who need both central and lateral upper eyelid correction. The incision planning and tissue excision patterns are specific to each patient's orbital anatomy and the degree of lateral canthal descent. Dr. Karamanoukian discusses the Foxtail technique at consultation for patients whose anatomy and aesthetic goals align with this approach, and explains clearly how it differs from a brow lift, which addresses a different anatomical structure at a different level.

Fractional CO2 Laser Resurfacing for Non-Surgical Eyelid Rejuvenation

Not every patient who presents with eyelid aging requires surgery. Fine periorbital lines, eyelid skin laxity, and the creped texture that develops around the eyes from cumulative ultraviolet exposure and collagen loss can often be substantially improved with fractional CO2 laser resurfacing without a scalpel, without sutures, and without the downtime of a surgical procedure. Dr. Karamanoukian offers fractional CO2 laser treatment of the eyelid and periorbital skin as a non-surgical alternative for selected patients and as an adjunct to surgical blepharoplasty for patients who would benefit from both structural correction and skin quality improvement.

Fractional CO2 laser delivers thousands of microscopic columns of laser energy into the eyelid skin, creating controlled zones of thermal coagulation that stimulate the production of new collagen and elastin while the surrounding untreated skin accelerates healing. The result is a measurable improvement in fine lines, skin tightness, and surface texture in the periorbital area that develops progressively over 3 to 6 months as the neocollagenesis response matures. For patients with primarily surface-level eyelid aging who are not ready for surgery, it provides meaningful improvement. For patients who have already undergone blepharoplasty and want to optimize their result, CO2 resurfacing of the periorbital skin complements the structural correction with surface quality improvement that surgery alone cannot achieve.

Combining blepharoplasty and CO2 laser at Kare Plastic Surgery: Dr. Karamanoukian performs fractional CO2 laser resurfacing of the lower eyelid at the same operative session as transconjunctival lower blepharoplasty in selected patients — the structural fat correction is performed first, followed immediately by laser resurfacing of the lower eyelid skin surface. This combination addresses the bag (structural), the fine lines (surface), and the overall skin quality of the lower lid in a single recovery without additional procedures. Not all patients are candidates for simultaneous surgery and laser; Dr. Karamanoukian advises at consultation whether combination or staged treatment is appropriate for your specific situation.

Revision Blepharoplasty

Revision Eyelid Surgery in Los Angeles — Correcting Prior Blepharoplasty Results

Revision blepharoplasty is among the most complex procedures in all of facial surgery. When eyelid surgery produces a result that the patient is not satisfied with, whether from too much skin removed, too much fat excised, lower lid retraction, asymmetry, scar irregularity, or an overall look that appears operated rather than natural, correction requires a surgeon who understands both the anatomy of the normal eyelid and the altered anatomy that prior surgery has created. Dr. Karamanoukian sees revision blepharoplasty patients from across Los Angeles who are living with results from other surgeons and seeking both a candid assessment of what can be improved and the surgical skill to actually improve it.

The most common revision presentations at Kare Plastic Surgery include upper eyelid hollowing from aggressive fat removal, upper eyelid show from excessive skin excision, lower lid retraction and scleral show from transcutaneous lower blepharoplasty without adequate support, asymmetric eyelid creases, and hypertrophic or visible blepharoplasty scars. Each requires a specific surgical strategy. Eyelid hollowing is addressed with fat grafting or the repositioning of orbital fat from adjacent areas. Lower lid retraction requires release of the scarred septum, mid-lamellar grafting, and canthopexy or canthoplasty to restore lower lid position. Vbeam laser at Kare Plastic Surgery effectively treats residual redness in blepharoplasty scars as a non-surgical complement to any surgical revision plan.

Authority Page · Kare Plastic Surgery & Skin Health Center Foxtail Eyelid Lift and Eyelid Scar Revision Los Angeles →

The complete Foxtail eyelid lift and blepharoplasty scar revision guide at Kare Plastic Surgery — Vbeam laser for blepharoplasty scars, revision upper and lower blepharoplasty, and the Foxtail technique by Dr. Raffy Karamanoukian in Santa Monica and Los Angeles.

Frequently Asked Questions About Eyelid Lifts in Los Angeles

Where can I get an eyelid lift in Los Angeles?

Kare Plastic Surgery at 804 7th Street in Santa Monica near Montana Avenue offers expert upper and lower blepharoplasty by UCLA-trained dual board-certified plastic surgeon Dr. Raffy Karamanoukian. Upper blepharoplasty, lower blepharoplasty, pinch blepharoplasty, Foxtail eyelid lift, fractional CO2 laser resurfacing, and revision blepharoplasty. Call (310) 998-5533. We serve patients from Santa Monica, Beverly Hills, Brentwood, Pacific Palisades, Malibu, and all of Los Angeles.

Is eyelid lift surgery performed under general anesthesia?

Many eyelid lift procedures at Kare Plastic Surgery can be performed under local anesthesia alone or with light oral sedation, without the need for general anesthesia. Upper blepharoplasty and pinch blepharoplasty are both well-suited to local anesthesia protocols, which shortens recovery time and eliminates the risks associated with general anesthesia. Quad blepharoplasty and combined procedures with brow lift or facelift are typically performed under general anesthesia or intravenous sedation in an accredited surgical facility. Dr. Karamanoukian recommends the anesthesia approach that matches the scope of the planned procedure and the patient's medical history and preferences at consultation.

Will eyelid lift surgery affect my vision?

Cosmetic blepharoplasty at Kare Plastic Surgery does not affect vision. In patients who have upper eyelid skin overhanging the lashes sufficiently to impair the superior visual field, blepharoplasty actually improves peripheral vision by lifting the obstructing tissue. Immediately following surgery, vision may appear temporarily blurred from lubricating ointment placed in the eye during the procedure, and mild swelling may affect comfort looking upward for a few days. Both resolve as early healing progresses. Any change in the visual field or visual acuity that extends beyond the first week of recovery is reported to Dr. Karamanoukian immediately.

What is the difference between an eyelid lift and a brow lift?

An eyelid lift removes excess skin and fat from the upper and lower eyelids themselves. A brow lift elevates the eyebrow position and smooths forehead lines by releasing the brow from its descended position. In many patients with upper eyelid heaviness, what appears to be excess eyelid skin is actually descended brow tissue pushing down onto the eyelid from above. Operating on the eyelid alone in these patients produces a suboptimal result because the root cause of the fullness is the brow position, not the eyelid skin itself. Dr. Karamanoukian assesses the brow position at every upper blepharoplasty consultation and advises honestly whether a brow lift would provide more benefit than, or should be combined with, the eyelid procedure.

Related Resources at Kare Plastic Surgery

Kare Plastic Surgery & Skin Health Center · Santa Monica · Near Montana Avenue

Schedule an Eyelid Lift Consultation

Dr. Raffy Karamanoukian, UCLA School of Medicine graduate and dual board-certified plastic surgeon, offers comprehensive eyelid lift consultations at Kare Plastic Surgery in Santa Monica — upper and lower blepharoplasty, pinch technique, Foxtail eyelid lift, CO2 laser resurfacing, and complete revision blepharoplasty for patients across Los Angeles and Beverly Hills.

(310) 998-5533

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