James R. Payne M.D.
Aesthetic Plastic Surgery

1334 Nelson Avenue
Modesto, CA 95350
209.524.9904 T
209.524.4 1 0 1 F


Purpose of Procedure

The goal of blepharoplasty surgery is to correct the effects of aging around the eyes. This usually involves surgical treatment of the upper and lower eyelids for maximum results but some patients will choose to do only the uppers or the lowers.

This surgery is often combined with other facial surgery to optimally treat the patient and to rejuvenate the face and neck as a global aesthetic unit.

Brief Description of the Procedure

This surgery may be performed under local anesthesia with/without intravenous sedation or it may be done under general anesthesia. All surgery is done at Dr. Payne’s MediCare and California State Certified Pueblo Nuevo Surgery Center located within his office.

Surgery on the upper eyelids involves placement of a well hidden incision across the top of the eyelid. Excess skin is removed as well as any excess muscle bulk that might be present. The levator muscle/fascia may be modified, if needed, to correct drooping eyelids. The lateral brow is sometimes lifted through this incision and the muscles that produce wrinkling in the glabella (zone between the eyebrows) can be trimmed giving this area a smoother look. Fat excess is treated with either excision or repositioning .

Surgery of the lower eyelid involves trimming of skin and muscle excess, removal or repositioning of orbital fat, treatment of the hollow lower lid and upper cheek, shortening of the lower lid to cheek distance, and suture support of the lateral lower eyelid to facilitate more aggressive techniques in the lower lid associated with a better cosmetic outcome. Other operations can be done through the lower lid incisions including mid-face cheek lifts. Incisions in the lower eyelid are usually done on the inside of the lid (trans-conjunctival) or just beneath the lower eyelid eyelashes (sub-ciliary).

The scars associated with blepharoplasty surgery usually heal quickly and become either invisible or very faint within a few months. Poor quality scars are unusual in this area. Patients may use makeup initially to camouflage these incisions.

Likely Outcome and Longevity

For maximum rejuvenation and correction many patients need a brow lift combined with upper and lower blepharoplasty.

This surgery is very powerful and can really correct much of the stigmata of aging around the eyes. Dr. Payne believes that there are certain operations in the field of plastic surgery that have the ability to transform human appearance—forehead/brow lifts combined with blepharoplasty is one of those procedures. The forehead lift tends to be more long lasting than blepharoplasty alone. When these procedures are combined, however, the results are better and more durable over time.

As people age certain specific changes begin to occur with the body. In the face the skin begins to lose it’s elasticity (rubber band like quality which is responsible for skin looking tight and smooth). The skin can become thinner. Chronic sun exposure results in skin having lines and wrinkles and pigment irregularities with splotchy skin color. The fat under the skin can begin to melt away or droop and shift to a lower position. Muscles lose tone and bulk. Even bone can begin to resorb and melt away. All of these changes taken together result in the appearance of the aging face.

When human beings look at each other they focus on the eyes first and foremost and secondarily on the mouth. These two zones are the most dynamic and expressive parts of the human face. These areas communicate to the outside world what we are thinking and feeling. They are the physical conduit linking our inner complex intellectual and emotional processes to our fellow human beings.

With the aging process our eyes begin to look a certain way and, unfortunately, not much of this appearance may be positive. Aging eyes and faces look tired, stressed, worn out, worried, anxious, angry, perplexed, depressed, uncertain, or aggressive. When other people “read” our faces this is what they may see. This in turn can set the circumstances that will dictate what kinds of interactions we have with the people that surround us. If our surrounding community of people engage us according to how they think we are feeling or thinking based on our appearance then this may lead to inappropriate assumptions and negative social interactions.

Blepharoplasty (often combined with forehead and brow lift) surgery very significantly helps to correct the aging changes. Improvement in appearance after surgery can help to communicate youth, vitality, optimism, strength, energy, enthusiasm, and improved health. When our eyes and upper face look better other people “read” us differently. If your eyes, brow, and forehead communicate a positive message then when others engage us they may use an approach with us which we find to be more positive, encouraging, and validating.

Dr. Payne will interview and examine each patient in detail. He will then share his thoughts in full scope with each client. He will discuss the face and neck in a global way so that the entire aesthetic picture is filled out for the patient. He will let each patient know what he thinks would be best for them. He will, undoubtedly, talk to each patient about issues they had very little awareness of prior to the consultation. His treatment recommendations will include surgical and non-surgical issues. He will discuss diet, exercise, nutrition, hormone, and lifestyle issues with each person. Pros and cons of all options will be explored in detail with each patient. One of his goals with each client is to help get them on a long term path to better living which may help people to look better and feel good. By providing an overview of information to each person they will end up with a much better understanding of the complex issues of aging. Hopefully this will result in greater personal satisfaction with the overall issues of the forehead, brow, eyes, and face and these issues will be put into the context of the body and life as a whole. A greater understanding of the problem will always facilitate the development of a game plan aimed at making the most of what we have physically and emotionally.

Please be aware that for maximum results with the face and neck multiple treatment options are suggested. In addition to blepharoplasty procedures it may be necessary to consider forehead and brow lift, cheek lifts, face and neck lifts, rhinoplasty (nasal surgery), laser skin resurfacing, broad band light therapy, other laser technologies, chemical peels, dermabrasion, botox, restylane, and other soft tissue injectable fillers as well as other treatments. Everyone benefits from getting on a good topical skin care program for life which helps to sustain surgical benefits and improve the postoperative results.

Patients will continue to age with time and more treatment to the upper face and eyes may become necessary.

Recovery Issues

Blepharoplasty operations are not very painful. There is usually some swelling and bruising after surgery and this can take several weeks to resolve. Eyes may feel irritated and annoying with associated tearing for a few weeks. Most patients will require a minimum of one week off duty from work. Camouflage makeup is provided to any patient that wants to use it.

Each client will be given detailed postoperative instructions and medications aimed at minimizing pain and discomfort. Dr. Payne usually calls each patient the evening of surgery and the morning following surgery to reinforce instructions and make sure the patient is doing well.

Most patients are seen one to two times per week for the first few weeks to provide for careful monitoring and instruction. Patients are followed until they are fully healed and back to normal.

Patients may resume exercise and engage in strenuous activity within ten to fourteen days after surgery assuming they feel up to it. Instructions are individualized to fit each person’s needs.


Please contact our office for information regarding cost. You can get a ballpark non-binding quote over the phone for this surgical procedure. The cost of the consultation is $100 and will be applied to any surgical procedure that you have. Once you have had your consultation with Dr. Payne the final details of the operative game plan will be made. At that point you will be given a final fee quote. There are multiple options for each patient hence cost may vary from person to person.


Please contact our office if you wish to make an appointment to see Dr. Payne for a consultation. Our office will be happy to talk to you in detail about this procedure. Feel free to ask lots of questions.

Your initial consultation will be with Dr. Payne. This generally will take about 1 hour. You may visit the office prior to this consultation to have preoperative digital photographs taken or to simply come by and chat. If you would like you can view our Before and After album filled with multiple examples of this type of surgery and other facial cosmetic procedures. You will be given multiple brochures and other paperwork which will help to prepare you for your consultation. All your options will be discussed with you at the time you make your first appointment.

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From brow lifts to nasal surgery, Dr. Payne's facial procedures offer some of the most dramatic transformations plastic surgery can provide.
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Dr. Payne offers various treatments for clients who experience massive weight loss due to traditional methods or bariatric surgery.
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Laser & Skin Care Services

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