Upper eyelid surgery

Specialist Surgeon: Dr. Bernard Hayot

The New Approach to Eyelid Surgery at Epilium & Skin

After many years of practice, and following his training with fat transfer pioneer, Dr. Sydney ColemanDr. Hayot realised that ageing was not necessarily the result of excess skin but is mainly caused by a decrease in the volume of fat in certain key areas of the face.

He learned that by restoring volume which has been lost over time through fat transfer, you could create a more youthful appearance in the most natural way.

Seeing results first hand, Dr. Hayot now prefers to harvest the fat of his patients to use it to restore lost volume to parts of the face that have lost their youthfulness over time.

His main premise, in relation to eyelid surgery (blepharoplasty), is never to cut away too much skin. To just cut a little and restore lost volume to the eyelids by injecting fat creates a more subtle result.

By sculpting with fat, the face can be given a more refreshed and youthful  appearance. This advanced cosmetic technique can also be used to help correct problems such as hollowness and dark circles around the eyes and to remedy the loss of volume at the temples.

We call this additional blepharoplasty.

A word from our Medical Director…

A personalised approach to eyelid surgery increases the chance of a positive outcome. Through an in-depth consultation, I am able to determine each of my patients’ needs and expectations in order to provide targeted blepharoplasty solutions based on the needs of each unique patient.

—Dr. Bernard Hayot

Upper Eyelid Surgery

As we age, there is often a decrease in fatty tissue and our muscles become less taut. This is when we can start to see an excess of skin.

In this case the eyelid will appear heavy and may even start to droop resulting in a more tired and often aged appearance. The Upper Eyelid surgery (or upper blepharoplasty) is generally performed on patients aged 40 or plus when it is become difficult for women to apply make-up on the eyelids or for men to see properly due to the surplus of skin and/or fat over the eye. This excess skin, also known as dermatochalasis.

This blepharoplasty performed on the upper eyelid area consists of removing excess skin by cutting the palpebral fold with a laser. Dr Hayot uses the CO2 laser which allow him to have a greater precision in the incision and minimise the bleeding while operating for a better view of the area treated. During the same procedure, the surgeon is able to remove any possible fat herniation. It is important to note that only the upper blepharoplasty is able to improve the sinking of the upper eyelid and to open the eyes without changing their expression.

In most cases, upper eyelid surgery is performed alongside the Micro- fat transfer (or Micro-lipostructure) technique to help restore lost volume. As we age, there is also an apparent loss of fat at the temples causing them to look hollow. In turn, this leads the tail end of the eyebrows to droop. Eye Surgeon, Dr. Hayot recommends that the temple area, eyelids and wrinkles are filled with fat to result in a natural lifting effect on the eye area.

It is important to remember that each patient’s needs are different, and each case may require a different approach when it comes to the procedure. Before any surgery, an initial consultation is made with Dr. Hayot. A full physical assessment will be required in order to gather the information the surgeon needs to develop a thorough treatment strategy. You will also discuss your personal goals and concerns and Dr Hayot will ask to see a photograph of the patient aged 25 so he can use it as a guide to recreate the youthful appearance of the eyes.

With all of this in mind, Dr Hayot will determine which surgical technique and approach should be used in order to guarantee the best outcome with the least amount of risk.


  • A greater precision with the CO2 laser treatment and the use of a microscope during the surgery.
  • The incision is made in the upper eyelid fold which results in an invisible scar
  • Less hematoma and bruising.


We usually advise to take 6 days off any activity. Stitches are removed on 6th day.
The healing process after a laser eyelid surgery will take few weeks but patient will be able to see the first improvement of the operation after 7 to 10 days. The final results are seen after 3 months after the surgery.


Lower Eyelid surgery / Eye Bags Removal

Age is not necessarily the deciding factor when determining who may be a candidate for lower eyelid surgery. Hereditary factors, as well as ageing, weight fluctuation and even post-pregnancy volume loss can contribute to tired looking eyes. The slackening of the skin combined with the loss of fat can often form notable dark circles and eye bags underneath the eyes.

To remove bags under the eyes, Dr Hayot makes a very thin incision inside the eyelid (transconjunctival approach) with a CO2 laser to avoid any bleeding and removes the fatty deposits under the eyes. The palpebral muscle (orbicularis muscle of the eye) is reattached to make the lower eyelid more taught. Both techniques help to avoid scarring and the use of stitches.

With minimal amount of skin removed, it is important to understand that the lower blepharoplasty surgery will not change the shape of your eyes moreover, it will naturally enhance your beauty. If the patient also desires to eliminate more visible wrinkles under the eyes, Dr Hayot suggests using a technique call the “pinch blepharoplasty” which will remove 1 or 2 mm of skin to achieve the desired result. Dr Hayot commonly combine this surgery with the Nano-Fat Transfer to lift the skin, and/or the Micro Lipostructure to restore lost volume and/or counteract the hollow eye.

Each patient’s needs are different, and the procedure may entail a different approach for each case. An initial consultation is made with Dr Hayot prior the surgery to gather the health informations he needs to create a detailed strategy for the procedure. Personal goals and concerns will be discussed, and a photograph of the patient aged 25 will be required. Dr Hayot will use it as a guide to recreate the youthful appearance of the eyes. Finally, Dr Hayot will determine which surgical procedure and approach should be used to assure the greatest result with the least risk.

A word from our Medical Director…

With years at the helm of my plastic surgery clinics in Paris, combined with my extensive expertise in oculoplastic microsurgery and blepharoplasty (eyelid surgery), my patients expect the most effective results with the minimum amount of downtime.


  • Natural lifting of the eyelid
  • Undetectable scar, hidden on the edge of the lower lashes
  • The expression of the eye is not changed
  • Hones the orbicularis muscle bulge (which often appears when smiling)


It is recommended to take 6 days out of work upon your lifestyle or activity to minimise bruises & hematoma. The removal of the stitches is made on the 6th day.
After 7 to 10 days you’ll be able to grasp the first enhancement, but the definitive result is visible after 3 months.



For more than 30 years, aesthetic surgeons have proposed anti-wrinkles solutions which use of chemical components such as botulinum toxin or hyaluronic acid injections.

20 years ago, our Medical Director, Dr Hayot learned the revolutionary technique of fat injections from leading surgeon Dr Sydney Coleman. He brings the method back to his Parisian Clinic and developed his own techniques for preparing the fat. The procedure consists of extracting some of the patient’s fat from the abdomen or the inner side of the knees by performing a micro-liposuction using a micro-cannula. The fat is then rinsed into a special filter and meticulously cleans to remove all fibrous cells before being re-injected.

This way the fat is much more purer and smoother and can be injected with very thin needles and therefore can be injected into wrinkles.

The Fat injections can be used to treat the nasolabial folds (between the nose and the mouth), perioral wrinkles (smokers’ wrinkles around the mouth), crows’ feet (over the outer corner of the eye), neckline wrinkles without having to resort to any foreign bodies.

In Dr Hayot’s opinion, Fat Transfer is a more reliable, more effective, more sustainable solution, and offers a more natural and long-lasting result than any other injectable solutions. Finally, the recovery time for the surgery is very short; bruises and swelling diminish a few days after the surgery and can be covered up with make-up very easily.

Each patient’s requirements are different, and it is important to note that the procedure may require a different approach for each one of them. The initial consultation with Dr Hayot will allow him to understand your personal goals and concerns but also will determine which approach he should be using in order to assure the best result with the minimum risk.


In my opinion, fat transfer and regenerative medicine is the future of anti-aging techniques. We can restore lost volume, treat wrinkles and regenerate the tissue using your own cells. For years we have been using injectables to rejuvenate but now, with advances in stem cell therapy, we can regenerate the tissue- this is a revolution.


  • Immediate results after the surgery
  • The results of the fat injections are not ephemeral like any injectable treatments.
  • It is the patient’s own fat therefore there is no risk of complications.
  • The stem cells from the fat injections aid to rejuvenate the skin.
  • The fat injections into wrinkles gives a natural and discreet result.
  • Fat injections into wrinkles can be done simultaneously with a blepharoplasty for a more youthful appearance.


We advise to take 5 to 7 days off upon the quantity of fat injected and the number of areas treated. The side effects disappear a few days after the surgery and this is where the results appear.

The results are still developing over time due to the stem cells that fat contain which will activate your natural collagen production and fight against the new sign of ageing.


Regenerative Medecine (or Nano-Lipostructure)

The procedures of regenerative medicine or nano-lipostructure (rarely performed in Europe) are for Dr Hayot the most innovative techniques of this century. It is the next generation of treatment in Aesthetic Medicine.

Rejuvenating the skin tissue is not the main concerns anymore but regenerating them using the patient’s own stem cells and growth factors is what interested Dr Hayot on these techniques These procedures are still at the beginning, but surgeons saw exceptional results on the quality of the skin and dark circles.

These procedures involve superficial injections of the stem cells and growth factors of the patient similar to Mesotherapy. Unlike traditional mesotherapy, no foreign body or synthetically-modified product is injected into the patient’s body.

Dr Hayot observes excellent effects on wrinkles, skin quality, pigmentation marks and enhancement of the skin trophicity on the face, neck and décolleté. More than a year after the injections, the results of the nano-lipostructure continue to progress and regenerate the skin, which suggests that the quality of the skin will resume to improve years after the surgery.

The surgery involves the following:

  • Under a local or general anaesthetic, the aesthetic surgeon extracts a small quantity of fat cells from either thigh, knee or stomach.
  • To remove any fibrous cells from the fat extracted, the surgeon cleans and purifies the fat with a saline solution.
  • For a successful graft, the surgeon needs to keep only the micro-adipocytes from the purified fat which is filtered through a type of filter.
  • Small quantities of the fat are then injected to the patient’s face to guarantee a natural result.


  • New researches on Fat transfer proved that we are today able to regenerate the skin tissue using very superficial injections of the "fat broth" like a Mesotherapy treatment.


We recommend 5 to 7 days of work depending on the patients lifestyle.

First results are visible straight after the surgery, but researches shown that the skin is still regenerated after a year.