Eyes & Brows · Vancouver and North Vancouver
Eyelid surgery is a matter of millimetres.
Upper and lower blepharoplasty (eyelid surgery) with Dr. Thomas Buonassisi, MD, FRCSC, Specialist in Otolaryngology – Head and Neck Surgery, with a practice limited to facial plastic surgeries. He removes or repositions skin, muscle and fat in the upper lids, the lower lids or both, for a more awake look that's natural on your face.
Dr. Thomas BuonassisiYour surgeon for upper and lower blepharoplasty
Meet Dr. Buonassisi →
The first step is a complimentary, friendly call with a patient care manager.
Tell us what you're interested in, and a member of our team will call you for a complimentary, friendly conversation. We'll answer your questions and help you figure out your next step, with no commitment.
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We strive to provide quality services and care in a timely manner. If you require a faster response or have not heard back from us within 2–3 business days, please call us directly at 604-733-1669.
How Dr. Buonassisi approaches blepharoplasty
Upper lid incisions follow the crease where your skin naturally folds, usually 7 to 10 millimetres above the lashes.
He keeps lower lid surgery conservative: not a lot of skin taken, nothing pulled tight. In his words, aim for a base hit, not a home run.
Fat is removed or repositioned only where it's needed. Taking too much from the upper lid can leave the eyes looking hollow.
When a lower lid has loosened, shortening it at the outer corner brings back its tension. He compares it to a clothesline that has stretched.
Videos
A patient talks about her upper eyelid surgery, and Dr. Buonassisi explains where the incisions go, lower lid surgery for under-eye bags, and getting back to your day.
1:00Why she chose upper eyelid surgery, and what she says about her consultation with Dr. Buonassisi.
Dr. Buonassisi shows where the upper lid naturally folds, and why the incision sits in that crease.
How the approach depends on your anatomy and on what bothers you.
What you can do the day after, and what waits a couple of weeks.
Upper eyelids
Upper blepharoplasty removes extra upper eyelid skin that folds over the crease, and can reshape the lid a little.
Dr. Buonassisi compares the upper lid to a Roman blind. When you're young it sits fairly flat. Over time, extra skin billows over the crease when your eyes are open, and less of the crease shows. Taking out that extra skin is the main part of the surgery.
The incision sits in the supratarsal crease, where your skin naturally folds, usually 7 to 10 millimetres above the lash line. In his words, the incisions are visible, but you can't really see them when your eyes are open. He marks only as much skin as still lets your eyes close comfortably.
If you don't have a natural crease, creating or defining one is a different procedure: double eyelid surgery.
Talk it through with our team →Lower eyelids
Lower blepharoplasty treats under-eye bags, extra lower lid skin, or a lid that has loosened. There are two ways in, and which one suits you depends on your lids.
Inside the lid · transconjunctival
A small incision inside the lower lid reaches the fat that bulges forward to make a bag, so it can be removed or repositioned. There's no incision on the skin, and it doesn't change the shape of the lid. These fat bags can be genetic and can show up as early as 18 or 19.
Below the lashes · subciliary
An incision just under the lash line lets Dr. Buonassisi remove extra skin and some fat, and tighten the lower lid's skin and muscle. It's more often used for age-related changes, usually after 40, and he keeps the skin removal conservative.
Lid shortening · canthopexy or canthoplasty
Dr. Buonassisi describes a loose lower lid like a clothesline that has stretched: you can tighten the fabric, but until you shorten the line, the tension won't hold. Lid shortening at the outer corner does that, usually for people in their 50s or 60s.
Dr. Buonassisi on lower eyelids
The two ways into the lower lid, and why he takes out little skin and doesn't pull the lid tight.
Under-eye fat bags can be genetic and show up at 18 or 19. Tightening the lid is usually for people in their 50s or 60s.
Upper eyelids and brows
Heaviness above the eyes doesn't always come from the eyelid. A brow that has lowered over time can push skin down onto the lid.
Dr. Buonassisi checks your brows and your lids at the same consultation. Sometimes upper eyelid surgery is all you need. Sometimes a brow lift does more, and often the two are done in one surgery.
All about brow lift →Also at 8 West Clinic
Lines, hollows and crepey skin around the eyes come from different layers: the muscles that move, the volume underneath, and the skin itself. At your skin consultation our team looks at all three and suggests what would help each one. That can mean combining treatments, spacing them out, or leaving some out.
Wrinkle-relaxing injections are used for the lines at the outer corners of the eyes. Results last about 3 to 4 months.
About wrinkle-relaxing injections →Dermal fillers are used for hollows under the eyes, sometimes called tear troughs. They last about 9 to 18 months, depending on the product and the area. Hollow temples can also be treated with Sculptra, an injectable collagen biostimulator.
About dermal fillers →Light and laser treatments are used for fine lines, crepey skin, brown spots and redness, including around the eyes. Downtime ranges from a day or two to about two weeks, depending on the treatment.
About laser and light treatments →Regenerative aesthetics
Two regenerative aesthetic treatments are used around the eyes.
Whether either suits you, and where it would go, is decided at your consultation.
Light and laser
Our light and laser treatments range from a day or two of mild redness to about two weeks of downtime. Which one is right for you depends on your skin and on how much downtime you can take.
Skin consultations are complimentary. Not sure which applies to you? Tell us on the form or on the call, and we'll book the right consultation.
Before & after
Upper and lower eyelid results by Dr. Buonassisi. Every patient is different.
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AfterReal 8 West patients. Results vary.
View the eyelid surgery galleryRecovery
Recovery is typically 1 to 2 weeks, with bruising and swelling easing gradually.
After upper eyelid surgery, Dr. Buonassisi says most people can go back to day-to-day household activities the next day. Anything strenuous waits at least a couple of weeks, to keep your blood pressure and heart rate low while you heal.
After lower lid surgery from inside the lid, most people take about a week off work or social plans because of mild bruising.
You get your own aftercare instructions, with follow-up visits as you heal. Results are long-lasting, though your eyelids and brows keep ageing naturally over the years.
Your surgeon
Dr. Thomas Buonassisi, MD, FRCSC. His entire surgical practice is the face, head and neck.
He has over 25 years of experience in facial plastic surgery and has performed over 4,000 facial procedures. At your consultation he looks at your lids, your brows and the skin around your eyes, explains what's realistic for your anatomy, and tells you which approach he'd recommend and why.
More about Dr. Buonassisi →
How it works
Send the form at the top of this page or call (604) 733-1669.
We answer your questions and help you figure out your next step, with no commitment.
He assesses your eyelids and brows and recommends an approach. The consultation has a fee.
At a private, accredited surgical facility in the Vancouver area, with follow-up visits as you heal.
Free guide
The questions most people have before a consultation, answered for the eyes and brows, the face, the neck and the lips. Inside:
Questions
Patient reviews
Reviews across both clinics and every kind of treatment.
4.8 average across 1,900+ verified reviews
“Dr. Buonassisi was very professional and friendly. He listened to my questions and was very honest about my expectations. I had a blepharoplasty done, its been two months and it looks fantastic. I look years younger and less tired. I would also say the staff are lovely and very helpful.”
Eyes & brows
Visiting us
Two clinics, one phone number: (604) 733-1669. Financing is available through partner companies, and we can help you choose an option that fits your budget.
Every patient is unique and treatment results vary.
