Elbert Vaca

Upper Blepharoplasty Revision + Fat Grafting

This beautiful patient had previously undergone upper eyelid surgery elsewhere. Every case is unique, and hers presented several challenges.

Unlike the typical presentation, her upper eyelid “hooding” was concentrated along the inner (medial) aspect of the eyelids. She also had significant asymmetry, hollowing, and prominence of the medial orbital fat pads (the bulging near the inner corners of the upper eyelids).

Achieving a balanced, natural result required careful surgical planning and a customized approach. This included a modified skin excision pattern, selective sculpting of the medial orbital fat pads, and precise fat grafting, with a greater volume transferred to the left upper eyelid compared to the right. Additional fat grafting was performed along the lower eyelid–cheek junction to restore a smoother transition.

The result is a beautiful, yet natural-looking transformation.

Revision eyelid surgery is particularly challenging. The goal is not simply to remove excess skin or restore lost volume, but to achieve better symmetry, restore youthful contours, and create a refreshed appearance - all while preserving the patient’s unique features and identity.

Face & Neck Lift | Lower Blepharoplasty | Facial Fat Grafting

For this beautiful patient, our goal was to achieve a refreshed, more youthful appearance while preserving her unique features.

Her elegant result and improved jawline definition were achieved through a carefully planned and meticulously executed facelift.

For me, a precise & elegant facelift comes down to four key principles:

1. Scar concealment: Precise incision placement to make scars as inconspicuous as possible.

2. Lifting: Safe and meticulous repositioning of the SMAS and deeper tissues, while avoiding tension on the skin.

3. Reduction: Carefully sculpting the neck and jowls to address excess volume and restore definition.

4. Volume restoration: Strategic fat grafting to restore youthful facial contours and balance.

The challenge lies not only in executing each of these steps, but in understanding how they work together to create a natural, harmonious result.

This balance of technical precision and artistry is what makes facelift surgery one of the most challenging and rewarding procedures in plastic surgery.

3 months after surgery

Upper & Lower Blepharoplasty + Fat Grafting 🎨

6 months post-op.

I couldn’t be happier for this beautiful patient and her natural-appearing result.

Notice the improvement in her upper eyelid symmetry. I intentionally removed slightly more skin from her left upper eyelid to create a more balanced eyeshadow space between the two sides.

For her lower eyelids, I carefully sculpted the prominent lower eyelid fat and complemented the result with fat grafting to restore volume along the tear trough and high cheekbone.

Slide 4: Notice the restoration of volume along the high cheekbone and how it creates a smoother, more youthful transition between the lower eyelid and cheek.

Small details matter; especially around the eyes.

Face & neck lift surgery is truly an art and a labor of love ✨

This beautiful patient in her 40s was bothered by jowling, neck fullness, and skin laxity. Now 3 months after surgery, she is thrilled with her result and was kind enough to allow us to share her beautiful transformation.

We turned back the clock while preserving a natural appearance, revealing a beautifully sculpted neck contour and enhanced jawline definition.

Achieving this result requires careful release of the facial retaining ligaments, followed by lifting and repositioning of the deeper fascial layers of the face and neck (SMAS and platysma). We also sculpted the superficial and deep structures of the neck - often referred to as a “deep neck lift” - to reduce unwanted fullness and create a more refined contour.

Upper ✨

This beautiful patient in her 40s is looking fantastic at only 6 weeks after surgery.

While upper blepharoplasty may seem simple, achieving a refined and elegant result requires careful attention to the smallest details.

Note the beautiful, crisp, and youthful arc of her upper lid crease, the enhanced eyelid show (pretarsal space), and the reduction in fullness along the inner aspect of her upper lids.

She still has some mild swelling, and her result will continue to refine over the next few weeks 👌

Grateful for this incredible review from a patient of mine who traveled all the way from Hawaii to Florida for her face & neck lift. 🙏🏼

Perhaps the greatest compliment I can receive is hearing that a patient feels refreshed and younger, while still looking completely like herself.