Combined Upper and Lower Blepharoplasty with Canthopexy

Patient Overview

• Patient: Murat

• Age: 49

• Gender: Male

• Procedures: Upper and lower eyelid surgery (blepharoplasty), canthopexy

• After photos taken at: 1 month post-op

• Location: Istanbul, Turkey

Why Some Patients Need Both Upper and Lower Eyelid Surgery

When ageing affects the entire eye area, addressing only one eyelid can leave the result looking incomplete. Murat, a 49-year-old male patient, presented with heavy upper eyelids that created a tired, hooded appearance and lower eyelid concerns including prominent fat bags, skin excess, and a degree of scleral show — the visible white below the iris that can make the eyes look round or startled. Rather than staging these as separate operations, Dr. Cem Berkay Sinaci, a European board-certified plastic surgeon (FEBOPRAS) and member of ISAPS and ASPS, planned a single-session combined upper and lower blepharoplasty to restore harmony across the entire periorbital frame.

What Is Canthopexy and Why Was It Needed?

Canthopexy is a procedure that tightens the lateral canthal tendon — the structure anchoring the outer corner of the eye to the orbital rim. In Murat's case, this tendon had loosened over time, contributing to scleral show and a slightly downturned outer eye corner. By performing canthopexy alongside the lower blepharoplasty, Dr. Sinaci was able to correct the scleral show and create a positive canthal tilt, where the outer corner of the eye sits slightly higher than the inner corner. This subtle detail is one of the hallmarks of a youthful, rested eye and is frequently overlooked in standard eyelid surgery.

The Subciliary Approach for Lower Blepharoplasty

For Murat's lower eyelids, the open subciliary approach was chosen. This technique places the incision just below the lash line, providing direct access to the lower eyelid fat compartments and the skin envelope simultaneously. Through this single incision, Dr. Sinaci was able to remove excess fat bags that were creating shadowing and puffiness, trim redundant lower eyelid skin, and perform the canthopexy to reposition the lower lid margin.

The subciliary approach is particularly well suited for patients like Murat who have both volume excess and skin laxity. A transconjunctival approach — where the incision is placed inside the eyelid — would have addressed the fat bags but left the skin excess untreated. Having trained in advanced facial rejuvenation techniques in Brazil under renowned plastic surgeon Raul Gonzalez and through cadaver dissection courses in Bangkok, Dr. Sinaci selects the approach based on what each individual anatomy demands rather than applying a single technique to every patient.

Male Blepharoplasty: Preserving Masculine Features

Eyelid surgery in male patients requires a different aesthetic framework than in female patients. The goal is not to create a wide, bright, feminised eye but to restore a strong, rested appearance that suits the male brow and facial structure. In Murat's surgery, Dr. Sinaci was careful to preserve adequate skin fullness in the upper lid crease rather than removing too much, which can create an overly hollow or surprised look in men. The lower lid work similarly aimed for a natural reduction in puffiness without creating a hollow, skeletonised appearance.

Non-Dissolvable Sutures for Precision Healing

For both the upper and lower eyelid incisions, Dr. Sinaci used non-dissolvable suture material. While dissolvable stitches are popular for their convenience, they generate a stronger inflammatory tissue reaction as they break down, which can lead to wider or more visible scars in the delicate eyelid skin. Non-dissolvable sutures sit quietly in the tissue, cause minimal inflammation, and are removed in a simple clinic visit between four and six days after surgery. This approach consistently produces finer, less noticeable scars — a detail that matters greatly on the face.

Understanding the One-Month Result After Combined Eye Lift Surgery

Murat's before and after photos were taken one month after his combined upper and lower blepharoplasty. At this stage, the majority of swelling has resolved and the tissues have settled into a position very close to the final result. The upper lids show a clean, natural fold without excessive hollowing. The lower lids are smooth, with the fat bags and skin excess corrected, and the positive canthal tilt created by the canthopexy is clearly visible. The scleral show has been corrected, and the eyes now have a balanced, alert appearance.

It is worth noting that complete healing of eyelid surgery continues over three to six months. Minor firmness along the incision lines will continue to soften, and any residual trace of the lower lid scar beneath the lashes will fade further. However, what is visible at one month gives a highly reliable preview of the long-term outcome.

Is Combined Upper and Lower Blepharoplasty Safe?

Performing both upper and lower eyelid surgery in a single session is a well-established practice in plastic surgery, provided the surgeon has the experience to manage the tissue dynamics of both lids simultaneously. The key consideration is avoiding over-resection — removing too much skin or fat from the lower lid in particular can compromise eyelid closure and create complications. Dr. Sinaci's approach prioritises conservative, measured tissue removal in the lower lid and supplements the correction with canthopexy rather than relying solely on aggressive skin excision.

Choosing a Surgeon for Blepharoplasty in Istanbul

For patients considering eyelid surgery in Turkey, the complexity of a combined upper and lower procedure with canthopexy highlights the importance of choosing a board-certified plastic surgeon with specific training in periorbital anatomy. Blepharoplasty is one of the most commonly performed facial procedures worldwide, but cases involving scleral show correction and canthal repositioning require a deeper understanding of eyelid mechanics and the orbital support structures.

At this one-month milestone, the initial post-operative swelling has largely resolved, allowing the significant benefits of the male blepharoplasty 1 month post-op to shine through. The upper and lower eyelid surgery men Istanbul photos clearly demonstrate how the procedure has effectively addressed both excess skin on the upper lids (often causing a hooded appearance) and puffiness or bags under the eyes. This creates a more open, vibrant, and less tired look.

The aim of this male eye lift before after Turkey transformation is always to enhance the eyes in a way that is subtle and aligns with masculine facial features. We focus on creating natural male blepharoplasty results that make the patient look more rested and alert, without appearing 'operated on.' The carefully placed incisions are now very discreet and continue to fade, blending seamlessly into the natural creases of the eyelids.

For men considering Istanbul male eye rejuvenation or searching for under eye bags treatment male Istanbul, this case provides an excellent real-world example of what to expect at one month into the healing process. The patient's refreshed gaze and more alert appearance are a testament to the effectiveness of cosmetic eye surgery for men Turkey in delivering long-lasting and harmonizing results.