Breaking Beauty Podcast
EPISODE SUMMARY
Why Blepharoplasty is Everywhere Right Now, the Best No-Surgery Eye Fixes and Could Contact Lenses be Bad for Your Eyes?
Guest: Dr. Babak Maleki, Oculoplastic Surgeon
Aired: December 10, 2025
Episode Overview
In this episode, hosts Jill Dunn and Carlene Higgins explore the skyrocketing popularity of blepharoplasty—cosmetic eyelid surgery—with expert oculoplastic surgeon Dr. Babak Maleki. The discussion covers everything from what blepharoplasty is, how modern techniques are evolving, the reasons behind its surge in popularity, alternatives for those wanting to avoid surgery, the effects of contact lenses on eye health, and a candid look at Carlene’s personal experience with the procedure—including revision surgery. The episode is loaded with honest insights, myth-busting, and practical advice for anyone considering eyelid rejuvenation.
Key Discussion Points and Insights
1. What Is Blepharoplasty?
[03:50] Dr. Maleki’s elevator pitch:
- Blepharoplasty reshapes the eyelids via removal or repositioning of excess skin and fat.
- “It may involve removal of skin, it may involve removal of fat, it may involve repositioning of fat or adding fat. So it’s basically reshaping the eyelids.” – Dr. Maleki [03:50]
Upper vs. Lower Blepharoplasty [04:11]
- Upper: Focused on removing excess skin/fat from the upper eyelids.
- Lower: May remove excess skin/fat and correct under-eye hollows—often with additive fat techniques.
Why preservation matters:
- Modern approaches emphasize preserving and restoring volume rather than just removing tissue, to avoid the dreaded “hollow-eye” look.
- “When you remove too much fat, you get into trouble in terms of making people look very hollow ... modern techniques for blepharoplasty really is about preservation of tissue.” – Dr. Maleki [04:38]
2. Why Blepharoplasty Is Trending
- According to the International Society of Aesthetic Plastic Surgery, blepharoplasty surpassed liposuction as the most performed cosmetic surgery in 2024, with 2.1 million procedures—a 13.4% year-over-year jump. [02:02]
- It’s relatively affordable compared to facelifts:
- “For blepharoplasty, it can range anywhere from $5,000 USD to up $10,000 USD … if you're looking at facelifts … like 15 to 20 [thousand USD] to up to a hundred thousand.” – Dr. Maleki [17:25]
Value:
- Called “the poor man’s facelift.”
- “In terms of bang for your buck, I feel like this is the poor man’s facelift.” – Carlene [17:02]
- Immediate and noticeable rejuvenation, often making people look 10+ years younger. [18:19]
3. Personal Journey: Carlene’s Story and Ptosis
- Carlene shares her two-part journey: initial surgery and later revision.
- She had ptosis (drooping eyelid), not just cosmetic concerns.
- Ptosis in 11% of people aged 18-65; up to 30% over 65.
- Caused by aging, dry eyes, contact lens use (contact lenses strongly linked!) [20:01]
On ptosis surgery:
- It requires advanced technical skill—different from standard blepharoplasty. Often only oculoplastic surgeons feel comfortable and experienced enough to perform effective ptosis repairs. [21:04–22:29]
- “For those who have actual true lid ptosis, we have to work on the muscle … most plastic surgeons don’t perform ptosis repair … typically done by an ophthalmologist who has training in oculoplastic surgery.” – Dr. Maleki [21:04]
Personal note:
- “I wore contact lenses for 30 years … I had no idea…” – Carlene [22:29]
- Dr. Maleki prefers glasses or LASIK to contacts for long-term eye health. [22:59]
4. Revisions, Expectations, and Choosing a Surgeon
Revisions are common:
- Healing is highly individual—sometimes planned results don’t fully materialize, and revision may be necessary. [24:45]
- “We saw that there was an improvement in the ptosis, but not a complete resolution ... there was still a little bit of asymmetry between the eyes. ... I think this has bothered me enough that we should look at it again.” – Dr. Maleki [24:49–25:49]
It’s not a failure:
- “I don’t see this as, like, a failure in any way ... I’d rather that we did it this way than take the risk of going too far.” – Carlene [27:22]
Choosing a surgeon: Ask if they do revisions
- “Should things not go as planned, are you able to do your own revision surgery? ... If someone’s not doing any revisions at all, that’s a bit of a red flag.” – Dr. Maleki [29:11; 30:41]
5. Aesthetic Considerations & Trends
Overdone Blepharoplasty (the ‘Hollow Eye’ problem):
- Cautionary tale: Speculation about celebrities (e.g., Bradley Cooper’s eyes)—too much fat removal, loss of masculine/feminine facial features, and the dangers of ‘overcorrection’.
- “It’s really important to maintain a person’s character in their eyes. ... In a case like this ... I would probably recommend doing some fat grafting to the upper eyelid.” – Dr. Maleki [09:47–10:12]
- Modern techniques: Volume replacement, tissue preservation, working with—not against—natural anatomy and gendered features. [04:38, 08:33]
6. Surgery Experience & Recovery
Anesthesia:
- Typically done with local anesthesia plus oral/IV sedation—not just “awake with local.” [31:23–32:20]
Downtime and Recovery:
- Most patients back to makeup/everyday life in about one week.
- Scarring: Clever incision placement hides scars in eyelid creases or inside lower lid; final healing can take months.
- “Most surgeons... try to make their incisions in areas that are either completely hidden or not very visible ... I do most of my lower blepharoplasties internally, so there’s no external scars.” – Dr. Maleki [38:44–39:06]
Longevity:
- “Well-executed blepharoplasty typically lasts for years to decades.” [37:09]
- You may not need further procedures for 10–15 years or longer.
7. Alternatives to Surgery: Med Spa Treatments
[41:35] Rationale:
- Surgery is best for significant skin/fat changes, but fine lines/wrinkles often respond better to non-surgical treatments.
CO2 Laser:
- Powerful for tightening skin and reducing fine lines. [41:31–42:44]
- “CO2 laser ... tightens the skin around the eye. So the fine lines and wrinkles... huge difference.” – Dr. Maleki [41:31]
Other Treatment Modalities:
- Radiofrequency microneedling, PRP, fat transfer, brightening creams, and tailored lasers for pigmentation.
- Med spa suite was developed as both adjunct and alternative to surgery. [41:35–42:32]
8. Dark Circles & Eye Bags: The Truth
- “Dark circles” have three main causes:
- Hollowing (tear troughs)
- Eye bags (fat prolapse)
- Skin pigmentation [44:04]
Treatments:
- Eye bags: “Surgery, hands down.” [45:21]
- Hollowing: Prefer fat transfer over fillers, as it’s permanent and doesn’t cause swelling like hyaluronic acid can. [46:41]
- “Your fat ... doesn’t draw water in ... it’s a permanent solution.” – Dr. Maleki [47:41]
- Pigmentation: Lasers and prescription brightening creams (hydroquinone for short term, maintenance with niacinamide/transamic acid). [48:21–50:30]
9. Fat Transfer: The Rising Star
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Microfat and nanofat grafting are the latest buzz in rejuvenation, providing subtle, stable, and natural corrections—especially for hollows.
- “Fat transfer is the thing that’s ... Everyone’s talking about ... now what we’re doing is micro fat ... smaller fat particles ... to get into the minutiae of correcting people’s hollowing. ... works amazing for under eye hollows.” – Dr. Maleki [51:29]
-
Can be done standalone (as a mini procedure) or with surgery. [53:05–54:24]
Notable Quotes & Memorable Moments
- On overdone eyelid surgery:
- “You can feminize eyes or masculinize eyes or take away from that, depending on your approach. ... it's important to maintain a person's character.” – Jill [08:05] / Dr. Maleki [09:47]
- On revision surgery:
- “Should things not go as planned, are you able to do your own revision surgery? ... That’s a really important point.” – Dr. Maleki [29:11]
- On contact lenses causing ptosis:
- “Most of my patients who come to see me who are in their 30s, 40s, and 50s ... either there’s a history of trauma or contact lens use or dry eyes or allergies, those are the kind of four big ones.” – Dr. Maleki [21:09]
- On patient expectations:
- “I wouldn’t say it’s a simple procedure, but it is certainly doable in terms of reversing some [overdone eyelid surgeries].” – Dr. Maleki [10:24]
Timestamps for Key Segments
- [03:50] – Dr. Maleki explains blepharoplasty
- [04:38] – Modern fat-preserving techniques
- [06:01] – “Hollow-eye” problem in pop culture
- [17:25] – Cost and “bang for your buck”
- [20:01] – Ptosis explained, link to contacts
- [24:45] – Revision surgery dialogue
- [29:11] – Questions to vet your surgeon
- [31:23] – Anesthesia and surgical experience
- [37:09] – Longevity of blepharoplasty
- [38:44] – Scar minimization strategies
- [41:31] – Adjunct med-spa treatments
- [44:04] – Dark circles: causes and solutions
- [51:29] – Fat transfer and new advances
Final Thoughts & Resources
- Blepharoplasty remains popular for good reason—high-impact results for cost, rapid recovery, and evolving safe techniques.
- Fat transfer, both as an adjunct and primary treatment for hollows, is a significant trend.
- Always vet your surgeon carefully; ask about revisions and specialty.
- Med spa technologies offer alternatives or enhancements for appropriate patients.
Follow Dr. Maleki on social media: @DrBabakMaleki
For visuals, check Breaking Beauty’s feed for before/afters and further resources.
This summary captures the episode’s core value for anyone considering eyelid surgery or less invasive eye rejuvenation—and delivers real behind-the-scenes wisdom from both patient and surgeon perspectives.