I have excess flesh drooping over my eyes which makes me look constantly tired. I have consulted with a UK surgeon but he told me an upper-blepharoplasty would be a bad idea and instead recommended a brow-lift (I assume because the excess skin is fleshy rather than just thin skin), he also informed me that my eyelids are fairly Asian in appearance, I'm quite happy with the position of my eyebrows and would like a wider opinion on whether or not to seek an upper-blepharoplasty elsewhere. Russel
24 Year Old Male with Excess Flesh Above Eyes. Considering Upper-Blepharoplasty? (photo)
Doctor Answers (11)
Male Upper Lid Blepharoplasty vs Browlift or Both
Correction of upper lid fullness and skin laxity often involves a combination of browlift and blepharoplasty. The browlift primarily addresses the tail of the brow where the ptosis or drooping is seen as the hooding of the lateral or outer upper lid with extension beyond the corner of the eye. If this hooding is seen, upper blepharoplasty alone will improve some of the upper lid laxity but there will continue to be hooding particularly in this outer aspect. As already stated, browlift in males must be done conservatively to avoid an operated-on or feminized appearance. If you are unsure, it is certainly best to seek additional consultations. You might also consider starting with the blepharoplasty and then if you are not completely satisfied, consider the browlift as a separate procedure. Another thing to keep in mind is the placements of the incisions for the browlift. Even if you have hair now, this may change in the future and scars may become visible if placed in the front of the scalp. Since most of your hooding involves the tail of the brow, you might consider a temporal browlift that would leave the scar in an area that is not typically associated with masculine hair loss. Hope this helps.
Conservative blepharoplasty may help
24 yr old Eyelid and Brow Surgery
Eyelid surgery may be appropriate at your age, but a physical exam would be necessary to determine this. Also, it would be helpful to evaluate your brow position at rest and in animation. Botox carefully administered could be used to simulate a brow lift prior to anything being done to get an idea of how that would improve the eyelid skin.
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Upper blepharoplasty for 24 year old male with excess skin
A blepharoplasty is usually all that is needed when excess skin is touching the upper eyelids. When patients have very low eyebrows across the forehead, then consideration can be made for a brow lifting procedure. The incision for the upper lid blepharoplasty is located in the upper lid crease and is only minimally detectable once it is healed. Both brow lift procedure and a blepharoplasty are performed under general anesthesia as outpatient surgery.
Brow lift is the direction to consider.
Your brow position is the culprit. Consider a moderate browlift. You could consider Botox injection to lift the brow as a temporary fix which would allow you to visualize your brow when elevated.
Male upper blepharoplasty
Male upper blepharoplasty is more conservative than female upper blepharplasty. Upper blepharoplasty is also more conservative in Asian people. If you like the current position of your eyebrows, then upper blepharoplasty may help you but it has to be done conservatively. See an oculoplastic surgeon.
Brow lift and possible upper lid surgery?
Of course, an exam is essential. But based solely on your photos, you look like you have a low brow and possibly could benefit from it being lifted.
Blepharoplasty or brow lift.
It is a bit difficult to give you a definitive answer without a direct examination, but your photos do suggest that a brow lift would be a better option as the position of the brow is low. This will help "open" the eyes and give a more rested appearance. Occasionally, in younger individuals, a neuromodulator such as Botox or Dysport in the glabella (between the eyes) and the crow's feet can lift the brows a little bit. This may be enough for a while and worth a try before proceeding with surgery.
24 Year Old Male with Excess Flesh Above Eyes. Considering Upper-Blepharoplasty?
The three best options for this type of problem are blepharoplasty, browlift or combined blepharoplasty and browlift. The choice depends upon your anatomy and the reason for your heavy upper lids (extra skin/ fat, drooping eyebrows or both). My suspicion based on your limited photos is that both procedures would provide you the best result. The key in facial plastic surgery for men is to maintain your masculine appearance and not feminize your face. Seek a consultation with a Facial Plastic Surgeon who will not feminize your face. I hope this information is helpful.
Stephen Weber MD, FACS
Thank you for your question and the pictures. It is difficult to give an accurate opinion without an in-person exam, however it appears that you would benefit from a brow lift as well. The recommendations are not because the excess skin is fleshy but rather because your brows, at least from the photos, appear to be low in position.
The best advice I can give you is that if you are dissatisfied with your first consultation, seek a second and if need be a third opinion. Again from looking at the pictures you have provided and not having the advantage of an in-person exam, it seems as though your first consultation was spot-on.
I hope this helps. Best of luck.
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