I have always had a low crease with full upper eyelids. (photo)

Hello, I have always had a full upper eyelids with a small lower crease. Now that I'm 46 the skin on the upper eyelid is drooping and sagging over the lower crease and making it difficult to apply eye shadow and not to mention making my look tired. What can be done to maintain my natural ethnic appearance that I have always had and reveal my natural shape of my eyes with out looking surgical?

Doctor Answers (8)

I have always had a low crease with full upper eyelids.

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I am not sure you have just a low crease??? Only IN PERSON examination would allow that to be determined. I think you have excess skin that hangs over the crease... 


Miami Plastic Surgeon
4.5 out of 5 stars 64 reviews

Proper evaluation for Upper Blepharoplasty

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Classic Upper blepharoplasty typically creates well defined but hollow and not necessarily more youthful look. Your photos are quite illustrative. A young person’s eyelid is well defined and yet full and youthful. An experienced and talented surgeon will attempt to recreate a a youthful appearing eyelid by using techniques that not only define the eyelid crease but recreate youthful fullness. Seek out an experienced plastic surgeon that will carefully analyze your current anatomy and your wishes for a more youthful look. Make sure that you and your surgeon are clearly communicating as to your desired final appearance.

Boris M. Ackerman, MD
Newport Beach Plastic Surgeon
5.0 out of 5 stars 33 reviews

I have always had a low crease with full upper eyelids

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From these photos, it looks like you would get a homerun result with an upper lid blepharoplasty. This procedure would make you look more rested and open up your eye. In my experience the most important thing in assuring a quick recovery from blepharoplasty is minimizing bruising and swelling. Bruising is much easier to prevent that to get rid of. I have all my patients ice as much as possible from the time they get home until they go to sleep that first night. And I instruct them to not recline any more than 45 degrees until they go to sleep that night. And stay away from salt. Patients who follow these instructions generally heal very quickly with little or minimal bruising or swelling. Good luck, Dean Vistnes.

M. Dean Vistnes, MD
Bay Area Plastic Surgeon
5.0 out of 5 stars 20 reviews

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Sagging of upper eyelid in Asian eyes

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Sagging of upper eyelid in Asian eyes may need only a mini brow lift since you have a tired appearance .
This may need a slight upper blepharoplasty with it but I doubt is since the brow lift "kills 2 birds with one stone".

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
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Upper blepharoplasty for excess skin and fatty deposits

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The fullness in the upper lids is caused by excess fatty deposits in the 2 compartments on the upper lids and excess skin present  folding over upon itself over the eyelashes. A  conservative upper blepharoplasty can address removal of excess skin and fat to rejuvenate the upper eyelids. For many examples, please see the link below

William Portuese, MD
Seattle Facial Plastic Surgeon
5.0 out of 5 stars 60 reviews

Asian blepharoplasty

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You can maintain your ethnic appearance and improve your eyelid appearance with judicious removal of skin and sculpting of the fat around the eye. You may benefit from repositioning the brows, as well. Have your eye evaluated by a board certified surgeon with expertise in Asian blepharoplasty.

Suzanne Kim Doud Galli, MD, PhD, FACS
Washington Facial Plastic Surgeon
5.0 out of 5 stars 5 reviews

Anchor blepharoplasty sure, that it the basis for making a hard upper eyelid crease.

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What you need is very thoughtfully performed double fold surgery.  The goal is not raising the crease.  It is not removing all of the upper eyelid skin that hangs on the eyelid platform.  The goal is to expose a small strip of eyelid platform just below the upper eyelid crease so you have a distinct place to apply makeup without fundamentally altering the character of the eyelid.  This means making a lower upper eyelid crease.  This means removing a minimal amount of upper eyelid skin.  This means performing an anchor blepharoplasty to attach the upper eyelid platform skin and muscle to the levator aponeurosis.  Tarsal fixation is not actually appropriate because this prevents the transmission of the force from the levator palprebra superiors muscle into the upper eyelid skin.  Permitting this force into the upper eyelid platform means that the skin stays snugged like one might tighten a bed sheet.  This prevents irregular skin below the upper eyelid crease that can interfere with the successful application of upper eyelid make up.  As you look for a surgeon, be absolutely that they actually perform double fold surgery and know what they are doing.  Fixing these situations after the wrong procedure is very difficult.

Kenneth D. Steinsapir, MD
Los Angeles Oculoplastic Surgeon
5.0 out of 5 stars 18 reviews

An upper blepharoplasty can establish a higher lid crease if you wish.

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You may not know that an upper blepharoplasty can not only remove redundant skin and sculpt the eyelid, but it can be performed to create a higher lid crease by a technique called tarsal fixation. This has been popular with some asian people for many years. I would advise a detailed consultation with an expert eyelid surgeon, such as a board certified facial plastic or occuloplastic surgeon to discuss the details, and see results.

Harrison C. Putman III, MD
Peoria Facial Plastic Surgeon
5.0 out of 5 stars 10 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.