Is Blepharoplasty something to consider for me? Will it have strong potential to ameliorate the appearance of my eyes? (photo)

It appears from this that the upper eyelid has a lot of excess tissue and may be causing asymmetry as well as a droopy/tired appearance. Does this seem to be the case and does this seem like exactly the job for an upper eyelid surgery or no/not really/diff would be minimal?If so, what sort of improvement/alterations could be done and what would be involved?

Doctor Answers (11)

You appear to have ptosis which can be addressed through specialized surgery by an oculofacial/ oculoplastic surgeon

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With the photo you submitted, your upper eyelid looks a little bit lower than normal. I suspect that you have a condition called ptosis. Ptosis means drooping of the eyelid. To examination the eyelid, we do something called a ptosis evaluation and look at the several things. The center of the pupil and how it relates to the upper eyelid and that is called the marginal reflex distance. When it’s above a certain level, there is no ptosis. However, when it’s below a certain level, there is ptosis. Ptosis is also graded: mild, moderate or severe.

When I look at your photo, I noticed that the creases are very high and there is a slight difference of skin between the two eyes. If you could imagine, if that skin was removed which is what is typically done in an eyelid blepharoplasty, I think there would be no significant difference. As a cosmetic oculofacial plastic surgeon, which has a combination of background training in eye surgery followed by specialized training in plastic surgery of the eyes, I can tell you that I’ve seen many patients who had upper eyelid surgery where the plastic surgeon removed skin in the upper eyelids and yet the person still looked tired. A significant percentage of those cases were due to the fact that the patient actually had ptosis or drooping of the eyelid.

Before you move forward, I think it’s important that you get a proper diagnosis so you can come up with a plan of how to address this ptosis. There are some critical elements of the examination that have to be done. We assess the marginal reflex distance and then look at the activity of a muscle called the levator muscle which is responsible for most of the function of the elevating your eyelid.

I think your next step would be to meet with an ophthalmologist or an oculofacial plastic surgeon to get an evaluation. A proper examination to diagnose your situation is critical, otherwise you may end up getting a cosmetic procedure that does not address the problem. You may need a combination of a levator muscle procedure otherwise known as a ptosis correction to help you improve that tired look. In addition, it’s very important when evaluating ptosis that you look at your history such as looking at old photos and determine if there is a change in your appearance. I hope that was helpful, I wish you the best of luck, and thank you for question.


New York Oculoplastic Surgeon
4.5 out of 5 stars 29 reviews

Ptosis, not blepharoplasty

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You have eyelid ptosis, caused by weak or relaxed levator muscle responsible for lifting the upper eyelid. It is not from excess tissue so blepharoplasty will not help, but rather ptosis surgery. See an oculoplastic surgeon.

Mehryar (Ray) Taban, MD, FACS
Beverly Hills Oculoplastic Surgeon
5.0 out of 5 stars 9 reviews

Droopy eyelids

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I agree with other surgeons. You have ptosis of the left eye, with a high fold which is characteristic of disinsertion of the muscle that elevates the eye.  The right eye is probably normal, but that is best determined on physical exam, and exploration at surgery.   There are many causes for ptosis, but from your photograph, it appears likely that your droopy left eye and asymmetry is due to a weakness in the attachment of the muscle to the eyelid which is easily repaired.  Both plastic surgeons with experience, and oculoplastic surgeons can address this problem, and the correction is pretty straightforward.

Thomas A. Mustoe, MD, FACS
Chicago Plastic Surgeon
5.0 out of 5 stars 20 reviews

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Upper eyelids

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Thank you for your question. As the surgeons below have noted, you have ptosis (drooping) of the eyelids. The right side is mild, the left more pronounced. Correction of ptosis is a completely different operation from blepaharoplasty (cosmetic eyelid surgery) and it is done for completely different reasons. It would be very important to find a plastic surgeon or an oculoplastic surgeon who is familiar with ptosis correction. Not all plastic surgeons have this expertise. Am exam by an ophthalmologist may be the best place to start. As Dr. Demars says below, "It is definitely not a routine blepharoplasty."  

William McClure, MD
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Ptosis surgery

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you have a ptosis of the upper lids, and some asymmetry of the crease and sulcus.  See an oculoplastic surgeon who will be able to address all of these issues for you.

John J. Martin, Jr., MD
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Upper Bleph?

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Thank you for your photo.  I am not appreciating excess skin of your upper eyelid.  I do appreciate left upper eyelid ptosis.  I would seek evaluation and correction of that issue.

Earl Stephenson, Jr, MD, DDS, FACS

Earl Stephenson, Jr., MD, DDS
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Is Blepharoplasty something to consider for me?

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You have bilateral and asymmetric ptosis. There are several possible reasons for this and different options for the repair and may be covered by your insurance. Start with a thorough exam from your aphthalmologist and he/she can then refer you to a surgeon who takes care of that problem. It is definitely not a routine blepharoplasty.

Ronald V. DeMars, MD
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Blepharoplasty is the wrong surgery for you!

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Your photo clearly shows that you have upper eyelid ptosis.  See an oculoplastic surgeon for a careful assessment of your best options.  There are a number of excellent oculoplastic surgeons in the Chicago area.  The American Society for Ophthalmic Plastic and Reconstructive Surgery (ASOPRS) maintains a geographic directory that will help you find a highly qualified surgeon in your area.

Kenneth D. Steinsapir, MD
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Upper eyelid surgery in a male patient

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Upper eyelid surgery in a male patient
Upper eyelid surgery in males requires different approach than in females. Youthful male lids do not have hollow appearance. Prior to performing any surgery it is imperative that the surgeon properly assess individual patient to determine the best surgical approach. Even though definitive diagnosis must be made in person consultation, it appears that in your particular case you have an eyelid ptosis, which requires a very specific type of surgery, different from a standard blepharoplasty. Make sure you seek out an experienced and talented surgeon to properly diagnose and treat your condition.

Boris M. Ackerman, MD
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Is Blepharoplasty something to consider.

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Lid rejuvenation is a excellent way to reduce hooding and fatty prominence in the lid, however based on your photo this might not be the solution for you. See a board certified surgeon in your area and explain your goals.

Peter E. Johnson, MD
Chicago Plastic Surgeon
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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.