Ask a doctor

It is possible to lower my eyelid crease?

My eyes often look sunken in because my eyelid crease is higher up, as well as making my eyes look bigger than I would like. Is it possible to have your eyelid crease lowered?

Doctor Answers (3)

Lowering the eyelid crease.

+1
It is aesthetically desirable and usually possible to ‘lower’ the eyelid crease. Without further information this answer is rather general because there are several possible reasons for a ‘high’ lid crease.
Some people are born with a higher than usual eyelid crease, described as such because the lid fold which is formed from the lower part of the infrabrow skin above the crease is not sufficient to hang low enough on the lid to conceal the crease.
An integral part of the aging process is resorption of some of the original fat here. So, people who had deep-set eyes when young develop deeper set eyes that can eventually give a gaunt look. Replacing the missing volume with a small amount of fat injection or filler is most effective.
The commonest acquired cause seen in my experience is people who previously had standard upper lid surgery that has been overdone. As a result the lid fold has been over- reduced. This can usually be improved with secondary upper lid surgery combining the tarsal fixation technique to conserve skin, and often adding volume in the form of a small amount of fat.
In older people, weakness can develop in the attachment to the lid of the levator muscle that lifts the lid. You can see this as the edge of the lid sits lower on the eyeball from dropping of the lower part of the lid. This part of the lid becomes too visible, while the crease itself is pulled higher by the lifting muscle. This is called lid ptosis and is correctable




Melbourne Plastic Surgeon
5.0 out of 5 stars 18 reviews

Generally it is very difficult to lower a crease.

+1
Fillers are helpful to suggest a more full sub brow area and this can help hide the crease.  Generally it is unrealistic to expect a satisfactory result by grafting fat into the upper eyelid.  That is because the fat will cause scaring and be unsatisfactory.  The best resuls occur when there is coexistent upper eyelid ptosis.  Correcting the ptosis creates an opportunity to raise the upper eyelid crease.  In some cases it can also bring orbital fat forward which improve the hollow upper eyelid sulcus.  I recommend a certain level of skepticism of promises.  I would ask to see before and after photos showing examples of what the surgeon is proposing.

Kenneth D. Steinsapir, MD
Los Angeles Oculoplastic Surgeon
5.0 out of 5 stars 16 reviews

It is possible to change your eyelid crease height.

+1
It is very difficult to assess the problem you are describing without a photograph or an examination. Elevated eyelid creases can be caused by eyelid ptosis (drooping) or hollowness. These problems can be corrected either surgically or with fat grafting or dermal fillers. It would be a good idea to have this evaluated by an experienced Oculoplastic Surgeon.

David Schlessinger, MD
Long Island Oculoplastic Surgeon
4.5 out of 5 stars 10 reviews

You might also like...

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.