What Procedures Can Be Used to Remove Extra Creases in the Eyelid?

I have never received blepharoplasty. I developed a natural crease, but the high crease has put pressure on the lid causing a second crease to form very close to the lash line. The lower crease only extends halfway, but when I squint a lot due to laughing or smiling it extends all the way and obstructs my higher crease. I was told that the prodcedure requires an incision across my whole eye. Is this the only way? Can the suture method be used halfway or fillers? I don't want something unnatural.

Doctor Answers (8)

You have skin laxity in the upper eyelid platform.

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Normally, this skin is held firm over the eyelid platform by attachments between the upper eyelid skin and the levator aponeurosis-the tendon of the muscle that raises the eyelid.  These attachments make the upper eyelid crease.  When there is breakdown of the attachments, one sees laxity of the skin in the upper eyelid causing the appearance you see.  Surgery necessary to correct this is called anchor blepharoplasty.  It reestablishes the connection between the upper eyelid skin and the levator aponeurosis.  This is an advanced technique that should only be performed by a properly trained, expert eyelid surgeon.  Most general plastic and facial plastic surgeons lack the necessary training to perform this type of surgery.  However, by doing your home work, you will find well qualified surgeons who can help you with this very precise upper eyelid surgery. 


Los Angeles Oculoplastic Surgeon
5.0 out of 5 stars 16 reviews

Excess Creases in the Eyelid

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It sounds like you have been given correct advice- this does sound like a surgical problem. Sometimes these excess creases are related to a partial levator dehiscence, which needs to be repaired if it is associated with a significant lid droop.

Jeffrey Epstein, MD, FACS
Miami Facial Plastic Surgeon
4.5 out of 5 stars 46 reviews

Blepharoplasty for skin folds

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I would agree that a blepharoplasty will most likely be your best option. However, I would need to see your brow better in order to determine if you may benefit from a brow lift as well. Fillers may help, but in your case, my guess is that blepharoplasty will likely be your best option. There is no definitive way of knowing without an exam, so I would encourage you to seek a consultation. Good luck with your search.

Ryan Greene, MD, PhD
Fort Lauderdale Facial Plastic Surgeon
5.0 out of 5 stars 43 reviews

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Blepharoplasty Is Needed To Remove Skin Fold

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That 'new' second lower upper eyelid crease appears to be loose skin between the normal lower eyelid crease and the lashline. It is possible it may be caused by some brow sagging but your picture does not show the eyebrow area. Injectable fillers will only make your upper eyelid fuller and will not eradicate the bothersome skin fold. It appears that only skin removal through a blepharoplasty incision approach will be effective. 

Barry L. Eppley, MD, DMD
Indianapolis Plastic Surgeon
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Eyelid crease

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Some of the "eyelid crease excess" is due to fat loss in the upper eyelid, brow area, causing sagging of overlying skin.  For that, filler injection in the upper lid a good option.   However, it is best to get a consult to evaluate the upper eyelid.  Blepharoplasty may be an option.

Dr Taban

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

Upper blepharoplasty, eyelid creases

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In my opinion one other option is to position the creases a little higher by upper blepharoplasty approach. As the crease also tends to displace inferiorly with age, so I think repositioning it might help.

Sanjay Parashar, MD
Dubai Plastic Surgeon
5.0 out of 5 stars 6 reviews

Restalyne or Juviderm can be used for fill out the eyelid crease.

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Restalyne or Juviderm can be used for fill out the eyelid crease. A upper lid blepharoplasty can remove the excess skin. If you eyebrow has fallen, a forehead(brow) lift will kill 2 birds with one stone.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 15 reviews

It looks like extra skin

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It appears that the aging process has loosened the skin below the crease. Since your crease is already deep I don't think the suture technique for forming a crease would be helpful. I think you do need to cut the eyelid where the crease is and remove some extra skin.

Jeffrey Schiller, MD
Staten Island Oculoplastic 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.