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Can Raising Just the Lower Eyelid Through a Canthoplasty/midface Lift Have an Effect on the Upper Eyelid Position?

After an upper blepharoplasty my eyes have been rounded unnaturally so i am looking for options to lower my upper eyelid or raise my lower eyelid, Can permanent fillers be used for this or will I need surgery? In pictures when the lower eyelid is raised I notice it seems to bring the upper eyelid down partially, in your experience does/can this happen? Also can the lower eyelid be raised evenly or does the corner have to be raised more? I consulted two surgeons who told me different things.

Doctor Answers (6)

Upper lids generally are not affected by lower lid surgery however....

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Upper lids generally are not affected by lower lid surgery however....when the lower eyelid revision surgery is done, it is often done by a lateral canthoplasty/canthopexy. This will change the shape of the eyes by changing the lateral canthus position [where the upper eyelid meets the lower eyelid]. This change can be subtle, or dramatic, depending on the surgical manipulation of its position.

When you state that "in pictures, when the lower eyelid is raised, that the upper eyelid is brought down"  reflects the mechanism of action of the orbicularis oculi muscle. This muscle is a circumferential muscle that runs around the entire eye [both the upper and lower eyelid], and as such, when ever you smile, it  has the effect of raising the lower eyelid, and lowering the upper eyelid, which in effect makes the eye look smaller.

Lower eyelid surgery will not have the same effect as smiling does in photographs.

I hope this makes things clearer.


Seattle Oculoplastic Surgeon
5.0 out of 5 stars 24 reviews

Canthopexy, lower lid blepharoplasty

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A lower lid blepharoplasty typically will not change the shape or position of the upper eyelid.  However, a canthopexy can change the shape of the upper eyelid. A canthopexy is usually performed with an absorbable suture, and the upper eyelid position should return to normal after the suture is resorbed and disappears. If the shape of the eyes is altered by a lower lid blepharoplasty it is usually caused by changes in the position of the lower eyelid , which may also improve over time.  Eyelid shape and position can be corrected with surgery, but this should be postponed for at least a year if there are no symptoms of dry eyes or exposure of the eye causing itching or burning.

Edward Farrior, MD
Tampa Facial Plastic Surgeon
4.5 out of 5 stars 10 reviews

Eyelid Shape Can Be Changed With Surgery

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Eyelid surgery can change the shape of your eyes.  Revisionary surgery can also adjust changes.  A definitive diagnosis and recommendation cannot be made without an examination and photos. Seek consultation form a board certified surgeon with significant experience in oculoplastic surgery.

Robert F. Centeno, MD, FACS
Fairfax Plastic Surgeon
5.0 out of 5 stars 38 reviews

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Eyelid level altering

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Upper and lower eyelids can be altered separately, without effect on the other.  Surgery is an option but filler injection may do the same thing, in the right patient/problem.  See an oculoplastic surgeon for evaluation.

Mehryar (Ray) Taban, MD, FACS
Beverly Hills Oculoplastic Surgeon
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Canthopexy

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A canthopexy is performed for lower lid malposition or weakness. It will not affect the upper lid significantly.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 17 reviews

Yes but it is not what you think.

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Unfortunately pushing the eyelid around with the finger is not the same effect as what surgery does.  The rounding of the eyelid corner is the result of stretch back of the eyelid after eyelid surgery.  This literally pulls the corner of the eyelids alway from its insertion on the lateral orbital rim.  When this occurs, the upper eyelid is able to float causing lateral flare of the upper eyelid.  Returning the lateral canthal angle to the orbital rim fixes the rounding and the flared upper eyelid.  How we accomplish this depends on the anatomic details of your eyelids and can be addressed in a personal consultation.

Kenneth D. Steinsapir, MD
Los Angeles Oculoplastic Surgeon
5.0 out of 5 stars 17 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.