I have been told that once upper and lower eyelid surgery has been performed, that subsequent eyelid surgeries are not recommended as they often do not go well. Is that true? I had an upper and lower bleph done 20 years ago and it looked great for many years. Now at 63 years old, due to aging and a bad fat transfer procedure, I am considering a 2nd upper/lower bleph... but am worried about trying it a 2nd time. What are your thoughts on 2nd bleph surgeries?
Second Upper and Lower Eyelid Surgery Recommended?
Doctor Answers (8)
Eyelid Ptosis Surgery Candidate
Depending on anatomic changes such as skin excess and the development of eyelid drooping (called "ptosis"), you can safely have more than one eyelid procedure in your lifetime. I would like to point out to you that you appear to have ptosis, particularly affecting the left eye where it is difficult to see your pupil. A blepharoplasty alone is not likely to make your eyes look "brighter" without the ptosis being addressed. Ask your doctor when you have your consultation about "eyelid ptosis" and learn about your ptosis eyelid surgery options.
Blepharoplasty is cosmetic surgery to remove skin, muscle or fat. This is not what you need!
Your upper eyelids are sunken. This can occur over time but removal of the upper eyelid fold at the time of blepharoplasty can certainly contribute to the process. There is essentially not a drop of spare skin in your upper eyelids. However your upper eyelids are droopy or ptotic with the upper eyelid margin encroaching into the pupillary axis. The hollow upper eyelids are consistent with a particular type of upper eyelid ptosis known as levator dehisence ptosis. Will you benefit from ptosis surgery? The answer yes must be also weighed against how dry your eyes are. Right now the heavy upper eyelids protect the corneal surfaces. When the upper eyelid margin is lifted with ptosis surgery, more of your cornea will be exposed to the air which can contribute to drying. A detailed consultation is really needed to accurately address this question to be certain that performing this type of surgery will not cause excessive eye dryness. Regarding the lower eyelid, again from the photo I suspect that a chemical peel rather than surgery might be a better approach for you. Can eyelids benefit from more than one surgery, The answer is yes, but it is wise to have things done right the second time around.
Eyelid ptosis and volume loss is the problem most obvious in the photo you have posted. The eyelids are droopy. You are obviously compensating on the left eyelid with your brow elevation.
Addressing the eyelid ptosis may also improve the hollowness of the upper eyelids, but certainly fillers or fat grafting [done appropriately] would also improve this hollowness.
If you decide to explore this further, I would recommend consultation with an ASOPRS trained Oculoplastics surgeon. You can find one close to you on the ASOPRS dot org website.
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Second Upper and Lower Eyelid Surgery Recommended
You certainly can have another eyelid surgery if it is needed. However, often it is not the same procedure as you had before. For instance, It seems like you have ptosis (droopy eyelid). A ptosis repair might be all you need and that would be a different incision and plane from your previous surgery. Sometimes a brow lift is indicated. Laser resurfacing or peels can be performed for your lower eyelid skin. The best thing for you to do is see an Oculoplastic surgeon to determine what the best cosmetic procedure is for you and see if you are a good candidate for that procedure. Good luck.
Repeat eyelid surgery / blepharoplasty
There is no problem with having another eyelid procedure, especially 20 yrs after your original surgery. Your eyelids will continue to age and your eyelid skin will continue to loose tone. Repeat eyelid surgeries are a little more complicated because of changes in eyelid anatomy and scarring. The tissue planes may not be as distinct. This is only a problem if you have revision surgery when the wounds are still healing and the scar tissue hasn't had a chance to settle down. Initially when fresh wounds heal, the scar tissue is very thick and firm. After 6 months to a year, the scar tissue settle down and soften. Once the scar tissue has settled, surgery is much safer and easier. Consult your plastic surgeon to discuss your specific needs and surgical plan. During surgical planning, your surgeon will take into account your previous blepharoplasty surgery.
There is no specific problem with performing a second blepharoplasty procedure, especially 20 years after your initial surgery. With any revision surgery changes resulting from the previous procedure must be taken into account so you should consult with a surgeon with experience performing second blepharoplasties. Additionally, the aesthetic considerations will be different for you now since you are 20 years older and have had fat transfer. All of this needs to be discussed to determine which procedures are best for you.
Revision blepharoplasty is sometimes indicated, but it is very individualized based upon your exam. I recommend a consultation with a surgeon. Good luck.