Eyelid Surgery

Ptosis Surgery

Botox

Based on your photos, I think that mainly your brow has descended into your eyelid area and is creating that hooded/droopy appearance which a brow lift would address. You might also have some excess eyelid skin that a blepharoplasty might address, but this requires measurements taken at an in person consultation. I would suggest getting evaluated by an oculoplastic surgeon who had optimal understanding of the eyelid/eyebrow anatomy, and will guide you to choosing the surgery that will give you the best results without wasting your money.

I know it’s probably ideal to get both but with money being an issue I have to pick one for the moment.

Do I need upper Bleph or Brow lift? (photo)

Some patient have more "scleral show" which is the white part between your eye and your lower eyelid. This is often due to anatomy and the relationship between your eye, eyelid, and eye socket. Sometimes the eye protrudes farther out of your eye socket due to systemic issues such as thyroid/autoimmune conditions. An orbital decompression is a surgery that enlarges your bony eye socket to create more space for your eye (and make it not protude as much). It is a very big surgery, and you need proper evaluation with bloodwork and imaging to determine if you are a candidate. You can also consider eyelid surgery (canthoplasty) to bring the lower eyelid higher up but that will change the overall shape of your eyes. For these surgical evaluations you should seek a consultation with an oculoplastic surgeon.

Growing up, I have always been insecure about my eyes, especially when it came to photos because I’d always focus on my uneven eyelids and the white space above my lower eyelids. I’ve also been always told I have big eyes or bug eyed. Im not sure exactly what procedure would exactly work for me but orbital decompression seems to be the only option that would work for me. Would I be a good candidate for this? Is there something else that might work better like a blepharoplasty?

Orbital Decompression? Insecure about my uneven, bulging eyes. (photos)

Can try another form of botox (xeomin, dysport, daxxify) to see if it will paralyze the muscles in the area more and soften the 11s. Otherwise will have to consider a procedure (forehead lift) if you want to more permanently treat the area.

I am a male about to turn 50. What bothers me most is the lines between my eyebrows immediately people say Botox could assist, but after recently receiving a treatment of 76 units, I still had the issue so I went back two weeks ago and had an additional 20 more to treat the area. Obviously, I still have the problem and I am not sure if it was because of the treatment not being done correctly or if in fact, I should consider something else in terms of a procedure.

Men’s Botox for the 11s (photo)

It looks like your left upper eyelid hangs lower over your eye than your right. This is called "ptosis." Your case is mild and is like congenital (you were born with a weaker muscle on that left side) and is just getting worse overtime. There are surgical (ptosis repair) and nonsurgical (upneeq drop) options to fix mild ptosis. I would suggesting seeing an oculoplastic surgeon who will test and offer you either option to help lift the left eyelid to match the height of the right one.

For a few years now i have noticed my left eyelid is lower than the right. I don’t believe it was always like this (unless it was very subtle to begin with). From minimal research, i’m not sure if it may be ptosis, extra eyelid skin, or something else. Is there a way to fix this, and what might it be?

One eyelid is lower than the other - how to fix? (Photo)

If you have had two upper blepharoplasties and there is still some heaviness/hooding especially in the outer corners, then it is probably your eyebrow that is overhanging your eyelids. Your eyebrow also "droops" with time and gives the appearance that there is excess eyelid skin. However, your surgeon removed the maximum amount of eyelid skin without giving you issues of closing your eyes. So I would consider brow lifting procedures if you are still bothered by the appearance.

I had a revision from unsatisfactory upper bleph but now my outer lid is heavier especially the right eye. I've included photo of before procedure after procedure. My eyes seem more crepy and look older than before. What needs to be done to make this better?

Outer lid heavier after revised upper bleph (1 year post-op) - What needs to be done to make this better? (photos)

You can try steroid or 5FU injections to help with the thicker areas of the scar. Massaging the scar is also very effective for improving the bumpiness. If the IPL does not help I would then consider surgical revision after a few months.

~9 months post-upper and lower bleph. I’ve had persistent bumps along my incisions, currently working with an oculoplastic whose done 2 rounds of profrac laser to help with the suture bumps and flatten out scar but it might be making it worse? Also dealing with ocular rosacea and blepharitis and recently started IPL for those issues. Do I stop the profrac orask about other laser options? Do I seek out a revision once I’m done with IPL? Feeling very discouraged and wish I hadn’t had disolvables.

Bumpy bleph scars - seek revision?

I usually wait 2-3 months after ptosis surgery before I assess the final eyelid height/appearance and consider revision. The muscle that was worked on is bruised/swollen and takes longer to heal than your eyelid skin.

i have congenital ptosis of the left eye, had 2 previous ops, i have just had a 3rd revision, this time it was over corrected a small amount intentionally, its been 10 days + still healing which i understand but it looks worse than before, the crease appears to be too high and more excess skin, it feels really heavy on the eyelash part of my lid, as i said I’m aware its still partially swollen, but i cant help but feel like this will be the end result. Would it be best to revise now or wait?

Ptosis revision - would it be best to revise now or should I wait? (Photo)

An upper eyelid blepharoplasty is consider ophthalmic because it deals with the "periocular" or area around your eye. Some oculoplastic surgeons (those specialized in eyelid plastic surgery) use absorbable or nonasborbable sutures. The eyelid skin is very thin and so requires a small nonreactive/inflammatory suture to help it heal. The most common sutures used are prolene (nonasborbable, removed within a week after surgery) or gut suture (nonbraided absorbable). Velosorb is a braided aborbable suture that is supposed to dissolve fast (similar to a gut suture). I (as an oculoplastic surgeon) do not have experience with this specific suture, but the braided nature worries me that it can cause more inflammation (aka scarring) of the scar.

Hello, I’m considering an upper bleph and doing as much research as possible, (including suture type) so I can ask the best questions. I know some surgeons use absorbable sutures and a couple mentioned Velosorb, “braided fast absorbable sutures composed of an absorbable synthetic polyester comprised of glycolide and lactide.”The mfr of these doesn’t recommend them tho for ophthalmic surgery. Is an upper bleph considered ophthalmic and if so, why wouldn’t this suture type be appropriate? Thanks!

Velosorb sutures for upper blepharoplasty

Blepharoplasty is a specialized procedure that involves removal of excess eyelid skin. The eyelid has very specific anatomy that affects your eye (aka your vision). It is very different from the rest of your face. This is the number one surgery performed by a specialized eye doctor called an "oculoplastic" surgeon (aka an eyelid plastic surgeon). That is who you should trust to perform this surgery for you.

I'm interested in Blepharoplasty surgery and keep reading the best person to perform the surgery would be an experienced eye Dr, not a plastic. Any guidance here?

Blepharoplasty - Eye Doctor or Plastic Surgeon?

i agree that there is trace residual herniated orbital fat. However, the puffiness you see right under your eyelids is actually a muscle (orbicularis oculi) that is responsible for blinking/closing your eye. Some people have more a more pronounced muscle that becomes more apparent after removing the surrounding fat with the blepharoplasty procedure. You can consider botox the muscle to soften/flatten it. You can also consider some skin tightening (such as with laser resurfacing) to smooth out the appearance of the entire lower eyelid area. You can do either of these options with or without a repeat blepharoplasty to remove the residual herniated orbital fat.

had an upper and lower blepharoplasty 8 years ago. But feel the fat pads are starting to show again. I'm not sure if I'm being paranoid? I've used polynucleotides but don't think they've made enough difference. The right eye has always been worse.

Fat pads are starting to show again. Should I have another blepharoplasty? (photo)

Lauren D. Mileo, MD

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Double Eyelid Surgery

Oculoplastic surgeons, also known as oculofacial surgeons, are ophthalmologists who have completed advanced training in eyelid, orbit, tear duct system, and facial cosmetic and reconstructive surgery.

Oculoplastic Surgeon

11 Answers from Oculoplastic Surgeon, Board Certified In Ophthalmology Lauren D. Mileo, MD See Education, Board Certification, and Treatments Offered.

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Ophthalmology, NYU Grossman School of Medicine

Consultants in Ophthalmic &amp; Facial Plastic Surgery- Ophthalmic Plastic &amp; Reconstructive Surgery (ASOPRS)

Columbia University

SUNY Downstate College of Medicine – Degree

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New York

Smithtown

Meet Lauren D. Mileo, MD, a trusted Oculoplastic Surgeon, Board Certified in Ophthalmology. See 11 expert answers, before-and-after photos, credentials, treatments, and  real patient reviews. Book a consultation today!

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