Consultants in Ophthalmic and Facial Plastic Surgery - Flint

The upper eyelid crease is formed by eyelid structures (septum and levator aponeurosis) and their attachments to the skin. This is an anatomically derived line. Filler to the upper eyelids must be done very carefully as it can easily lead to unwanted effects due to the eyelid having very thin skin. Additionally, there are multiple muscles that lie within close proximity in the eyelid that can be damaged by filler injection. Filler to the superior sulcus can add volume to the upper eyelid appearance. However, this would not necessarily lower the eyelid crease. In my experience, the eyelid crease is best changed (raised or lowered) with surgery.

Receiving a personalized treatment pattern is key for success and patient happiness. Having a discussion with your provider about your goals for treatment is very important. The glabellar region (procerus and corrugator muscles) depresses the medial brow and creates the "11 lines." By injecting this area, the "11 lines" diminish and the central brow becomes smooth. By injecting across the forehead, you treat the frontalis muscle, which is the only muscle which elevates the brows and forehead. With various patterns combined with other injection sites (mainly the glabellar area and crow's feet and sparing the lateral frontalis muscle), you can get a mild lateral brow lift due to unopposed action of the lateral frontalis muscle. If the main concern is forehead wrinkles, an injection pattern dispersed across the frontalis muscle is very reasonable and does not require additional injection sites. It is important to realize that injections into the forehead can lead to drooping of the brow since this weakens the only muscle that elevates the brow.