It does seem that you have ptosis of your midface on the left side. Possibly due to chronic pulling or sleeping on that side or a past trauma, etc... A midface lift on the left side would help improve the volume loss of the left cheek and lessen the subsequent nasolabial fold created by the midface descent. This may help improve your lid cheek junction transition by resuspending your lower eyelid at the same time.

Hello! I had a rhinoplasty about 5 years ago that caused a lot of breathing issues. I used to pull my cheek outward so I could open up my airways after my rhinoplasty and I'm not sure if doing that caused my left cheek to stretch downward. Could it be that I have Ptosis? What is this and how can I fix/lift my left lower eyelid and cheek? I am 30 years old. Thank you so much!

What can I do about the sagging lower eyelid and cheek (left side)? (Photo)

Eyelid Surgery

If you truly have a prominent fat pad of your lower eyelid (difficult to tell from the photo), then the only solution is a lower blepharoplasty. Filler will not solve your problem and only look worse. However, it appears that you have both a fat pad (volume excess) and a tear trough (volume loss). In this case, I recommend lower blepharoplasty first, then 6 weeks or more later after the swelling has resolved, filler to the tear trough.

I'm 52, btw, so likely in need of upper bleph, but could I improve the one bag non surgically for the time being?

Recently developed prominent bag under one eye - filler, or is blepharoplasty the only way? (Photo)

I do appreciated some degree of crepiness of your lower eyelids. I also see the fullness, although mild, that you are talking about. An appropriate surgical candidate for a blepharoplasty has to do with the condition that is present rather than age. It is actually best to have surgery earlier in life, since it is often less complicated, which means less down time, less surgical risk, and less money! Also you are able to enjoy the results longer during the prime of your life. The duration of results for a lower blepharoplasty is about 25 years.

I'm almost 40 and I don't know if I am a good candidate for blepharoplasty yet or if an excellent result could be achieved with something less invasive like a laser. My skin has become more crepey and I have bags, though they are not fatty and puffy. Filler in my tear trough seems to look puffy (some days, not always). I've read so many things that seem to contradict. I would be grateful for a clear treatment plan. Thank you

Almost 40 - Too soon for blepharoplasty? (photos)

If your eyelid margin (edge) is truly lower on one eyelid than the other, then you likely have eyelid ptosis (a weak eyelid muscle). This is corrected by tightening one or both of the eyelid muscles that raise your eyelid, which is called ptosis repair. You also may have some redundant eyelid skin (dermatochalasis), which can also be addressed by performing a blepharoplasty.

My eyelids are not symmetrical- ie one eyelid droops over my eye more than the other (it feels like it gets worse when I get tired as well). I also have a lot of extra skin/fat below my eyebrow that feels like excess, and my outer corners of my eyes droop. Would a blepharoplasty address these concerns?

Would a blepharoplasty be the correct procedure to address my concerns? Asymmetry, extra skin, and drooping. (photos)

While the photos are blurry, it does appear that you have some degree of volume loss in your tear trough. The volume loss component can be treated by hyaluronic acid fillers. If there is hyperpigmentation of the skin, this can be treated by topical creams, ex., hydroxyquinone and 2% Alpha Arbutin. It is most important to only see an ASOPRS certified oculofacial plastic surgeon because it the filler is not placed properly in your tear trough, it can result in blindness.

Can I fix this with a filler or surgery? I have deep eyes and one eye is extra deep compared to the other. This causes asymmetry which has been bothering me. Please suggest possible solutions to bring my eyes out.

I have deep/ sunken eyes. One eye is deeper/ more sunken in that the other. Solution? (Photo)

Carrie L. Morris, MD, FACS

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