Remagin

A: It's difficult to assess lower eyelids just from photos but it appears like you have excess/overactive orbicularis muscle and skin in your lower eyelids. You could benefit from pinch skin excision and/or laser resurfacing. Sometimes patients have lid laxity that needs to be addressed and that can only be evaluated in person. You do have some options that can help improve your lower lid appearance.

A: Fillers can sometimes affect the lymphatic drainage of the eye and multiple rounds of hyaluronidase can be needed to dissolve it. I would recommend seeing oculoplastics/ facial plastics to ensure you don't need more dissolving and to assess if you are a candidate for a surgical lower blepharoplasty.

A: This is a great question - in some patients addressing the brow is necessary because there is a limit to how much skin that can be removed. I assess where the brow lies in relation to the orbital rim. If it is below it then I recommend a brow lift. If it is not then I give patients the option and also stress that you can always do the eyelids only right now and the brows can be addressed at a later time. There are different approaches to lift the brow as well. An internal browpexy doesn't give as much of a lift but it can be done at the time of a blepharoplasty.

A: There is asymmetry to the eyes with one canthus slightly higher than the other. It is difficult to assess from the photos if one eye protrudes more than the other but this can be determined in person by your surgeon. Asymmetry is normal and can be due to differences in soft tissue but also underlying bony structure. Eyelid surgery addresses the soft tissue. To help you with the nuances of your eyes I would recommend that you see an oculoplastic surgeon.

A: Under eye puffiness following filler can be due to the filler hydrating or the filler can block lymphatic channels.