24 Year Old Male with Excess Flesh Above Eyes. Considering Upper-Blepharoplasty? (photo)

I have excess flesh drooping over my eyes which makes me look constantly tired. I have consulted with a UK surgeon but he told me an upper-blepharoplasty would be a bad idea and instead recommended a brow-lift (I assume because the excess skin is fleshy rather than just thin skin), he also informed me that my eyelids are fairly Asian in appearance, I'm quite happy with the position of my eyebrows and would like a wider opinion on whether or not to seek an upper-blepharoplasty elsewhere. Russel

Doctor Answers 11

Male Upper Lid Blepharoplasty vs Browlift or Both

Correction of upper lid fullness and skin laxity often involves a combination of browlift and blepharoplasty.  The browlift primarily addresses the tail of the brow where the ptosis or drooping is seen as the hooding of the lateral or outer upper lid with extension beyond the corner of the eye.  If this hooding is seen, upper blepharoplasty alone will improve some of the upper lid laxity but there will continue to be hooding particularly in this outer aspect.  As already stated, browlift in males must be done conservatively to avoid an operated-on or feminized appearance.  If you are unsure, it is certainly best to seek additional consultations.  You might also consider starting with the blepharoplasty and then if you are not completely satisfied, consider the browlift as a separate procedure.  Another thing to keep in mind is the placements of the incisions for the browlift.  Even if you have hair now, this may change in the future and scars may become visible if placed in the front of the scalp.  Since most of your hooding involves the tail of the brow, you might consider a temporal browlift that would leave the scar in an area that is not typically associated with masculine hair loss.  Hope this helps.

Phoenix Facial Plastic Surgeon
4.8 out of 5 stars 20 reviews

Conservative blepharoplasty may help

your photos are not very clear and not in a good position either. We need a straight clear face shot. But from what I can see in these photos, you do have eyebrow ptosis. But if you like the position of your eyebrows and don't like to have eyebrow ptosis repair, then a very conservative upper blepharoplasty may help you with some of the problems you have. There are few procedures, which are minimally invasive that can help your eyebrows as well. and they may lift the lateral eyebrow and change your eyebrow position only laterally, which makes your eyes less puffy. So I really recommend conservative eyebrow ptosis along with upper blepharoplasty for you.  

Soheila Rostami, MD, FAAO, FABCS
McLean Oculoplastic Surgeon
5.0 out of 5 stars 15 reviews

24 yr old Eyelid and Brow Surgery

Eyelid surgery may be appropriate at your age, but a physical exam would be necessary to determine this.  Also, it would be helpful to evaluate your brow position at rest and in animation.  Botox carefully administered could be used to simulate a brow lift prior to anything being done to get an idea of how that would improve the eyelid skin. 

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 492 reviews

Upper blepharoplasty for 24 year old male with excess skin

A blepharoplasty is usually all that is needed when excess skin is touching the upper eyelids.  When patients have very low eyebrows across the forehead, then consideration can be made for a brow lifting procedure.  The incision for the upper lid blepharoplasty is located in the upper lid crease and is only minimally detectable once it is healed.  Both brow lift procedure and a blepharoplasty are performed under general anesthesia as outpatient surgery.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 143 reviews

Brow lift is the direction to consider.

Your brow position is the culprit.  Consider a moderate browlift. You could consider Botox injection to lift the brow as a temporary fix which would allow you to visualize your brow when elevated. 

John Pak, MD, PhD
Chicago Oculoplastic Surgeon
5.0 out of 5 stars 8 reviews

Male upper blepharoplasty

Male upper blepharoplasty is more conservative than female upper blepharplasty.  Upper blepharoplasty is also more conservative in Asian people.  If you like the current position of your eyebrows, then upper blepharoplasty may help you but it has to be done conservatively.  See an oculoplastic surgeon.

Mehryar (Ray) Taban, MD, FACS
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 72 reviews

Brow lift and possible upper lid surgery?

Of course, an exam is essential. But based solely on your photos, you look like you have a low brow and possibly could benefit from it being lifted.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 28 reviews

Blepharoplasty or brow lift.

It is a bit difficult to give you a definitive answer without a direct examination, but your photos do suggest that a brow lift would be a better option as the position of the brow is low. This will help "open" the eyes and give a more rested appearance. Occasionally, in younger individuals, a neuromodulator such as Botox or Dysport in the glabella (between the eyes) and the crow's feet can lift the brows a little bit. This may be enough for a while and worth a try before proceeding with surgery.

Brian J. Lee, MD
Fort Wayne Plastic Surgeon
5.0 out of 5 stars 12 reviews

24 Year Old Male with Excess Flesh Above Eyes. Considering Upper-Blepharoplasty?

The three best options for this type of problem are blepharoplasty, browlift or combined blepharoplasty and browlift. The choice depends upon your anatomy and the reason for your heavy upper lids (extra skin/ fat, drooping eyebrows or both). My suspicion based on your limited photos is that both procedures would provide you the best result. The key in facial plastic surgery for men is to maintain your masculine appearance and not feminize your face. Seek a consultation with a Facial Plastic Surgeon who will not feminize your face. I hope this information is helpful.

Stephen Weber MD, FACS

Stephen Weber, MD, FACS
Denver Facial Plastic Surgeon
4.9 out of 5 stars 129 reviews

Male Upper-Blepharoplasty

Thank you for your question and the pictures. It is difficult to give an accurate opinion without an in-person exam, however it appears that you would benefit from a brow lift as well. The recommendations are not because the excess skin is fleshy but rather because your brows, at least from the photos, appear to be low in position.

The best advice I can give you is that if you are dissatisfied with your first consultation, seek a second and if need be a third opinion. Again from looking at the pictures you have provided and not having the advantage of an in-person exam, it seems as though your first consultation was spot-on.

I hope this helps. Best of luck.

Pedro M. Soler, Jr., MD
Tampa Plastic Surgeon
4.9 out of 5 stars 39 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.