35 Year Old Female. Am I a Suitable Candidate for Blepharoplasty? (photo)

The appearance of my eyelids was always rather full. In recent years I am experiencing strong fluid retention (during sleep) that is increasingly uncomfortable (e.g. pressure on eyeballs) and a lot of extra skin which leaves my eyes looking tired and unfriendly. Would I be a suitable candidate for blepharoplasty and if yes would the removal of excess fat prevent future fluid retention? Please advise suitable technique and whether or not other causes for these symptoms should be considered.

Doctor Answers 9

It's important to have other causes of eye swelling first like the thyroid. If all else is OK, you like a good candidate

It is unusual to have a significant amount of swelling around the eyes which developed into a real pressure healing. As an oculofacial plastic surgeon with original training in ophthalmology, I want to emphasize a condition called thyroid-immune orbitopathy which is commonly referred to as Graves' Disease. I’m not saying that the symptoms you have automatically means you have Graves' Disease, but there are many people whose first symptoms of thyroid eye disease include swelling, congestion and variability. Their eyes often swell and they suffer from double vision. Other things that can cause these types of symptoms include sinus problems and allergies.  I recommend that you first see a medical doctor, an endocrinologist, or an ophthalmologist and even consider getting some imaging studies so that you can rule these out as causes of your symptoms.

If you rule everything else out, I think it’s worthwhile to consider upper eyelid blepharoplasty and lower eyelid blepharoplasty. Upper eyelid blepharoplasty is a procedure where excess skin over the eyelid as well as soft tissue and fat is sculpted and reduced so that the eyes appear more open or awake. For the lower eyelids, there can be reorientation of fat pockets, the reduction of the skin and tightening of the support so that they don’t look puffy.

I suggest that you do a little research before you choose a doctor to do your eyelid surgery when you’re ready for it. As a specialist, I learned that there is sometimes an oversimplification of eyelid surgery. I know many doctors are capable of doing a good eyelid procedure, but only a smaller group is able to do great work. Only some doctors can understand the artistry and the execution of these procedures. I hope that was helpful to you, and thank you for your question.

New York Oculoplastic Surgeon
4.3 out of 5 stars 72 reviews

35 Year Old Female. Am I a Suitable Candidate for Blepharoplasty?

       I think that an upper eyelid surgery would help to reestablish a nice crisp upper eyelid fold and eliminate the heavy or tired look.  Find a plastic surgeon with ELITE credentials who performs hundreds of eyelid surgeries each year.  Then look at the plastic surgeon's website before and after photo galleries to get a sense of who can deliver the results.  Kenneth Hughes, MD Los Angeles, CA

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 496 reviews

Blepharoplasty candidate

  The fluid is present in the upper and lower lids is called interstitial fluid and it shifts in and out of the fat pads in the upper and lower lids physiologically.  This is a normal phenomenon. Salt intake, allergies, hormones, poor sleeping habits can make the puffiness worse. Thyroid issues can also make the puffiness worse at a young age.  An upper eyelid blepharoplasty would involve an incision in the crease and removal of excess skin and fat will help rejuvenate the upper lids. A trans-conjunctival approach is all that is required for the lower lids  whereby a conservative amount of fat is removed from the lower lid fat compartments.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 146 reviews

35 Year Old Female. Am I a Suitable Candidate for Blepharoplasty?

 Aesthetically speaking, from the photos provided, the upper eyelids are quite heavy with skin on or approaching the lashes.  The brows appear to be low, with the right lower than the left and this should be evaluated during your consultation with the plastic and cosmetic surgeon.  Only then can the appropriate amount of upper eyelid skin be determined.  

 This, amount of excess upper eyelid skin, is what can and should be removed with an Upper Blepharoplasty or Eyelid Surgery.  If the eyebrows are also low, which is what I suspect, the eyebrows would need to be lifted with a Brow Lift to create further opening of the upper eyelids.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.6 out of 5 stars 25 reviews

35 Year Old Female. Am I a Suitable Candidate for Blepharoplasty?

Based on your photos you are a good candidate for a blepharoplasty procedure. This would involve removing skin and fat from the upper eyelid. Your swelling is likely edema resulting from laying flat in the evening. There is another uncommon inflammatory condition referred to as blepharochelasis but your history does not sound consistent with this type of disorder. I hope this information is helpful.

Stephen Weber MD, FACS

Weber Facial Plastic Surgery

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

35 Year Old Female. Am I a Suitable Candidate for Blepharoplasty? (photo)

From your photos and your description, you are a candidate for blepharoplasty.  However, what is the cause of your swelling.  You need an in person examination to make sure you have no ophthalmic condition that needs to be treated prior to surgery and to discuss which procedure is best for you. 

Sam Goldberger, MD
Beverly Hills Oculoplastic Surgeon
4.7 out of 5 stars 16 reviews

Candidate for upper eyelid surgery

Yes you are a candidate and it would work well to open your eyes and expose more of your upper lid making you look fresher. Your plastic surgeon will discuss with you the exact procedure based on your physical exam and medical history. Concerning your question about removal of fat to prevent fluid retention;  the fat does not collect fluid so that is not the likely cause of the 'fluid retention', once again, an exam would be important to further clarify this question. 

Dilip D. Madnani, MD, FACS
New York Facial Plastic Surgeon
4.8 out of 5 stars 90 reviews

Eyelid surgery

according to your pictures, you would be a good candidate. You do have extra skin that can be removed. In my past, I have removed extra fat below the muscle as well. It gives you a sharper look. Engorgement of your fat due to your sleep position may explain yopur symptoms. Seek a consultation from a board certified plastic surgeon in your area. All the best.

Thomas A. Narsete, MD
Denver Plastic Surgeon
5.0 out of 5 stars 10 reviews

Possible candidate for upper blepharoplasty

It does appear that you would be a possible candidate for upper blepharoplasty.  Of course, you would need a consultation to examine your entire upper face, specifically looking at your eyebrows and eyelids.  If you were to just have the upper blepharoplasty, you most likely would not need much, if any, fat removed.  The primary issue is with excess skin, and not fat.    

Michael I. Echavez, MD
San Francisco Facial Plastic Surgeon
4.5 out of 5 stars 18 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.