One year ago, I had fat removed from the upper eyelid. Now, the skin has deflatted and my eyes look like they have excess skin. My doctor said a Brow lift would correct this but I want to know if I can do anything else.
Is Brow Lift the Only Option for Deflated Eyelids?
Doctor Answers 13
How to treat a sunken appearance post upper eyelid surgery
Aggressive upper eyelid fat removal can have the opposite effect-- leave a hollow appearance. This will also result in a relative excess of skin. Removing this skin will only make your eyes appear more hollowed out. In addition, a brow lift will further accentuate this appearance which is why I usually don't recommend brow lift surgery for someone with very deep set eyes.
The solution is to replace the lost volume in the upper eyelid as well as the brows and temples. Various fillers can be used such as fat, Restylane or Sculptra. If there is still excess skin, I would recommend resurfacing the skin to plump up the collagen with Fraxel laser.
Are your brows droopy or deflated?
If you have brow ptosis (brows that are in a lower that ideal position) then a brow lift may be the best option. If your brows are deflated then adding something to them to re-inflate them would be the next best step. Fillers (like Restylane or Juvederm) are very easy to add in the office and really have no downtime when used in that area.
Lastly, if you good brow position and only excess skin in the upper eyelid- then either a blepharoplasty or perhaps laser skin resurfacing around the eyelids may be worth considering.
As I write this reply I am recovering from my laser skin resurfacing that I had 3 days ago around my eyelids.
Robert F. Gray, MD, FACS
Browlift for "Deflated" Eyelids
Without pictures it is difficult to answer your question. A browlift should be done only if the brows need elevation. Otherwise, a blepharoplasty with skin removal or volume replacement with fat grafts would be more appropriate.
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Fat injections can correct deflated eyelids.
Of course, it is hard to tell without examining you, but if your upper lids are hollow, a brow lift may not be the best approach. We have gotten good at restoring volume with micro fat injections.
Brow Lift will not treat deflated eyelids
Your eyelids have a deflated appearance most likely because they have relatively excess skin after perhaps too much fat was removed. An Upper Blepharoplasty revision may address these issues. Most important is a complete exam to determine the exact cause and best corrective measures. For example, ptosis or drooping after an upper Blepharoplasty might be because of an underlying muscle injury (levator muscle) that could be repaired. A Brow Lift focuses on the Brow position which needs to be evaluated separately and may or may not be appropriate to lift.
As always, consultation with the most skilled surgeon is required. I suggest you do you research one that is a board certified plastic or oculoplastic surgeon with experience in blepharoplasty revisions. This will yield the most accurate information you need to make a decision.
Beware of brow lifts! Focus on the lateral hood!
Be very careful when asking for a brow lift, you might get it. If you look up brow lift results in published papers and before and afters you will see that many surgeons successfully lift the brow. Unfortunately a true brow lift makes patients look scared or surprised! It is almost never necessary to elevate the medial third of the brow. Many women actually benefit aesthetically from a slight lowering of the medial third. On the contrary, there are few women even at your age that would not benefit from elevation of their lateral brow. The reason for this is probably not what you think. Much more important than the brow positionand shape is the infra brow skin. If you look at yourself in the mirror you will see some bunching of skin under the brow next to your eye and a flat shape. I call this the lateral hood. The only kind of brow lift that I typically perform I call a lateral hood lift. If you gently pull up on your forehead skin above the lateral brow, you will see that a very subtle elevation makes you look younger. This is mostly because it cleans up the lateral hood. It is usually necessary to also restore brow volume at the same time as a lateral hood lift to create a beautiful rejuvenated shape. I hope this helps!
All the best,
Rian A. Maercks M.D.
Brow lift not intended to address excess eyelid skin
A browlift is done to readjust the level of the eyebrows along with adjustments of both corrugator and vertical lines between the eyebrows and the horizontal frontalis wrinkles in the forehead. It is usually not done for excess eyelid skin. When doing a browlift, it will help with some of the excess upper lid skin. If excess skin is the only item that is bothering the patient, then a simple upper blepharoplasty would suffice.
Options to treat deflated eyelids
Hi Kristall - Deflated eyelids may be treated with upper eyelid skin removal or blepharoplasty. it's difficult to determine without seeing you. Also, your eyebrow position may affect the appearance of your eyes. If they are low you may actually need a browlift. Frequently, upper eyelid skin removal is combined with a browlift to fully rejuvenate the area around the eyes. Check out some before and after photos to see what look you're going for. Thank you for your question and good luck!
Without pictures, it is difficult to give you a complete answer. However, if your eyelids are "deflated," which I am assuming you have loose skin, then you have three options. 1) replace the fat with fat grafting; 2) remove the extra skin with a blepharoplasty; or 3) have a brow lift to stretch out the skin. These are all options that you should discuss with your surgeon.
Restoring fullness to "deflated" eyelids or eyebrows
I know this may sound somewhat sarcastic but some surgeons advocate fat injections to the area just beneath the outer eyebrow to restore youthful fullness to the eye area. One way of "trying" this out is to use injectable fillers such as restylane.
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.