Aging Eyes - I'm Only 27!

My eyes were my best feature - open, almond shaped and symmetrical. Now (in last 18 months) one eye looks more 'open' than the other i.e. skin seems to have draped downward. Oddly, this can change. It can sometimes happen to both eyes OR I can get a spell of a few weeks where they both look good and symmetrical again but I keep getting disappointed when I wake up and 'arrghhh' the problem is back. I'm only 27! Does anyone have an opinion on this? It would be much appreciated.

Doctor Answers 12

Seasonal vs medical issue

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I'm always disappointed when surgeons only look at a patient and don't listen to them. You stated that this problem of lid droop is intermittent and not always in the same eye. This tells me that we're not talking about an aging issue but a medical one.

Many things will change the tissues of the face. This time of year is notorious for eye problems due to changing weather and pollen etc.. The fact that this is over the last 18 months suggests that maybe there could be a medical condition going on. See your primary care doctor and get a thorough evaluation.

Your brows are fine and don't need surgery or Botox. Your lids have a little excess skin but again this may be temporary. You're still young and attractive so relax and see your PMD.

Based on your photo, I would not recommend any surgery

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You have great eyes and a very nice overall shape to them, as well as a nice brow position and shape as well. In short, I would highly recommend leaving everything alone. There will be plenty of opportunity for cosmetic surgery in the future, but at the moment, you don't need any to your eyes.

Anne Hathaway eyes

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Unless we are suggesting Anne Hathaway go in for plastic surgery, you do not need to have anything done.

You have an eye configuration that showcases your eyes nicely. Your globe is prominent and the eyes large. In case you haven't looked on television today at many of the news anchors, who are selected for their beauty as well as their ability, this is not a deformity.

Brent Moelleken, MD
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 188 reviews

Fluid shift

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The change that you are experiencing with your eyelids has to do with fluid shift. There is fluid in and around the eyelids that is retained at night while lying down. This is accentuated with a high-salt diet. Once the patient is up and around during the day the fluid comes out of the eyelids. If the patient sleeps on one side of their face all the time, the dependent side will be more swollen than the upward side because of gravity. This will continue to happen even after any upper or lower blepharoplasty surgery.

You're reaching an age when these things start to present themselves

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I see the extra skin in your upper eyelids. I hope that is what you are talking about. This happens when you lose volume around your eyes which happens when you age. Underneath your brow, you slowly lose fat, connective tissue within your skin that causes the skin to sag downward because of the reduction of volume. During the seasons, depending on how much water you drink and what your nutritional intake is, you will have a different state of volume. This can account for the different appearances that you seem to be having when you look at yourself at different points in time.

Of course, you should have a complete medical evaluation to make sure that there is nothing else going on that could account this including issues with your kidney, liver, and even thyroid. Allergies can also play a factor. When everything else checks out fine, aging might be the sole cause. The answer to this includes filling back the volume or doing an upper eyelift and/or browlift. Although, you seem to have a fine position for your brows.

Philip Young, MD
Bellevue Facial Plastic Surgeon

You have difficult anatomy.

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Hi. I see what you are talking about. Your lower lids are too low, specially on the outside, and specially in your left eye. But you have prominent eyes and flat cheek bones (what we call a negative vector). This combination makes surgery riskier.

If you find a very experienced oculopastic surgeon, your lower lids can be improved. Otherwise, leave them alone. You look nice. There is time enough in the future for surgery.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon

Lax lower lids

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You are correct in your assessment. Your lower lids have lost support and are a bit low, especially toward the outside (laterally). This may be congenital, or acquired. Does anyone in your family have your eyelids?

27 is a bit young for a blepharoplasty, but it might be good for you. I would recommend a consultation with a ps for evaluation of the support structures so that if you need an additional procedure to cinch up the lower lid, it can be done at the same time.

I also would recommend that you get evaluated by your internist. Although unlikely, it is possible that you have a disorder that affects the nerve/muscle strength. If you do have one of these autoimmune disorders, diagnosing and treating it will treat your cosmetic concerns.

Your eyes still are a great feature

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There is a strong argument for leaving well enough alone in your case. Your eyes still look terrific to me in the photo. Rather than have surgery, you could try Botox as one of the earlier responders suggested.......or just by yourself a new outfit, which can make you feel better without the potential complications from surgery.........

Brow ptosis

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Dear Kitty

The surgeons here will tell you that you are very attractive, and it is true. But aesthetic surgery is so much about how you feel about your appearance.

The issue you are having trouble with is the position of the upper eyelid fold. Where this sits relative to your eyelid platform is related to how you carry your eyebrow.

In turn, the brow position is determined by a tug of war between the lifting muscle in the forehead, the frontalis muscle, and the muscles at the brow and the top of the nose that pull the eyebrows down.

Depending on how tired you are, this balance will change. So at the end of the day or early in the morning the brow may be a little more relaxed and this will cause the upper eyelid fold to ride lower on the eyelid platform.

If I saw you in my office, I would likely recommend a Microdroplet BOTOX® forehead lift. The idea behind this treatment is to use BOTOX to relax just the muscles that pull down the eyebrow. This will cause a uniform elevation in the brow position.

The bad news is that the BOTOX effect will only last 4-5 months. An alternative procedure would be a subtle endoscopic forehead lift to stabilize the brow position.

However, I would be very concerned with you having upper eyelid surgery. You have a beautiful, full upper eyelid fold that is a very important aesthetic element to your appearance. Upper eyelid surgery would be aesthetically damaging to you by removing this very important feature.

Also, removing some of the upper eyelid fold, which is what happens with upper eyelid surgery, your eyebrow will actually fall. Again, this has to do with the balance between the eyebrow lifters in the forehead and the eyebrow depressors in the upper eyelid.

So, yes you do have an issue. However, be careful what treatment approach you choose to address it because you can also have cosmetic surgery that would be profoundly damaging to your youthful beauty.

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

You look great!

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For some women seasonal changes can create mild swelling of the periorbital tissues causing slight asymmtries in relation to the bodies reaction to environmental stimulants such as dander, pollens, dust... You may want to vist your ophthomologist to see if they might be able to help.

Charles Perry, MD
Sacramento Plastic Surgeon

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.