Upper eyelid surgery to repair heavy eyelids? (Photo)

You are a great candidate for both upper and lower Blepharoplasty surgery. This surgery removes excess skin from the eyelids. With age, eyelids stretch, and the muscles supporting them weaken. As a result, excess skin and fat can gather above and below your eyelids. This can cause sagging eyebrows, droopy upper lids and bags under the eyes like your case at the moment.

Blepharoplasty is a surgery that removes excess skin from the upper lids. This surgery does not actually lift eye lids but removes the excess tissue to make them appear more open. Ptosis repair (levator resection) tightens the muscle of the lid and actually raises the eyelid. These surgeries are often done at the same time. Judging from your photos, you are an excellent candidate for upper lid blepharoplasty. You need an in person exam to determine in any ptosis is present. Best to see an eyelid expert.

The simple question is if you have ptosis, then you include that repair in the blepharoplasty. From your photos, it looks like you only have heavy eyelid skin. Ptosis would have to be evaluated in person. If you don't have ptosis, a blepharoplasty to remove extra skin and sculp the eyelids would look great. Be sure to see a facial specialist for consultation.

You have a large forehead and low eyebrows. You would benefit from a browlift to lower your hairline and pull up the eyebrows up. This will help some of the upper eyelid skin. You would also benefit from an upper and lower blepharoplasty.

Best Wishes,

Gary Horndeski, M.D.

Good morning,
This is a great question, and one that I get asked about a lot. Ptosis is when the eyelid position is low. Imagine taking a light and flashing it at your eyes. You will see a light reflex in the middle of your pupil. The distance between that light and the eyelid margin (area where eyelashes are coming out) is called the margin to reflex distance 1 (MRD1). When that distance is small (the eyelid margin is close to the center of the pupil), you have some degree of eyelid ptosis. Ptosis can be mild, moderate, or severe, and the treatment options depend on the individual findings. Blepharoptosis levator resect surgery is a way to tighten the muscle inside the eyelid that is responsible for opening the eyelid (levator muscle) to raise the resting position of the eyelid margin (increase the distance between the center of the pupil and the eyelid margin, or increase MRD1).
Separately, one can also have heavy upper eyelids. This can be from numerous causes, but most often I see excess skin on the upper eyelids contributing to the heaviness. Additionally, one can also have a degree of eyebrow ptosis. If the eyebrow position is low, this adds extra weight to the eyelids and further causes the heavy appearance. For the heavy eyelids, an upper eyelid blepharoplasty will excess the excess skin (and accumulating fat) to help sculpt and refresh the area. At the same time, doing a brow lift may be helpful to further remove any weight on the eyelids.
Depending on your individual needs, a surgeon may recommend doing any combination of the above surgeries (blepharoplasty, levator muscle tightening surgery, or brow ptosis repair). Each intervention addresses a different component of the heavy eyelids. Of course, an in person evaluation is best to determine what is best for you.
I hope this helps.