Will I Benefit from Blepharoplasy or a Less Evasive Surgery? (photo)

I have huge fat pockets above both of my upper lids. One eye is more pronounced than the other(cant remember which one lol). My eyes throw my entire face off. I have big eyes and I think they have potential, but not with these fat pockets hanging around. In addition, my lower lids sag downwards a little to me. I have about one or two small wrinkles underneath both eyes as well. (Horrible pics but all I had right now lol).

Doctor Answers 7

This is likely lacrimal glands.

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Sorry for the late post and I think you may have reposted another picture. But It is likely that the abnormality that you see is prolapsing lacrimal glands. See my response to your other post.

Seattle Oculoplastic Surgeon
5.0 out of 5 stars 41 reviews


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Your posted photos show a prominent role of eyelid muscle under the lower eyelashes but no protruding fat or excess skin in the lower eyelids and some prominence above the upper lid skin in the outer halves. I don't think your a candidate for a standard blepharoplasty procedure that involves skin and/or eyelid fat removal. The prominence above the upper eyelids is either an enlarged tear gland, bulging muscle analogous to the lower eyelid muscle or more likely some extra fat lying between the skin and and muscle in this area. That fat is not per se eyelid fat.

I would not recommend going after the lower eyelid muscle as the risks are probably greater than the benefit. If the upper prominence is fat it could be easily thinned but you need a face to face examination by a qualified surgeon to find out what your current state is and the best way to address it.

My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship.

Aaron Stone, MD
Los Angeles Plastic Surgeon

Huge fat deposits or something else?

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  To my surprise, I find myself disagreeing with many others who responded.  While I am not sure you are a candidate for a blepharoplasty, I certainly do agree that there is excess tissue above each eye.  To me, it looks like you have swelling of each lacrimal gland and that this is what is causing the problem.  Although this is hard to say without seeing you, bilateral swelling of the lacrimal gland is usually due to dacryoadenitis which may be entirely asymptomatic (despite what you might read on the internet) except for the lacrimal gland enlargement.  I think this warrants further evaluation, and may respond to appropriate medical treatment.

Lawrence Kass, MD
Saint Petersburg Oculoplastic Surgeon
4.9 out of 5 stars 138 reviews

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From the photo, it does not appear that you need eyelid surgery.

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Dear Mz

The primary issue is:  What is your concern?  Bottom line is that this consultation cannot be performed online.  There is just no substitute for a personal consultation.  However, standard cosmetic eyelid surgery addresses excess skin and fat.  You do not manifest these issues.  For this reason, I do not believe that blepharoplasty is what you need if you need anything at all.

Happy New Year.

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

Blepharoplasty not needed at this time.

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Your photos are very helpful and show a very youthful appearance where I am not able to see any asymmetry between the 2 eyes.  I noted you aren't sure where the asymmetry is either and therefore it must be small and difficult to see.  Small differences are normal and are usual, not unusual.  The fat deposits you spoke of would best be evaluated by a face to face exam.  As for removing them, I would be very cautious about this as the general trend is to maintain as much volume in the upper lids as possible as removing too much fat causes the skin to deflate and gives a premature aged appearance.  My summary is: your eyes look beautiful and I think surgery would be premature at this time.

Blepharoplasty vs less invasive procedures to improve eyelids

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From your photos you appear quite young, and I'm not certain I would suggest a blepharoplasty in your case.  I agree with Dr Aldea, that your eye asymmetry is probably due to structural asymmetry of the bone of the orbit and would not be corrected by a blepharoplasty.   Please understand that nobody's face is perfectly symmetrical and your face and eyes are well within the norm.  In the future, as you age, you may become a candiate for  a blepharoplasty, but, for now, I would not suggest eyelid surgery.  

Will I Benefit from Blepharoplasy or a Less Evasive Surgery?

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A few comments on your questions; First, as regards "One eye is more pronounced than the other(cant remember which one lol)", asymmetry is THE NORM, not the exception. Almost everyone is asymmetric to some extent. Facial symmetry is extremely rare. The fact that you cannot readily tell which side is more off speaks to the fact that your symmetry is NOT that pronounced.

Blepharoplasty refers to a set of eyelid operations intended to make the eyelid more attractive; they usually involve excess skin removal but can involve removal of muscle and either fat removal, rearrangement or addition of far. In your case your eyes are very prominent but this has little to do with the eyelids and much more to do with the support of the globes. Unfortunately, operations intended to increase the prominence of the lower orbit (either with implants which are screwed into the bone, or by fat grafting or by literally advancing the cheek bones forward LeFort II procedure) are much more involved than a basic blepharoplasty.

You really need to educate yourself on this topic by seeing several good Plastic surgeons before jumping into this. 

Peter A. Aldea, MD
Memphis 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.