Eyelid, undereye, and bleph vs brow lift - What procedure would get rid of undereye circles and asymmetry of eyes? (Photos)

In the photos that you shared,changes can be observed in all areas that make up the periorbital region. In your specific case; your lower eyelids, a herniation of the fat pads is observed, and a change in the ideal tilt position. There is also a marked lateral hooding and excess skin in the upper eyelid, which is more pronounced by the decrease in the position of the eyebrow! I would recommend a perioorbital rejuvenation. This would entail: a transconjunctval and external border blepharoplasty with lateral canthopexy to correct the tilt. A mico and nano fat graft, in order to correct the nasojugal fold (also known as the tear trough), an endoscopic browlift to correct the positon of the eyebrow and elevate the upper third of the face. Lifting the excess skin, making the incision/scar smaller when performing an upper blepharoplasty, which would also be ideal.

Thank you for your question. You have a herniation of the lower eyelid fat pads, a change in the ideal canthal tilt, marked lateral hooding, excess upper eyelid skin, and brow descent. In this case, the most effective surgical approach would involve a lower blepharoplasty to address the protruding fat pad combined with a canthoplasty to restore support and correct the altered eye shape. For the upper eyelid, a blepharoplasty would remove the redundant skin and improve the definition of the lid crease. However, given that a drop in eyebrow position causes the lateral hooding, upper blepharoplasty alone would not fully correct the heaviness. To address this, an internal brow lift could be performed concurrently through the same incision if the brow descent is mild; otherwise, an endoscopic brow lift would be more appropriate for a more pronounced lateral brow drop. A surgeon should evaluate you in person to pinpoint the exact cause of asymmetry and recommend the right combination.

Lower blepharoplasty will remove the excess orbital fat and should improve the undereye circles. Upper Bleph excises extra eyelid skin and may help with asymmetry due to different amounts of skin excess. A browlift elevates the eyebrows further rejuvenating the periorbital region.

Thank you for your inquiry! A blepharoplasty would be a great option for your eye concerns. We would love to meet with you to discuss your concerns. Schedule a consultation with a Board-Certified Plastic to help you reach your goals.

Your eyebrows are below the level of the orbital rim medially. I recommend a brow lift. This can be done in the frontal hairline or in the hair. When done from the hairline this will decrease the vertical height of the forehead, lower the hairline, and take care of some of the excess skin of the upper eyelids. The dark circles under the eyes would be best treated with bleaching treatments to decrease the discoloration. You may also benefit from upper and lower blepharoplasty.

Best Wishes,

Gary Horndeski, M.D.

But a detailed assessment of the eyelids may reveal bilateral upper eyelid ptosis. The left side also demonstrates a compensatory left brow elevation. Please understand that blepharoplasty and forehead lifting does not address the upper eyelid ptosis. Many surgeons you may encounter who offer blepharoplasty or forehead lifting lack the skill needed to correct the ptosis. There is no substitute for a detailed in person assessment. For the lower eyelid likely a chemical peel and a transconjunctival arcus marginalis release will benefit you.

From the submitted photos it appears you are a good candidate for both an upper and lower blepharoplasty. This would remove excess skin and refresh the eyes. An endoscopic brow lift would reposition the brow to complete the look. I've included a video I hope you find helpful.

Based on your nicely posted photos, I would do a combination of eyebrow lift with upper eyelid lift lower eyelid surgery plus Endo lift laser of lower eye eyelids that combination of surgery fee $10,000-$20,000. Best of a virtual consult with.