Blepharoplasty - is It Appropriate and What's Important? (photo)

I'm a 34 year old woman, and for a few years I've become a little self-conscious about my puffy, saggy upper eyelids. The more so, because I rather like my eyes! I've used botox under my brows but it has resulted in a somewhat 'startled' appearance. I'm interested in blepharoplasty but I'm really worried about getting a bony, old look, with too much fat taken. Do you think I'm a good candidate and how do I avoid getting too much taken away?

Doctor Answers 10

Upper Blepharoplasty and Fat Removal

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Both your questions are easy to answer. First, you are NOT a candidate for blepharoplasty. Your eyes have none of the stigmata of aging. Anything done would just make you look worse. Secondly, you are right about removal of fat. It ages the eye instead of rejuvenating it. When you get to the point where a blepharoplasty could improve you, simply ask how whomever you see does the upper eyelid. If they always remove fat, see someone else.


Highlands Plastic Surgeon

Eyelid surgery not recommended at this time.

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From your photos, your eyelids show no signs of aging and I could not recommend that eyelid surgery would improve you at this time.  In the past, fat used to be removed to give a highly stylized appearance to the eye but today preserving the fat, if at all possible, is the approach.  Preserving the fat keeps the tissues around the eye plump and full, just like they were in youth.  If your doctor recommends removal of the fat, see someone else.

Blepharoplasty - is It Appropriate and What's Important?

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 Aesthetically speaking, It is important to keep things in perspective.  The aesthetic ideal, for the upper eyelid in women, is to have an open crease without excess upper eyelid skin.  From the photos provided, the right eyelid crease shows more skin than the left and both are less than the aesthetic ideal.  This would indicate a slight removal of upper eyelid skin would be indicated.  There does appear to be some excess fat above the upper eyelid crease as well.

 An in person consultation would further define the aesthetic goals for the Upper Blepharoplasty (Eyelid Surgery).  It's important that eyelid muscle not be removed as this, like removing too much fat, creates a hollow upper eyelid appearance. 

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 28 reviews

No Operation

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Thank you for your photographs.  Your eyelids are in good shape.  An operation at this point in time can not improve what you currently have.

Dr. ES

Upper eyelid blepharoplasty

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 The primary goal of upper eyelid blepharoplasty is to remove excess skin and  a small amount of fat.   The amount of skin and fat  removed is different  with each patient. If there is any ptosis present, the muscle of the upper lid  will need to be tightened as well. 

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 157 reviews

Do you need a blepharoplasty?

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I think your eyes look great as they are.  Perhaps you may have developing ptosis where your lids get closer and closer to your pupils to where they obscure your vision.  That is when it becomes an insurance procedure if you have insurance.  As for for fat removal, most doctors do not remove fat unless you have excessive amounts and you don't look like you do in your photos.

Curtis Wong, MD
Redding Plastic Surgeon
4.8 out of 5 stars 33 reviews

Ptosis surgery

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You appear to have upper eyelid ptosis (droopy) rather than excess skin, and might benefit from ptosis surgery.  Even if blepharoplasty was going to be done, nowadays we preserve all the fat and remove skin only.  See an oculoplastic surgeon for evaluation.

Mehryar (Ray) Taban, MD, FACS
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 91 reviews

Upper lid blepharoplasty?

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Just from your photos, your upper lids look fine. You want to maintain an  youthful full upper lid.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Please don't rush Mexico of surgery.

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Your problem is you do not know how to communicate with a potential surgeon.  Photos of yourself from your 20's would be helpful.  What I see in the photos you provided is a heavy upper eyelid with actual ptosis.  As a result you have compensatory brow lift.  When the upper eyelid ptosis is repaired, the brows will relax down restoring what you consider a more normal appearing upper eyelid fold.  You would also benefit from and anchor  blepharoplasty to tighten the eyelid platform and support the eyelashes so they look more perky.  The risk with most potential eyelid surgeons is the will miss the ptosis and perform over aggressive resection of the upper eyelid fold.  Alternatively some may propose a brow lift.  These will be wrong for you.  So please be very careful out there.

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

There are modern techniques without any sighting cut and scar

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you would  need a eyebrowns lifting  like a moderate botox but  for the rest of your life, the incitions are 3 at upper frontal hairy skin ( i cms each one) this put your eyebrowns like it used to be 20 years ago in a natural and permanent sight practicaly   hided  incitions ,without any scar, we realize also a mini lyposuction on uppeer and lower eyelids avoiding cutting, besides  we refill the lower palpebral sulcus with your own fat and plastma and lasts mores than 5 years, the results are amazing, natural, besides we correct the inter eyebrowns furrow

Ramon Navarro, MD
Mexico 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.