What Are my Options for an Outer Eye Lift?

I am wondering about different options for a younger person to undergo in order to recapture the eyes' upward tilt without leaving visible scars. I am wondering about different options concerning increasing the upward slant of the outer eye. I am 26 and have firm skin but have found from viewing pictures in high school that my eyes have "fallen" a bit.
I do not have bags under my eyes or wrinkles, so traditional skin-tightening procedures aren't exactly what I'm looking for. But I am interested in hearing all options, particularly ones producing minimal/hidden scarring. Are there perhaps suspension lifts that deal directly with this by tightening the upper cheek and temple area? This is my first exploration into cosmetic procedures that would address this issue, and I was at a loss on how to go about finding specific information that would pertain to me.

Doctor Answers 16

A simple filler injection will plump the cheek and help

I agree with the other doctors that your face looks very youthful. I would not mar your face with surgical scars. A canthoplasty at this early stage will adversely affect your eyelid shape.

Please do not take offense, but honestly the main difference I see in your face in the latest picture is that you look sad. If you have been through some life experience that has saddened or depressed you, then I would recommend that you address this. Sadness shows dramatically in the face and makes us all look tired and older. There are many effective methods to help, including exercise, counseling, medications and others.

The very slight anatomical change I do see is that the cheek fat pad also called the malar fat pad has descended a tiny bit.This loss of volume in the cheek can cause the lateral eyelid area to look depressed.

A new filler technique called the liquid face lift using injectable Radiesse, when done by a skilled physician, can plump the cheek, brighten the face, and create a much more youthful look. I am referencing an article below.

Please do not have surgery--it will scar your lovely face and could start you down a "slippery slope" of further surgery and revisions.

You may not need surgery at this point

Dear Neopsytox,

So do your really need surgery? Much of cosmetic surgery has nothing to do with aging and every thing to do with aesthetics.

If you presented to my office, I would ask you how many hours a day do you spend thinking about your appearance, what shame values do you place on your looks, do you have a psychotoxic mother who makes to feel insecure about your appearance and perhaps a father who was not emotionally available. I would also want to know if you have a history of self-cutting and depression. Essentially we are trying to uncover your motivation to have surgery and if there are any shame pathologies driving you to get "fixed." The biggies are body dysmorphic disorder and borderline personality disorder. The key for me is, is there an emotional insight or not?

With regard to the two pictures, for sure there are changes in your face. There is slight brow ptosis, you have mild upper eyelid ptosis and as I can't see your upper eyelashes in the second picture, I am going to guess that there is also some eyelash ptosis. The canthal angles are much harder to assess in this pictures. In the earlier picture, you face is rotated slightly downward, forcing the eyes up, which affects the appearance of the canthal angles-makes them appear to slope up. In the second picture, the face is rotated slightly upward. This brings the eyes down, giving the effect of flattening the angle into the lateral cathus. In the temples, there is less volume and fullness, and this probably reflects a slight change in weight. There is a slight descent in the midface.

With regard to the surgical suggestions presented here. I would advise you strongly against canthoplasty and very strongly against coronocanthoplasty (a canthoplasty performed through the upper eyelids). A brow lift might be an option. However, the easiest way to get help would be to try a MicrodropletTM BOTOX® forehead lift and perhaps some under eye Restylane. It is possible that you are a candidate for a very precise anchor blepharoplasty but this is impossible to know without a personal consultation.

Remember to be careful in what you are looking for because you are already very attractive. The likelihood is surgery at this time will harm not help you. Try decide why you want this surgery. You may still seek it out but at least you will have a better understanding of why.

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

Only minimal intervention, if any

I agree that surgery is too drastic for such a slight change you feel you see. A little filler can elevate the lateral lower lid and lateral canthus, which is what you are calling the "outer eye".

Richard D. Gentile, MD
Youngstown Facial Plastic Surgeon
4.4 out of 5 stars 36 reviews

You really do not need surgery

You really do not need surgical intervention for your concerns. You may benefit by some Botox in the lateral orbital area to help "open up your eye" and filler, such as Radiesse in your cheek area. You are correct that you do not need traditional surgery at this point.

David Shafer, MD
New York Plastic Surgeon
4.9 out of 5 stars 75 reviews

I would not touch your eyes

I appreciate the slight change you have been observing but I certainly would not recommend surgery for your eyes -- they look great and youthful! I do notice some subtle change in the volume distribution of the central cheeks below the eyes: you lost just a bit of volume in this region. This is not an issue today, but may be 10 years or so from now.

Frank P. Fechner, MD
Worcester Facial Plastic Surgeon
4.6 out of 5 stars 48 reviews

No surgery

you have very youthful and attractive face. . Please look at your self and enjoy the the face you have. I would not recommend any procedures at this time.

Kamran Khoobehi, MD
New Orleans Plastic Surgeon
4.8 out of 5 stars 122 reviews

Microadjustment of eye shape

There are certainly procedures that would technically address your concerns: conservative upper blepharoplasty, lateral subcutaneous browlift, superficial cheeklift (USIC), ultrashort incision. Those procedures are reviewed in the book chapter below.

The real question is should you have surgery so early in your life? All surgery, no matter how artistically performed, leaves traces behind, more with some surgeons than others.

That is a decision you and your surgeon will need to make.

Brent Moelleken, MD
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 177 reviews

Outer eye lift

It is impossible to have an upper blepharoplasty done without leaving a very tiny inconspicuous incision along the upper lid crease. Whatever excess skin is present laterally on the upper-outer eyelids, the surgeon has to make an incision there to be able to get rid of excess skin. This is usually blended into crow’s-feet wrinkles and as long as there is no tension placed on the skin, the incision should heal beautifully.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 143 reviews

Lateral Canthal Tilt

As we age, our cheek fat pad begins to drop. This, along with peri-orbital deflation, increases the lid margin to cheek distance that we start to see in our late 20's. Laxity of the lateral canthal tendon and tarsal plate also progress with age. These factors tend to make the eye look rounder and less almond-shaped.

Some non-invasive techniques would include small amounts of Botox to elevate the lateral brow and a Hyaluronic Acid filler for shaping of the peri-orbital soft tissues. Minimally invasive approaches would include suture tightening of the lateral canthal tendon (canthopexy). It is important that you seek consultation with a Board Certified Plastic Surgeon to discuss all of your treatment options.

Daniel Reichner, MD
Newport Beach Plastic Surgeon
4.9 out of 5 stars 45 reviews


Although you may look different then 5 years ago, you still look beautiful. No surgery is indicated. However, I am often confronted with patients that do have a significant drop in their brow and extra sag of their upper lid as a result. For those patients, limited lateral browlifts do an excellent job without the risks of more elaborate browlifts, and more effective then purly endoscopic procedures.

Robert M. Freund, MD
New York Plastic Surgeon
4.8 out of 5 stars 33 reviews

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.