BlephAroplasty for Inner Corner Hanging Skin?

Hi AndiP,

Thank you for your question. A blepharoplasy, upper eyelid surgery, removes excess skin and fat from the top eyelid, but does not change the eyebrow. A brow lift lifts the eyebrow, primarily from the sides of the brow but may also improve the area closer to the nose. A brow lift may also help improve the appearance of the upper eyelid, without having eyelid surgery. Commonly, both an upper blepharoplasty and brow lift surgery are performed at the same time. Surgeons tailor the brow lift procedure to the needs of each patient.

Most plastic surgeon do not consider a brow lift a radical or extensive procedure. However, every patient is unique and after personally consulting with a specialist can you better determine what is best for you. Only after a comprehensive evaluation can a cosmetic surgeon help determine appropriate options for you. Best of luck.

Dr. Chaboki


 

A simple blepharoplasty removed the upper eyelid fold.  Currently with the fold it is likely that you have a compensatory forehead elevation.  When the skin is removed, the forehead relaxes and the brows fall.  This will make the area that you are describing even more full.  The answer is an endoscopic forehead lift with or without eyelid surgery performed at the same time.

You will get some improvement from an upper lid blepharoplasty, but not as good a result as a forehead lift. You "kill 2 birds with one stone" with the forehead lift. If the lids are in good position then you only need the upper lid blepharoplasty.

Dear AndiP,

You should see a qualified plastic surgeon (or 2) for an opinion.  This could represent sagging skin or bulging fat or both.  It's tough to tell unless you see someone who can examine you.

Nonetheless an upper blepharoplasty is a safe and relatively easy procedure (in the spectrum of plastic surgery) with great results and satisfied patients.

Best,

Nima Shemirani

The problem you describe is a very common one.  The truth is that without seeing you it's impossible to determine if a blepharoplasty alone will achieve the result you desire, or if a brow lift might be necessary.  Most of the time a blepharoplasty alone will be adequate, especially for a younger patient, but again every case is individual.  The best recommendation would be to consult with a surgeon experienced with both procedures, who would be best able to offer advice.  Optimally, the surgeon should specialize in eyelid rejuvenation surgery.

An upper blepharoplasty will address hanging skin and puffiness on the inner corners of the upper lids.  The puffiness is created by orbital fat that is protruded and herniated outward.  Removal of the fat and a crescent shaped portion of the skin is removed in this area to remove excess skin during a blepharoplasty procedure.  

The APPEARANCE (vs. the reality) of "excess" upper lid skin may be due to:
- a sagging of the brow
- isolated excess upper lid skin OR
-BOTH of the above.

While an upper lid tuck (Upper Blepharoplasty) would nicely correct an insolated excess of upper lid skin, it would NOT fully correct either APPARENT upper lid skin excess caused by either pure brow sag or combined brow sag with skin excess. (Look in the mirror while pushing your brow lower gently).  This is similar to trying to correct a wall sheetrock damage with a fresh coat of paint.

In Surgery s in every other profession, we must pick the right tool for the right job. If instead of lifting a brow, we keep removing the apparent excess skin caused by the brow, we end with continuous sagging of the brow and recurrent apparent excess upper lid skin.

You need to be seen by a competent Plastic Surgeon to educate you on your options.

Good Luck.

Peter A Aldea, MD
Memphis, Tennessee

Andi P,

It is very difficult to answer this question without examining you or at least seeing a photo.   From your description, it sounds like a blepharoplasty may be all that is needed.  I recommend that you seek a second opinion from an oculoplastic surgeon.  You can find one at the American Society of Ophthalmic Plastic Surgery website.

It may be as simples as an upper eyelid lift procedure.  On the other hand a formal exam may show otherwise and a brow lift may be better depending upon its position.

Blepharoplasty removes extensive fat and skin from both upper and lower eyelids. The procedure can be done for the lower eyelids thru a small incision on the inner eyelid.  In your case, it appears as a bleph can take care of the problem, however, a bleph and an eyebrow lift are not one in the same.  I hope this helps.

 

Dr. Ritacca