You need a detailed consultation.
I wonder if you have a component of upper eyelid ptosis. There is a compensatory brow asymmetry that does suggest that you have an early upper eyelid levator weakness. Less is more for you. Too much skin removal will skeletonize the upper eyelids. You also seem to have a degree of mid face ptosis that will complicate lower eyelid surgery. This needs to be addressed with a more advanced type of lower blepharoplasty that supports the orbicularis oculi muscle in the lower eyelid.
Aging around the eyes involves so many different causes. Your photos are very helpful. Dropping of the brow, especially the left is causing eyelid skin to drop with it in an asymmetric fashion. Secondly, loss of volume in the brow has contributed to this skin laxity. Even the lower eyelids appear "deflated". Simply removing upper eyelid skin may make your upper eyelids appear sunken and older possibly; removing lower eyelid fat is also fraught with creating an older, hollow appearance. Without the benefit of an in-person exam of you in particular, I generally promote volume restoration,conservative skin removal and repair (not removal) of lower eyelid fat. Yes, it is always more complicated than a "lid lift" implies. Get more than one opinion; you are only 40 and should expect the most natural result possible.
Blepharoplasty and browlift
Thank you for including multiple photographs! From the front-view photographs you have provided, you would most certainly benefit, in my hands, from upper blepharoplasty and a brow lift at the same time. You have considerably more sagging and hooding of your left brow, so it would be important to be thoroughly examined by an experienced plastic surgeon to assess how the muscles of the forehead and the eyelids are functioning. Although you have very different positions of your eyebrows, brow lifts can usually correct this asymmetry substantially (although possibly less than 100%). Depending on how high your hairline is, different brow lift techniques/approaches can be applied so that a high hairline is not accentuated and made even higher. In addition, you have considerable sagging and lengthening of your lower eyelids, but it is difficult to discern whether you have excess skin (less likely), or perhaps crepe-like skin (more likely perhaps, and improved with laser resurfacing, rather than lower lid blepharoplasty). You appear to have significant laxity of your lower eyelids. Whether this is due to loss of supportive cheek fat/bone (flattening of the front of the cheek) or ongoing laxity of the lower lid edge is not clear to me. The potential treatments needed to improve your lower eyelids SAFELY are different with the different scenarios. Again, a thorough examination by a board-certified plastic surgeon is essential to developing an effective strategy. Best of luck to you for a beautiful result!
Is Blepharoplasty and good option?
You would greatly benefit from an upper lid Blepharoplasty and at least laser resurfacing of the lower lid skin if not an actual Blepharoplasty
Precedure depends on what you want
but from your photos, I would recommend a browlift before a blepharoplasty. That is what will make you look alert and more youthful. But if you would be happy with just crisper creases, then the blepharoplasty would be good enough.
Hello there, based on your photos, you have some degree of eyelid and brow changes that surgery could help with. I recommend you seeing an Oculoplastic surgeon that has extensive experience in eyelid and brow surgery. Best of luck,
Brow lift and lower lid blepharoplasty for a much rejuvenated appearance.
Brow lift and lower lid blepharoplasty for a much rejuvenated appearance. it would be unwise for you to have an upper lid blepharoplasty because you can correct this problem and raise your sagging browse at the same time. The lower eyelids can be done through a lower blepharoplasty as well. If you have a high hairline you should have the Irregular Trichophytic Forehead Lift with the scar not showing because this technique which we developed allows hair to grow through the incision. If you have a very low hairline this can be done endoscopically. See a very experienced surgeon with these techniques and look at the results of the hairline.
Is blepharoplasty a good option?
From your photos, upper and lower eyelid blepharoplasty may be a very good option for your. You left eye appears to have more severe sagging, as well as a component of brow ptosis. A brow lift may also be a good option for you. Seek out a board certified plastic surgeon with extensive blepharoplasty and brow lift experience. Best wishes, Dr. Lepore.
Eyelid surgery for puffy and hooded eyelids
The photographs demonstrate hooded extra skin on the upper limits and puffy lower lidss for which upper and lower blepharoplasty procedure can improve. For more information and many eyelid surgery before and afters, please see the link and video below
Blepharoplasty is an option for you
Yes, blepharoplasty (upper and lower) is a valid option for you to improve the eye appearance. See following link. See an oculoplastic specialist.