Visible Upper Eyelids and Unhappy w/ Eye Profile - Can I Change This?

Having a hollow appearance to the upper lids can be a result of aging or simply the way you're built. In your case, as a young woman, this is simply your genetic appearance. Let me start by saying that your eyes are lovely and not unattractive in any way. However, your opinion of yourself is more important than anyone's opinion. If this is something that bothers you a little bit you should really think long and hard about having a procedure to change it. If this is something that you think about all the time and it really bothers significantly you might want to consider surgery.

Before having any cosmetic procedure on your eyes you should have a thorough examination with an ophthalmologist. You may also want to check your thyroid hormone levels as high levels of thyroid hormones may contribute to this appearance in some patients. If you find that you are otherwise healthy and want to change the appearance of your upper eyelids there are some things you can consider. 

You do seem to have a very mild amount of upper eyelid ptosis (the medical term for sagging). While this is not fully to blame for the shape of your upper lids it does contribute a little bit. From your photos is seems to me that the hollowness of your upper lids could be improved with a conservative amount of fat grafting right below the bone over your eyes. This bone (the superior orbital rim) is not the problem, though the lack of fullness below it is the main reason for your hollow appearance (in my opinion). You can have fat removed from your tummy or hips and carefully placed right beneath that bone to create a fuller look. This should be done conservatively as too much fat would not look good either. A small amount of added volume could make a big difference in the appearance of your upper eyelids.

I hope this info helps!

Yes, Ms. Portman does have beautiful eyes.  Sadly, I don't have any magic to give you her exact look.

As a number of surgeons have mentioned, your eye appearance is related to a combination of features.  A little ptosis (droop) of the eyelid, perhaps a little forward prominence of the eye combined with a cheek that is a little weak, and so on.

The good news is that some of these can be improved.  Cheek augmentation could help, perhaps canthopexy.  Speak with a plastic surgeon or oculoplastic surgeon locally to discuss the options.

 

All the best! 

Hi saraj121 in Essington, PA,

Improving the appearance of the eyes in younger patients is greatly different as compared to typical eyelid plastic surgery for older patient. Your photographs suggest, as other eye plastic surgeons have mentioned, a shallow orbital bone. In other words, there is less bone space around your eye. As a result, the eye may protrude out a bit. Treatment for shallow orbit involves creating more space around the eye. This surgery is called decompression.

In addition, the upper eyelids appear droopy based on the photographs. Lifting the upper eyelid helps reduce the amount of skin show. Droopy eyelids usually come from age, but may also be congenital or other causes.

Only after a comprehensive evaluation can an plastic surgeon or specialist help determine appropriate options for you. Best of luck.

Dr. Chaboki

Dear Sara

You have a couple of things going on that account for the appearance of your eyes.

First, as you point out, your eyelids are ptotic.  Your right upper eyelid is actually heavier than the left upper eyelid.  Second, due to the heaviness of the upper eyelids, you are subconsciously compensating by raising the eyebrows.  The compensatory brow lift makes the sub-brow space look empty compared to Natalie Portman's eyes.  Finally, there is laxity of the upper eyelid platform skin which makes it hard for you to hold make up on the eyelid platform.  When this skin is tightened below the eyelid crease, this will help perk up your upper eyelid lashes.  Now here is the bad news, much less than 1% of surgeons offering eyelid surgery including oculoplastic surgeons are going to be able to deliver the type of precise and subtle eyelid surgery that you need.  Please do not just go to the guy down the street.  FInding the right surgeon will require very careful screening.  If you see someone and they do not exactly mention every item outlined here and have before and after pictures supporting this type of work, you are in the wrong place.

The problem with your eye/lids are that you have very prominent eyes with poor maxillary bone support.  Your eyelids are at a disadvantage in covering your eyes, with low lateral canthus.  There are options to improve the function and appearance of the eyelids.  Please consult an oculoplastic surgeon.

Dr Taban

It is impossible to create more fullness in the upper lid sulcus. From the pictures presented, it appears that the patient has a very deep sulcus on the upper eyelid. Fat injections into this area are not always successful and it is probably best not to do anything.  

Sara, the difference between the shape and look of your eyes and Ms. Portman's eyes is likely in the underlying bony architecture.  You do have prominent eyes which may be due to a thyroid disorder, or may be caused by having shallow orbits as mentioned previously.  Any decompression procedure would not likely be worth undertaking for a cosmetic procedure. However, what is missing from the pictures and not mentioned previously is that you seem to have a negative vector relationship between your forehead and your cheeks.  Simply, your cheeks/cheekbones may be underdeveloped compared to your globe (eye), which will give you a more prominent globe.  Thus, after ruling out all other possible issues for prominent eyes, you may benefit from building up your cheeks and as described earlier, fat injections around the globes--not a commonly performed procedure in the upper eyelid for several reasons.  Also, you would require an evaluation for droopy eyelids (ptosis) as has been well described previously. Good luck with your endeavor.

I agree with ruling out hyperthyroidism as a cause of prominent eyes. This also could be genetic.  Performing eye lid surgery without addressing or correcting hyperthyroidism may lead to significant, serious, complications.  Unfortunately, it is impossible to achieve the result you desire, at least with today's technology. 

The reason for the hollowness of the upper eyelid is bilateral ptosis. Your pictures show that even though you are using your forehead muscles to lift your eyelids , you still have upper lid ptosis. You will need for levator muscle function evaluation and possible ptosis repair. The other issue is your upper eyelashes that are pointing downward and i also elevate them at the time of the ptosis repair. As you see from the response there is a wide range of recommendations and you need full personal examination .

Before you consider any surgery I would obtain a medical work up for your eyelid position, ptosis, with a field of gaze examination. Also a medical work up for thyroid issues. From Miami Dr. Darryl j. Blinski