Is it be a good idea to raise my eyelid crease to 8 or 9mm?

Question

I had upper eyelid surgery in 2012 (unsuccessfully). I had a consultation with a new oculoplastic surgeon and he said "you probably have never had much eyelid showing when you were younger" (correct), and said my current crease was measured at 6mm but that he had to raise it to 8- 9mm so that he wouldnt end up removing too much skin and so I would be able to close my eyes. He said he would give me Asian eyelid type surgery and remove a small amount of muscle. Yay or nay? I want to trust him.

John Michael Thomassen, MD · Answer

It seems you have a crease that is obscured by hooding of skin.  If a standard skin only blepharoplasty is done you may have a nice crease show without needing to alter your crease further.

Kenneth D. Steinsapir, MD · Answer

The problem with raising the crease to 9mm is that it will heal about 2 mm higher.  I do not agree at all that you need a brow lift.  This will put your eyebrow too high and will make you look surgical and skeletonize your eyes.  I also disagree a "subbrow" excision which makes an unsightly scar in a highly visible location.  The idea of a small excision blepharoplasty is a good on but I suspect you will be better off with a crease at 6-7.5mm depending your actual examination.  Finally, depending on how dry your eyes are, a skin only blepharoplasty may be appropriate for you.

James R. Gordon, MD, FACS, FAAO · Answer

Thank you for your question and sharing your photographs. It appears that you simply need a blepharoplasty. You can keep the lid crease where it is already located. It is true that you do not want to remove too much skin because it should look natural; however, the right amount needs to be removed in order to give you a rejuvenated/youthful appearance. Good luck.

Peter E. Johnson, MD · Answer

We cannot know what is just right for you, however the current trend in upper lid rejuvenation is keeping the lid crease slightly lower as a high crease can cause the appearance of aging. Removing a very slim strip of muscle is a common method to help set the crease where the surgeon decides it is best. Removing too much skin can indeed cause regrets, and Asian eyelid procedures are a very large topic with goals not quite applicable to what you are in your photos.

Gregory D. Lewen, MD, FACS · Answer

The primary goal of blepharoplasty is to rejuvenate the eyelids and the appearance of the eyes.  If your crease is normally positioned lower and this is the way it looked even when you were younger, do you really want to change it?  It seems to me that the goal of your surgery should be to make your eyelids look like a more youthful version of what you already have, while maintaining the same shape and configuration of the crease.   It appears that you would do very well from a simple, conservative blepharoplasty.

Is it be a good idea to raise my eyelid crease to 8 or 9mm?

Answers (5)