Would blepharoplasty be the best option for "double rainbow" skin on upper eyelids? (Photos)

Question

Would an upper blepharoplasty address the “double rainbow” skin on my upper eyelids, or is filler actually the way to go? My eyes have been hollowing out the last 5-6 years exacerbating how much the extra skin stands out.

Jeffrey M. Darrow, MD · Answer

Thank you for your photo. A skin only upper blepharoplasty would remove the redundant skin of your upper eyelids while retaining all volume possible to maintain a youthful appearance.  This would be a permanent correction of this issue, while fillers would be a temporary fix requiring subsequent treatments to maintain the result.  An upper blepharoplasty can easily be performed under local anesthesia only with a single buried suture to each upper eyelid. Recovery is on the order of approximately 4 to 5 days. Discuss this with your Plastic surgeon. Best wishes.

Erin Smith, MD · Answer

You may be a good candidate for filler to address brow volume loss and a conservative upper belpharoplasty to reduce excess upper lid skin. Your surgeon will be able to provide more guidance after an in person exam. Good luck!

Javier Parada, MD · Answer

Hi, the “double rainbow” appearance on the upper eyelids is usually caused by a combination of skin laxity and volume loss, not just excess skin alone. An upper blepharoplasty can effectively remove redundant skin and improve lid contour, but if hollowing is a significant part of the issue, surgery alone may actually accentuate that hollowed look.
In many cases, the best results come from a balanced approach: conservative skin excision with strategic volume restoration (fat grafting) to soften the hollow and create a smoother, more youthful transition. The exact treatment depends on your anatomy and should be tailored during an in-person or virtual evaluation.

Lucian Ion, FRCS · Answer

Thank you for your enquiry and for sharing your photographs. My impression is that the most appropriate solution lies somewhere in between the two options you are considering. Although there is only a small amount of upper eyelid skin excess and a moderate degree of hollowing, attempting to achieve a smooth contour through volume augmentation alone is likely to overemphasise the upper orbital rim as it transitions into the upper eyelid.

A combined approach using upper eyelid blepharoplasty together with volume augmentation would seem more appropriate. This can be performed in a single sitting if fat transfer is used. Alternatively, if injectable filler is preferred, the blepharoplasty can be carried out first, with the filler added at a later stage once swelling has settled and the tissues have stabilised.

Gary M. Horndeski, MD · Answer

An upper blepharoplasty is an excellent procedure to remove extra upper eyelid skin.  If you have hollowing then no fat would be removed at the time of the upper blepharoplasty.

Best Wishes,

Gary Horndeski, M.D.

Stephen Prendiville, MD · Answer

Than k you for the question.  Filler is definitely not indicated for this aesthetic problem and will cause more problems than it solves.  Upper eyelid blepharoplasty would most likely be the best option.  Physical examination would be necessary to come up with a definitive plan.

Zoran Potparic, MD · Answer

It is very likely, based on this photo, that upper blepharoplasty would eliminate skin folds. However, possibility of upper eyelid ptosis needs to be ruled out. Good luck.

Kyle Kimura, MD · Answer

Thank you for your question and photo! 
I absolutely think an upper blepharoplasty would help with the excess skin of your upper eyelids. It is however important that your surgeon is not too aggressive removing eyelid skin to make the hollowing appear worse. Sometimes fat grafting or fat transposition is required to help fill the hollow areas at the same time as your skin excision with the upper blepharoplasty. 
Hope this helps and best of luck!Kyle Kimura, MD

George Marosan, MD · Answer

Thank you for your question and photo. An upper blepharoplasty, skin excision only, would give you a very nice result. If still experiencing some hollowing postop, I would use micro fat grafting. Both of these procedures can be done under local anesthesia. See a board certified plastic surgeon for an in person consultation/evaluation. Good luck.

Would blepharoplasty be the best option for "double rainbow" skin on upper eyelids? (Photos)

Answers (9)

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