Upper eye surgery skin with hallows - how to fix? (photos)

You have bilateral upper eyelid ptosis with central levator disinsertion and compensatory eyebrow elevation. This is fixed by crease lowering surgery, anterior levator advancement with virtually no skin removal. Removal of the too much skin and upper eyelid fold fillers will not help you but can disfigure you. The challenge is that few so-called eyelid specialists understand the underlying anatomic issue here. Do not get the wrong surgery. Fixing that is very challenging.

An upper lid blepharoplasty will address the excess skin adequately. You can add fat grafting to the upper brow to help reduce the hollow appearance.

You may benefit from combination of upper eyelid filler and upper blepharoplasty but need more detailed evaluation to determine.

The very delicate skin around the eyes tends to get crepey and puffy due to fatigue and stress. Eyelid surgery has become one of my most popular procedures. If excess upper eyelid skin is hooding the eye and needs to be eliminated, an incision is made in the crease at the top of the lid and excess fat and skin are removed. The incisions are closed and sutured on the underside of the skin.

If there is also upper eyelid sagging ptosis repair is performed to tighten and lift the levator muscle and reduce eyelid drooping.

An effective non-surgical option that might benefit you is Thermage, which can tighten the skin around the eyes. The new and improved Thermage is a virtually painless, non-invasive (no incision!) treatment that can tighten skin and stimulate your body to make healthier collagen—the building block that provides structure to your skin. Fast and easy, Thermage requires no downtime from normal activities. The use of certain topical creams can also be helpful to reduce the appearance of dark circles and puffiness around the eyes. I suggest making an appointment with a board certified plastic surgeon experienced in blepharoplasty.