Is there a way to get more deeper set eyes, can I reduce my abnormally large upper eyelid exposure? (Photos)

Question

Is there a way to get more deeper set eyes? I hate my eyes. Can I reduce my abnormally large upper eyelid exposure? Also what would the treatment entail in terms of recovery time? Is it quick?

Kenneth D. Steinsapir, MD · Answer

You have bilateral central levator disinsertion. Effectively you have bilateral upper eyelid ptosis that is compensated by brow elevation. You see so much upper eyelid platform that you effectively do no have an upper eyelid folds. That means these are innie eyelids. To partially hide the upper eyelid platform you need a fold. A fold is composed of the skin needed to close the eyelid and fat. The skin at the moment is primarily taken up by the compensatory eyebrow elevation. The fat that is normally in the fold is partially taken up also by the compensatory eyebrow elevation. The other important source of fat is pre-aponeurotic fat. That is fat that is associated with the levator aponeurosis. It lives between the aponeurosis and the orbital septum. With central levator disinsertion, the fat is retracted into the anterior orbit with the retracting central levator. To repair the situation, you need crease lowering, upper eyelid fold reconstruction, levator advancement and repair, and anchor blepharoplasty. I believe I am the only surgeon in the world doing this type of work. Do not get orbital decompression by a well meaning surgeon who may offer that because you are asking for deeper set eyes. They will misunderstand you and the result will be awful.

Raffy Karamanoukian, MD, FACS · Answer

Fractional laser is an amazing and highly effective treatment in our office. We use the laser treatment to help with acne scars, large pores, fine wrinkles, tissue collagen loss, scars, sebaceous hyperplasia, active acne, and for brightening dark pigmentation. Although there are very strong fractional lasers such as CO2 laser, we use lighter treatments for corrective skincare and maintenance of results. Our Thulium fractional laser, clear and brilliant laser, and Ultra Thulium laser are excellent options in our clinic. We also perform CO2 fractional and erbium depending on skin tone and tolerance for downtime. Patients do have to use a Melarase cream before and after treatment to help further reduce pigmentation after laser.  Melarase AM, Melarase PM, and Melapads can seriously improve surface sun damage and UV related pigmentation. Dark spots can improve with these treatments. I recommend fractional laser for incisional scars as well, especially after plastic surgery.  
Best,
Dr. Karamanoukian 
Realself100 Surgeon

Mats Hagstrom, MD (license on probation) · Answer

It is possible to reset the eyeball deeper in the eye socket by opening the eyesocket, creating greater volume in the cranial space. This is sometimes done for patients who have exophthalmus.
I don’t think you have exophthalmus and I don’t think you need that procedure.
I think you have unique facial features, which are balanced, appropriate, and attractive.
My best recommendation is to avoid permanent surgical intervention, unless it’s clearly indicated.
Best,
Mats Hagstrom, MD

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