Pre Eyelid Surgery: Eyelid Folds That Hang to the Side - How Does This "Blend In"?

If my excess eyelids are taken, how will the fold on the sides of my eyes look? My Dr. said it would look ok, but I'm worried.

Doctor Answers 9

Eyelid folds that hang on the side of the eyelid need special attention during Blepharoplasty or can be made worse

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Upper eyelid Blepharoplasty removes excess skin or hooding of the upper eyelids and has the effect of "opening the eye".

Optimally the incision is hidden when the eyelid is open, and most surgeons try to avoid carrying the incision out to the side near the forehead because if the incision goes out too far it will be visible.

This is a problem when there is excess upper eyelid skin hanging down toward the side of the upper eyelid below the outside portion of the eyebrow.

Most experienced Eyelid Surgeons design the outside portion of the incision to slant up so that this excess can be removed while still keeping the incision inside the outside bone of the eye socket or Orbit.

However, in some people who have a sagging brow, a Brow Lift must also be done to lift the lateral or outside hanging loose brow and eyelid skin.

Ask your Doctor to demonstrate to you how he/she will keep the eyelid incision inside the outside bony wall of your eye socket and still remove the hanging skin on the side.

If you are referring to crow's Feet-the wrinkle lines on the outside of the corner of the eye, Blepharoplasty Surgery will not remove Crow's Feet. Only Botox or Dysport will reduce Crow's Feet.

Eyelid Surgery should blend in skin above the eyelid creases.

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Yes, of course...the skin above the upper eyelid crease should blend in after the eyelid surgery if it's done properly.  That's what's involved in knowing how much skin to take from the upper eyelids in each individual patient.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 28 reviews

Eyelid Folds after Blepharoplasty or Eye Lift

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Upper eyelid surgery removes excess skin and sagging tissue. The skin removed generally starts near the inside eye to the sides of the eye. Incisions are hidden within natural creases. Some patients need an eyebrow lift along with the eyelid surgery. The folds on the sides of the eye may or may not improve, depending on the specific procedure your plastic surgeon performs. It's difficult to provide a more specific answer without photographs. Only after a comprehensive evaluation can an eyelid surgery help determine appropriate options for you.

Dr. Chaboki


Houtan Chaboki, MD
Washington DC Facial Plastic Surgeon
4.9 out of 5 stars 89 reviews

Lateral eyelid skin excess

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This is one of most important issues when doing upper eyelid surgery.  What really needs to be determined is if you actually need a browlift in order to get the best result.  Sometimes too much skin is taken from the lateral upper eyelid to try to achieve the desired look and this can result in a "pinched" look.  Photos would be very helpful to help you with your questions.  

Jeffrey E. Kyllo, MD
Seattle Plastic Surgeon
4.7 out of 5 stars 13 reviews

Individualize eyelid repair (blepharoplasty). Laser if needed.

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Each eyelid must be treated based on its findings. If the skin excess is significant at the sides, this requires a longer scar, and that scar is more visible there than over the eyelid itself. Brow lifts, laser resurfacing, and Botox or Dysport may also help. Lasering especially is often useful in this situation. I hope this helps.

Steven Goldman, MD
Cleveland Plastic Surgeon
5.0 out of 5 stars 168 reviews

Pre Eyelid Surgery: Eyelid Folds That Hang to the Side - How Does This "Blend In"?

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If the folds are removed as part of the excess skin, there should be no folds at all. However, you may notice that the scar will come up laterally instead of following the fold down. It will resolve with time.

Mohsen Tavoussi, MD, DO
Orange County Facial Plastic Surgeon

It is appropriate to be very concerned about this.

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Don't be in such a hurry to have surgery without having all your questions answered.  Ask to see photos of other patients with issues similar to yours and see what the surgeon did for these individuals.  Sometimes people are surprised after eyelid surgery that there is a scar visible in the eyebrow where the doctor had to chase the eyelid fold.  If your surgery practices anchor blepharoplasty, an uncommon skill, this can help make the skin break and fold more naturally.  However, for some the answer is repositioning the forehead tissue (forehead lift) at the time of the eyelid surgery rather than expecting everything will be address just with upper eyelid surgery.

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Blending the Lateral fold in Eyelid Lift

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The fold laterally is included in the excision of the eyelid skin. If there is a significant problem, then a Brow Tack or Brow Lift is usually also done. This is a part of all Blepharoplasties and is modified for each procedure.

Robert T. Buchanan, MD
Highlands Plastic Surgeon

Eyelid surgery

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In terms of technique, the amount of skin excision is tapered as it reaches the outer most aspect of your eyelid. In this way, skin is allowed to be approximated without buckling or folding. I think you should review some post op photos with your surgeon so you could appreciate the possible outcome.

Maurice M. Khosh, MD
New York Facial Plastic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.