Eyelid surgery at 30? (photo)

Question

I recently went in for a Botox consultation and was told I was not a canidate. The doctor instead said I would need a slight brow lift and upper eyelid surgery. I've always noticed the extra skin over my eyelids and have known that I would need surgery at some point to correct this but am I too young for this procedure now?

Kenneth D. Steinsapir, MD · Answer

it is complex but you are at high risk of being harmed by eyelid surgery.  I encourage you to read my blogs on my website so that you are much better informed about these choices.

Bryan Mendelson, MD, FRACS, FACS (retired) · Answer

The reasons not to perform eyelid
surgery in young people is the risk of the scar being visible and of recurrence
after the surgery. In this case repeat surgery would inevitably be required in the
future. This is the reason for the origin of the term ‘nip and tuck surgery’.

To digress for a moment, if it was your nose
that was not correct, most surgeons would have been happy to operate on it when
you were in your late teens. Similarly with overly small breasts in a teenager,
most surgeons are happy to operate to correct the deficiency in the patients
late teens.

So you may reasonably ask, what is
the difference with your upper lids then? First,  upper lid surgery was developed to correct aging changes. Yet you had this situation even before you had aged.
So, in your situation you are wanting correction of a deformity that precedes
aging but looks like aging. This occurs in a small proportion of people with
upper eyelids that are not attractive.

Second, the standard upper lid
operation has limitations, but these do not present a problem in older tissues;
but they would in a younger person, such as a 30 year old. That is the reason
most surgeons wisely do not recommend surgery at a young age.

However, you should know that there
is a more sophisticated upper lid correction operation that is perfect for your
situation. It is called the tarsal fixation blepharoplasty. Unfortunately, it
is practiced by only a few surgeons and these surgeons need to perform it regularly
to have the correct finesse with the operation.

The essence of the operation is to
surgically define the lid crease. This involves the skin, at the correct level,
being attached to the internal tissues. This is a permanent crease that people
with lovely eyes have, but is what is lacking in your situation. The formation
of the crease takes up a lot of the skin that looks to be excessive and only
after this, is any true skin excess measured and removed. This is much less
skin than with the standard operation.

Because the skin is not tight, there
is no tension on the lid skin so the scar will heal to be so fine to become
invisible, even with the eyes closed. Furthermore the eyelashes will naturally
curl up rather than droop and remarkably, the brow gives the illusion of
being higher. So you definitely should not consider having a browlift. Low
brows are attractive and youthful provided the lid fold is there and doing what
it should.

Because of the tarsal fixation
operation I have performed upper lid correction on many women in their
twenties, over the years. They have the benefit of having the correction when
they need it and all love their scarless eyes. Some of my patients had this done 25+ years ago and have not looked like needing a revision.

Eyelid surgery at 30? (photo)

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Everything you need to know about Eyelid Surgery

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Eyelid surgery at 30? (photo)

Answers (2)

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Recommended reading

Everything you need to know about Eyelid Surgery

Our mission is to create a world where every investment in modern beauty is Worth It.