My baby sister is turning 18 in a week and for the past year, she has been saving her money for an upper eyelid surgery. Her upper eyes are and have always been slightly droopy and she constantly looks tired or mad (even when she is not). The skin hits her eyelashes, which sometimes causes a rash on the skin. She is very unhappy. I’m just a little worried and I want to know if 18 years old is too young to have upper eyelid surgery. Also, what are the complications for someone this young? Will it look worse as she ages or will this be good for her? Thank you!
Is 18 Years Old Too Young for Eyelid Surgery?
Doctor Answers 18
Anatomy before age
Age is not the most important factor here. The anatomical problem should decide which surgery is appropriate, if any. We frequently operate on people from infancy to advanced age based on the problem they have and what is best to correct it. Have her consult with an ASOPRS trained oculoplastic surgeon in your area to discuss the correct course.
18 might not be too young for upper eyelid surgery
The age of 18 may or may not be too young for upper eyelid surgery depending on what one wants to achieve with eyelid surgery. If excess skin is causing inversion of the upper eyelids or if the upper eyelashes are rubbing on the cornea causing irritation to the cornea, these may be good reasons for upper eyelid surgery on an 18 year old.
Also we commonly do upper eyelid on Asians who are around 18 years old to create a supratarsal fold that is not normally present.
18 is not too young for eyelid surgery
Depending on the causes of your baby sister's problem and her aesthetic goals, she may not be too young for eyelid surgery. One very prominent example is among Eastern Asians, who often have "double-eyelid" surgery in order to remove the heavy lidded appearance of eyelids which have no visible fold. This is often done at a younger age.
The best thing for your sister to do is to see a qualified surgeon in consultation and discuss her concerns. Then she can be evaluated appropriately and learn whether or not eyelid surgery is the ideal solution. Best of luck!
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Upper eyelid surgery for young patients
It sounds as though from the description, that when the eyelid skin is touching the eyelashes and irritating the eye that indeed, there is an indication to perform upper blepharoplasty. Sometimes on certain ethnic eyelids there is excess fat in the upper lid that herniates over the eyelid, which can be removed. There is probably only a minimal amount of skin that needs to be removed at age 18. Indeed, 18 years of age is a bit young to have upper blepharoplasty; however, when it is interfering with vision or creating an irritation on the upper eyelid skin, there may be a medical indication for it. There are no other complications in this age group for this type of surgery other than to be very conservative with the excess skin removal.
Upper lid blepharoplasty in an 18 year old
It is extremely , extremely rare to have to need upper eyelid rejuventation in such a young person unless they have some sort of underlying skin disease or facial abnormality. Without examining this person, I would not be able to offer any suggestions.
Upper lid surgery may be more necessary than cosmetic
While 18 does seem way too young for a cosmetic upper eyelid procedure, it may be the right thing to do. Some people do develop upper eyelid laxity or "droop" at an early age. It can be related to the muscle or nerve function of the eyelid. It must be appropriately evaluated. If it is asymmetric, or each eye looks different, there may be multiple causes. If it is symmetric, or the eyes droop the same, surgical correction may be the only answer.
Make sure she has an evaluation by both a Plastic Surgeon and an Ophthalmologist to fully evaluate her condition. The together they can determine if surgery is her best answer.
Upper eyelid surgery at age 18
She does seem too young to have upper Blepharoplasty. But there are individuals with abnormal early laxity of their skin. in these cases upper Blepharoplasty could be successful. The possibility of a visible scar should be discussed with the plastic surgeon, as this would be more noticeable in a young person.
18 years old for upper eyelid surgery
It sounds like the issue is not cosmetic per se but congenital. The "tired" or "mad" look is indicative of congenital ptosis. So you're sister is not looking at cosmetic surgery. She needs to see an oculoplastic surgeon who specializes in congenital ptosis. Surgical correction of this problem can be quite difficult. She might want to look into the larger institutions that really specialize in this kind of surgery.
Upper eyelid surgery in a young patient is seldom indicated
Upper eyelid surgery in a young patient is seldom indicated unless they have congenital excess skin which is rare. The other indication for a droopy eyelid surgery might be from a condition called ptosis where the upper eyelid hangs close to the pupil where normally in caucasian eyelids it should rest 1-2mm below the iris. Excess skin alone is very uncommon; however, sometimes a very small amount needs to be removed to accomodate correction of ptosis. On the other hand, I would caution against removing too much upper eyelid skin or removing fat to avoid eyelid closure problems which can lead to dry eyes or if too much fat is removed, a hollowed look can result.
She may have a true upper eyelid ptosis
She may or may not be too young to make this decision. Certainly she should make this decision with the help and support of her parents. She may very well have a functional issue. If the droopiness of the upper eyelid is due to the eyelid margin (where the eyelashes are) resting low on the eye, this condition is referred to as upper eyelid ptosis. If your are referring to the upper eyelid fold, this needs to be more carefully assessed.
I would strongly recommend assessment by an oculoplastic surgeon. This is a board certified ophthalmologist who has completed a fellowship training in eye plastic surgery. The American Society for Ophthalmic Plastic and Reconstructive Surgery maintains a website that can help you locate a well qualified surgeon in your area (www.ASOPRS.org).
As these are very specialized issues, it is best to see a fellowship trained eye plastic surgeon rather than a generalist like a board certified general plastic surgeon or a facial plastic surgeon. And yes, the results of surgery need to last a lifetime.