Will upper eyelid surgery make me look worse?

Question

I’m only 24 but scheduled an upper lid surgery. I’ve always had extra skin that covers a portion of my eyes. I tried Botox a couple times,and didn’t notice a difference. It seems to run in my family but I’m worried about what I’ll look like after,as I was told by one doctor I needed a brow lift but two others told me I did not and that due to my higher hairline, I wouldn’t be a good candidate for it anyways

Kenneth D. Steinsapir, MD · Answer

You will benefit from eyelid surgery but not from routine blepharoplasty. Routine blepharoplasty removes skin. That is very likely to skeletonize your eyes exposing what is your actual issue. Unfortunately most "highly accomplished blepharoplasty surgeons" (read that sarcastically) think of themselves as skin, muscle, and fat removal surgeons. That will take away your upper eyelid fold. However, that fold is an essential feature of your face. Without that small bit of upper eyelid skin that is your upper eyelid fold, your upper eyelid platform will be exposed. You will be immediately harmed because the fold hides the platform and softens the appearance of the eyes. Removing the eyelid fold will skeletonize the eyes and permit the eyebrows to drop like stones. It will instantly age your appearance. In some cases, the surgery can exacerbate the upper eyelid ptosis. Do not do this to yourself. Do not have a forehead lift. That will also be so very wrong for you. It pulls up the eyebrows and results in a similar effect as an overdone blepharoplasty. To understand what you actually need, you need to appreciate that you have a mild upper eyelid ptosis with a mild eyebrow compensatory  elevation. Medially you can see the you have deepening of the upper eyelid crease and hollowing. That represents a partial levator disinsertion. One can loose upper eyelid volume from other reasons such as the use of a prostaglandin lash growth product such as Latisse or one of the over-the-counter products that contain isopropyl cloprostenate. These kill fat in the upper eyelid fold. To repair your eyelid, the fold must be preserved. Your levator disinsertion and mild upper eyelid ptosis need to be repaired. I would do this with an anterior levator resection ptosis surgery and an anchor blepharoplasty to support the upper eyelid lash ptosis. Repairing the levator disinsertion will general bring fat from the anterior orbit forward which will help revolumize the upper eyelid fold. I also think you may benefit from a right lateral canthoplasty. Don't let a well meaning eyelid surgeon wreck you. Once your upper eyelid fold is removed, it will be very hard to restore your apprearance. Don't do this to yourself.

Marc Polacco, MD · Answer

This is a classic situation. Whenever I see a patient who wants an upper eyelid surgery, I always start by looking at brow position. I think for you it depends if you like where your brows sit. If you'd like them higher, then a brow lift would likely be the best procedure, because that will also relieve some of the upper eyelid heaviness. However, if you like where your brows are, then conservative blepharoplasty may be the best solution. Either way, please have careful discussion with your surgeon regarding your wishes and goals. Hope that helps!

Toby Mayer, MD · Answer

Irregular Trichophytic Forehead Lift with Hairline Lowering for sad eyes. This is what will give you the best results in my opinion based on more than 2000 of these. The scar will be hidden by hair growing thru the scar and in front of it. An upper blepharoplasty won’t give you this! See actual results with the hair pulled back.

Mark Taylor, MD · Answer

You are young and may be able to delay upper eyelid surgery for some time, however it appears that you have inherited heavy upper eyelids and would eventually benefit from upper eyelid surgery.

Darryl J. Blinski, MD · Answer

Might offer an upper lid skin only blepharoplasty, more excision on lateral areas. Fees range from $2,500-$5,000 under local with IV sedation.

Akin Inaloz, MD - Account Suspended · Answer

Blepharoplasty is the solution for you. You will lose the extra skin in your upper eyelid and you wont have to do Botox or anything else to fix it. its a permanent solution and you will get the result you want.

Robert T. Buchanan, MD (retired) · Answer

I would highly recommend that you do nothing, as, unless you see an absolute expert in treating the area in someone your age, you are likely to regret the surgery. Your brow has an excellent arch well above the orbital rim, right where it is supposed to be. Therefore, you do not need a brow lift. The amount of tarsal (the flat area just above the lid margin) show, though less than some is still considered very normal and present in well over half of the models making millions on their faces. If you still decide to do anything, make sure of the qualifications of the surgeon you choose and that you absolutely know what you wish to accomplish and can convey that.

Will upper eyelid surgery make me look worse?

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