Unsure what to do for eyes (Photo)

Question

44, lost a lot of facial fat after breastfeeding last child. I've had an upper bleph already two years ago. I had undereye fillers 10 years ago and cheek filler two weeks ago. Botox in corner of eyes helps but when I try under the eyes it doesn't help/ Iooks weird. Sometimes I feel like my eyes sink into their sockets and overall they look tiny compared to my youth. How small they get when I smile is really bothering me, and I feel like filler made it worse. What do I do?

Gary M. Horndeski, MD · Answer

It appears you still have excess skin of the upper eyelids.  Your photographs are somewhat limited.  You may benefit from a brow lift and you may also benefit from a lower blepharoplasty to transpose the fat to fill in the tear troughs.

Best Wishes,

Gary Horndeski, M.D.

Nelson Lee Novick, MD · Answer

There is no substitute for an in-person examination by an experienced, board certified dermatologist injector expert that allows for palpation and manipulation of the tissue. However, from what I can see in the photos provided, there appears to be a downturning of the outer third of the eyebrows. Microdroplets of Botox, appropriately placed in the lateral brows, accompanied by injection of an appropriate HA filler placed below the lateral brows, is likely to achieve the more desirable feminine upward and outward flare of the outer third of the brows--which would likely also lend to achieving a less narrowed and more open appearance. 
Finally, at least from the photos, a bit more of a robust HA volumizing filler can be added to the upper outer cheeks, which would likely improve not only the contour of the cheek (a more Ogee Curve and a more oval, heart-shaped face), but would further smooth and create a more gradual, less hollow transition between the upper cheek and the under eyes. Hope this helps and best of luck.

Unsure what to do for eyes (Photo)

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Unsure what to do for eyes (Photo)

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