Am I a good candidate for upper blepharoplasty? Age 40 (Photos)

Question

40 years old and my eyelids have begun to droop so much that I can often see them when I look up. Botox(which is currently wearing off) does a decent job raising my eyebrows but is becoming ineffective for the droopy lids. What are my options? Is it advisable to perform an upper blepharoplasty at the same time as a lower facelift(which I'm also planning)? The picture in different lighting is from a few years ago so that you may bear witness to the steady decline that is my face lol. Thanks!

Kenneth D. Steinsapir, MD · Answer

Sadly, you will get a surgery that is not right for you. You have no herniated eyelid fat and really no excess upper eyelid skin. Wha you do have is a very hollow upper eyelid and a high crease. The skin that you think is excess is the skin you need to operate the eyelid normally. What is going on is that you have a central levator tendon disinsertion. This is the tendon that opens the eyelid. When it slips, it takes anterior orbital fat into the orbit with it. A detailed, in person consultation is needed to evaluate the eyelid. However, it is likely that you need the central levator disinsertion repaired and repositioning of the anterior orbital fat. The crease should be lowered at the same time and crease restructured with an anchor blepharoplasty. Your eyes can be your best feature. Do not do this with the facelift that you do not need. The surgeon will simply remove the upper eyelid skin, which in my opinion will harm you not help you.

Selcuk Inanli, MD · Answer

Hello! First of all thank you for your question.I have evaluated your case regarding the information you provided and your photos.You don't need a blepharoplasty. On the contrary, your lateral upper orbital bone rim is prominent and eyebrows especially medial portions are too low and close to the globes which make the area crowded and medial suprapalpebral areas look hollow.You need a total brow-lift and fat injection to the medial A frame areas.

Jason Emer, MD · Answer

As we age, our eyelids naturally sag and droop. A combination approach would be best to see visible improvement. In terms of non-surgical treatment options, I would recommend a Chemical Brow Lift (using Botox, Dysport, Xeomin, or Jeuveau) and filler injections to rejuvenate the temples, eyebrow, eyelid, eye troughs, upper eye hollows, and forehead. I typically combine this with Ultherapy and thread lifting to lift the brow; RF and skin tightening laser treatments to stimulate collagen production and rejuvenate the skin; and laser or superficial RF devices for improvements in texture, color, and any crepey skin around the eyes as needed. In some cases, surgery is the best solution to achieve the desired results. See an expert for a formal consultation. Best, Dr. Emer.​

Zoran Potparic, MD · Answer

Based on these photos, you may be a candidate for conservative upper blepharoplasty, not sure? Hollowness of the orbits underneath medial brows, could be corrected with selective fat grafting which will visually create impression of the medial brow lift. Hope this helps.

John Paul Tutela, MD · Answer

Thanks so much for reaching out. Yes in fact, it does look like you’re a good candidate for an upper blepharoplasty.  Furthermore, it looks like you may be a candidate for skin only procedure where nothing other than skin is removed. Be sure to say board-certified plastic surgeon for the best results. I hope this helps :-)

Soon-Dong Kim, MD · Answer

By aging, from the forehead, it's sagging and drooping. Also you can see the sagginess especially on your eyes. I actually don't recommend upper blepharoplasty only. Better to get ENDOTINE FOREHEAD LIFT with double eyelid surgery for making one line. It can make your eyes younger and fresh. If you have further questions then please leave a message:)

Thomas Spalla, MD · Answer

You do appear to have some excess skin that can be removed. Your brow appears to be in a natural position at this time, so a brow lift doesn't appear to be indicated at this point. 
Yes, an upper blepharoplasty can be done at the same time as a facelift. In fact, it's a great time as you'll already likely be under some degree of anesthesia and you'll have only one recovery period. It's not "too much" to do in one sitting.

William Portuese, MD · Answer

Yes indeed, your left upper eyelid is more hooded then you're right side, so a conservative skin only upper blepharoplasty would be helpful to rejuvenate your upper eyelids. You also have low eyebrows, so give some consideration to a brow lift.

Brooke R. Seckel, MD, FACS (retired) · Answer

Thank you for your question.  If the loose skin that you see is present when you gently lift the eyebrow and upper blepharoplasty can remove excess eyelid skin but caution should be utilized to avoid removing any drooping brow skin during that procedure.

If you are contemplating a facelift in the future an upper blepharoplasty could well be delayed and done at the same time of the facelift.

If during your facelift the brow is also elevated then a more accurate appraisal of the amount of excess skin removed from the upper eyelid can be made at that time

Am I a good candidate for upper blepharoplasty? Age 40 (Photos)

Answers (9)

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