I Have Heavy Upper Eyelids for my Age (I'm 23) Due to Genetics...

I have heavy upper eyelids for my age (I'm 23) due to genetics. I'm not sure whether the most appropriate surgery would be an upper bleph, eyelift, or possibly a canthopexy..(my outer eyelids seem to slope downards). Any advice would be very helpful!

Doctor Answers 11

Eyelid Surgery

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You may just need a simple blepharoplasty with fat removal and perhaps some muscle.  A qualified Board Certified Plastic Surgeon can assist you in making the decisions ahead.  The lateral downward slope can also be due to the excess skin.  Delay a canthopexy until that looks like the best option.

Danville Plastic Surgeon
4.9 out of 5 stars 26 reviews

Heavy upper eyelids

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The goal of upper eyelid blepharoplasty is to remove excess skin from the upper lids.  There are also two fat pads in the upper eyelids that can be partially removed to allow more eyelid show.  Removing both skin and fat will increase eyelid show, eyes won't appear so heavy and patients look better rested.  

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 158 reviews

Heavy upper eye lids due to genetics can be treated with ptosis repair and blepharoplasty

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Heavy upper eye lids due to genetics can be treated with ptosis repair and blepharoplasty.  Canthopexy would not really be indicated until the upper lids were treated first, and you can see what the whole picture will look like.  I wouldn’t recommend a canthopexy at the same time.  Depending on the measurements, it looks like ptosis repair as well as careful removal of some skin may be indicated.  The other option is to have a ptosis repair and put some hyaluronic acid filler in the upper lids which may cause a less hollow look.

Joseph A. Eviatar, MD, FACS
New York Oculoplastic Surgeon
4.7 out of 5 stars 68 reviews

Eyelid surgery

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There are certain eyelid procedures which are straightforward and others which are not.  Because of your age and subtle findings I would be careful of the decision you make regarding surgery.  You have subtle degrees of lid changes (slight excess skin and ptosis - low lid height).  Unless you are really bothered by this I would not proceed with any surgery at your age.  If it truly is a concern than seek out an eyelid specialist to avoid problems 




Dr. Massry

Guy Massry, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 54 reviews

Upper lid fullness

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  Different surgeons will recommend different procedures and this can leave the patient quiet confused. Following an in-person detailed consultation with a qualified surgeon will be extremely valuable in making the correct diagnosis and thus, helping you and your surgeon plan the best course of action. Simpler procedures include a very conservative upper lid blepharoplasty. It would also be important to rule out a degree of ptosis (weakened upper lid muscle) during the consultation.  Ptosis repair and brow (forehead) lift are a bit more involved. Discuss the pros and cons of all these options before making a decision. Good luck. drc

Donn R. Chatham, MD
Louisville Facial Plastic Surgeon
5.0 out of 5 stars 75 reviews

Mild ptosis and excess upper eyelid skin

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As mentioned above, the eyelid changes can be very subtle and need a proper in person evaluation to tease out the nuances of your individual anatomy.

Based on these photos, however, it seems that you have a mild degree of ptosis [droopiness] in addition to excess skin. The position of your lateral canthus maybe very minimally low compared the normal, however it is a unique attribute of your eyes and changing them can be quite a major change in most patients and I would not recommend a canthopexy/canthoplasty.





A.J. Amadi, MD
Seattle Oculoplastic Surgeon
5.0 out of 5 stars 42 reviews

Upper eyelid fullness

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 I have performed Eyelid Surgery and Brow Lifts for over 20 years and IMHO, it's much more likely that your eyebrows are low than you have true upper eyelid excess skin at 23 years of age.  In person evaluation, of upper eyelid fullness in women, requires placing the eyebrows into their proper aesthetic position.  If the upper eyelid fulless disappears, the eyebrows are low and a Brow Lift is required.

 The forehead and face age by falling from the outside towards the midline and this turns almond shaped eyes into more rounded appearring.  The Brow Lift would reverse this trend.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 28 reviews

Upper Blepharoplasty

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You can get a very nice result with upper blepharoplasty that should last you many, many years.

You have a nice shape and position of you eye brows.  I would strongly say to not touch your eye brows.

E. Anthony Musarra II, MD
Atlanta Plastic Surgeon

Heavy Upper Eyes in Young Patients

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It's difficult to determine without an office evaluation, but one may consider a Botox brow lift to help reduce some of the heavy tissue. Results with Botox are subtle and treatments need repeating. Blepharoplasty, eyelid rejuvenation for older patients, is not performed in younger patients and avoided.

While droopy eyelids typically occur with natural aging, they may also occur in young patients and teenagers as well. Droopy eyelid treatment, or ptosis repair, typically involves surgery of the upper eyelid. Some patients might be candidates for eye drops. If you haven't already, then you should first be evaluated by an Ophthalmologist to help determine appropriate options for you. Best of luck.

Dr. Chaboki

Houtan Chaboki, MD
Washington DC Facial Plastic Surgeon
4.9 out of 5 stars 89 reviews

Less Will Be More

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It is impossible to give a precise recommendation based on your photos, but it would appear that if any surgery is indicated, it would probably be along the lines of just removal of a small amount of upper eyelid skin. 

From the photos, it appears that the shape of your eyes, the position of your canthus and lower lid all appear to be quite nice and should be left untouched.

It is very important that you clearly express your specific goals during your consultation with a Blepharoplasty specialist.  Many Blepharoplasty "disasters" result from overreaching surgical goals that leave an unnatural surgical appearance.

Paul C. Zwiebel, MD
Denver Plastic Surgeon
4.7 out of 5 stars 45 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.