Which procedure would target excess skin in the outer corner of the brow while also restoring almond shape? (photos)

Question

Hi, I’m 47 and I’ve noticed over the last 5-7 years that my eyes have become smaller, rounded and the outer corner - more hooded especially when I smil, making my eyes look very tired and old. I had an upper blepharoplasty, indotine brow lift and some filler in the upper eyelid 4 years ago. While I don’t regret any of those procedures, they did not address my main concern - the extra skin under the outer brow corner. Is there a procedure that can pull the temple skin sideways? Anything else?

Philip S. Schoenfeld, MD, FACS · Answer

Your upper eyelids look great and the issue you are having is decent of the lateral eyebrow.  A temporal brow lift can correct for this issue.  There are several ways to perform this technique and the key is to provide brow elevation that will be long lasting.  An experienced surgeon can guide you through the procedure.  In the meantime, a little neuromodulator such as Botox or Dysport to the lateral orbicularis muscle can really help elevate the brow temporarily.

Lexie Wang, MD · Answer

It looks to me like you still have some extra skin here. You could either do a revision brow lift and/or revision upper bleph to try to get this. Another thing to consider if you're bothered by the lines in general when smiling is botox to the muscle in this region and/or laser skin tightening.

Ruslan Zhuravsky, DO · Answer

Hello, if you had filler in the upper eyelids, this can be a possible reason. Filler for the upper eyelids can be nice to treat a ball in socket type appearance, which can be the result of over aggressive surgery but can occur naturally as well. It's something I find applicable on a very rare basis. Even Filler from 4 years can stick around and create fullness. I would first try to dissolve this area. If not, a lateral brow lift and brow fat pad pexy can address that lateral holding. When you smile, the obicularis squeezes and exacerbates the situation. Some botox can help but the muscle can also be weakened during brow lift. Hope that helps!

Jacob Tower, MD · Answer

Hello, hope you are well. Great questions and photos. I perform a temporal brow lift for exactly these reasons! The temporal brow lift (sometimes called a "lateral brow lift") is to elevate the tail of the brow, reduce lateral eyelid hooding, and reduce saggy skin near the 'crow's feet' region. I perform this under local anesthesia in the office; there is minimal downtime and the recovery is typically fast with a near-immediate result. The incisions are concealed behind the hairline. Some of patients that I see for this procedure have already tried and failed with thread lifts or botox, and I would discourage taking those directions for temporary results at best.
Best,Dr. Tower

Darryl J. Blinski, MD · Answer

Based on the nicely 2 posted photos I recommend temple lift or "Cat Eye" lift with micro dosed Botox for dynamic lower lid smile lines/wrinkling. Fees from $6,000+. Best to virtual consult with.....

Which procedure would target excess skin in the outer corner of the brow while also restoring almond shape? (photos)

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