1 year post upper eyelid surgery - was enough skin removed? (photo)

You are very perceptive. I agree with you that you have a residual problem. What looks like crepey excess skin in your photo is more likely volume loss. By adding volume to the sub-brow region, you will have a more youthful upper eyelid eyebrow complex. At present, you look hollow.

Removing the proper amount of skin during the Upper Blepharoplasty surgery is one of the major components to a successful result. I take great care to remove the correct amount and sometimes asymmetric excisions are needed depending on the patient's anatomy. Although it does seem that you may benefit from additional skin resection, it is very important to make sure that your brows are in the correct position. Low brows can cause the appearance of excess eyelid skin. You should discuss your care with a Board Certified Plastic Surgeon who will be able to provide more information. If you are ever in Arizona I would be happy to see you. Thank you for your question!

HelloMy opinion you also need adding some volume to your upper eyelids as they looks sunken. Pinch skin excision can be added if there is enough skin.

For unique cases where a variety of modalities could be used to treat the condition, I would suggest an in-person or virtual consultation to develop a custom and effective treatment plan. It is difficult to precisely define the best option without collecting the same information. I suggest reaching out to an expert for a consultation with surgical and non-surgical methods to get a comprehensive option. Best, Dr. Emer.

Thank you for sharing your photo and questions. To get further improvement you would require an endoscopic forehead lift and (possibly/likely) addition skin removal from the upper eyelids. While the brow lift would be subtle, it is unlikely you'd get satisfactory results from upper blepharoplasty alone. Your primary surgeon was exercising good judgement in not offering additional surgery and being conservative.

Good morning, hope you are well. In upper blepharoplasty surgery there is little margin for error; there is a fine line between removing 'enough' skin, and too much. The concern is if too much skin is taken, it can be very problematic and detrimental to eyelid function causing chronic symptoms. Moreover, there are standard measurements that many surgeons use to guide the excision so as not to remove too much skin. Having said that, there can be some variation in opinion on where that threshold lies. So presumably your surgeon performed a safe upper blepharoplasty, and achieved an improvement. There may still be room for a conservative revision, but I also notice the superior skin creases appear to be caused by mild brow ptosis. A brow lift may be a more appropriate and safer means to address the 'heaviness' that you perceive in your eyes.
Best,Dr. Tower

Thanks for sharing this question. The concern about residual loose skin ladder upper blepharoplasty is a very common one. Unsurprisingly, you are getting different answers from different surgeons as there are many ways to approach this issue. My experience has taught me that one of the main reasons for loose upper eyelid skin is not just “excess skin” but rather age and hereditary related deflation of the bone and soft tissue around the eyes and brow. I have found that the most natural and satisfying results for patients come when the loose upper eyelid skin issue is addressed with more tools than just skin excision. Brow rejuvenation with a lift or volumizing with fat or soft tissue fillers combined with skin excision can provide the best results overall.

This is a tough question to answer based on your photo and without an examination. However, it's much better to take "too little" skin than "too much", and I always prefer caution in this regard. Additional observations: you appear to have rather deep set eyes and a well performed endoscopic brow-lift may be a more suitable procedure.

It's not uncommon for different surgeons to have different opinions, especially when it comes to cosmetic procedures. Factors like the surgeon's training and experience, the specific techniques used, and individual variations in anatomy and healing can all play a role in the outcome of a procedure. In this case, it is always worthwhile seeking for a third opinion.

It's also possible that the two surgeons have different aesthetic preferences or approaches to the procedure, which could influence their opinions.

In my personal experience, a revision is possible and could improve your eyelids.

Of course, an “in person” exam is necessary.

I hope this helps,
best of luck !

I would go with the opinion of your oculofacial plastic surgeon. Most plastic surgeons work on the entire body, from head to toe. On the other hand, oculofacial plastic surgeons sub-specialize in complex eyelid and facial plastic surgeries. It looks like you have excess skin that your oculoplastic surgeon can help you with.