Drooping eyelids, should I opt for a brow lift, fillers, canthopexy or canthoplasty? Advice? (photos)

Question

Recently I have noticed that my top and bottom eyelids have started to droop. I appear to have a lot of fat near my brow and upper eyelids that has pushed the outer corners of my eyes down. This is especially apparent when I close my eyes. My questions are should i opt for a browlift, fillers to raise my cheeks and straighten my lower bowed out eyelids, canthopexy or canthoplasty, or upper bleph. Why does my negative canthal tilt get so much worse when I close my eyes?

Mehryar (Ray) Taban, MD, FACS · Answer

Negative canthal tilt may not get resolved with canthoplasty alone; it may need what I can call almond eye surgery. See following link. Best to get personal consultation for proper eye evaluation and discussing various treatment options you mention.

Johnson C. Lee, MD · Answer

Thank you for your photos. It is difficult to determine what procedures are necessary to modify your eye and brow positions by photos alone. Unlike other parts of your body (eg: breasts), your eyes and brows are dynamic and are constantly changing shape with movement. Therefore, it is best to have an in-office examination to evaluate your anatomy, function, vision, and quality of the structures around the eye to determine the safest and most effective treatment plan to achieve your goals. Options may include a brow lift, upper blepharoplasty, and lower eyelid tightening repositioning/tightening procedure, but this cannot be determined by your photographs alone. Hope this helps!Johnson C. Lee, MD Plastic Surgery@drjohnsonlee

Sara A. Kaltreider, MD (retired) · Answer

Based on your photographs, I would recommend starting with a small lateral brow lift. You appear young, so I would say less is better for now. Your lower lid contour looks great from the first photo and the sides - don't think a canthoplasty or pexy would be indicated. Blepharoplasty would bring the brows even closer to your lid crease - inadvisable in my opinion. You may want to proceed with an in-person evaluation with an Oculoplastic surgeon in LA. Get a good examination and learn your options prior to making a decision. Best wishes.

Ronald V. DeMars, MD (Retired) · Answer

With no knowledge of your age and without seeing the full face we cannot help you with any decisions. Male eyebrows look best when flatter as opposed to the arch we prefer in female brows. An arched male brow looks peculiar and feminized. See an experienced surgeon for a consultation and answers to your questions.

Drooping eyelids, should I opt for a brow lift, fillers, canthopexy or canthoplasty? Advice? (photos)

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