Upper bleph, laser or filler for upper eyelid crepiness? (Photo)

Question

I had Botox to my forehead and my brows dropped a bit, which is making the creepy skin on my upper eyelid worse. The pictures are taken only one month apart. I am 35. Would upper bleph or Laser or fillers best address the issue?

Brent Moelleken, MD · Answer

First, you should let the errant Botox expire, then judge what, if any, procedures would benefit your eyes.  You can't judge your brow or upper eyelid position accurately when Botox is present.  You should allow a full three months after the injection, not sooner, or the Botox will still be partially working.

Brian K. Machida, MD, FACS · Answer

Although other alternative mentioned have value, you might consider a fractional laser treatment to the upper eyelids to help with the appearance of the skin.  It would be longer lasting than botox and not as aggressive as a different surgery.

Mehryar (Ray) Taban, MD, FACS · Answer

Likely a combination of skin removal (upper blepharoplasty) and volume addition (via filler injection) would be ideal. Consultation and photos looking straight ahead are needed.

Kenneth D. Steinsapir, MD · Answer

Sometimes it is worth paying for a detailed consultation to get unbiased information about your best options.  The photographs you have posted with your eyes closed are not particularly helpful.  Many folks are shoving fillers where ever they can.  It is absurd to say that filler should not be used around the eyes.  However, in studying your photos including in your other posts, here are my thoughts.  First, don't double down on bad treatment.  Get a better botox service.  Look into my patented Microdroplet Lift® cosmetic brow lift as an alternative to botox services that freeze and drop the eyebrow.  You current botox treatment should resolve enough in 4 to 6 weeks to make it appropriate to superimpose a correcting botox service. In you other photos, you have a compensatory eyebrow elevation, upper eyelid ptosis, and eyelash ptosis. I think you would benefit from a detailed assessment to determine your best options for addressing the problems with the upper eyelid.  I do not think upper eyelid fillers are the answer.  Don't double down on bad treatment.

Johnson C. Lee, MD · Answer

Botox can sometimes "reveal" when someone has too much extra skin by allowing the forehead to relax. The excess crepey skin can be removed with a simple office-based procedure which can dramatically accentuate your eyes for a brighter and more youthful look. Johnson C. Lee, MD 
Board-Certified Plastic Surgeon
@drjohnsonlee

Curtis Wong, MD · Answer

and when you paralyze your forehead muscles, your brows will drop and contribute to excess skin in your upper lids.  So are you going to continue with Botox to your forehead?  If so, laser will tighten the upper lid skin for some time but you will need repeated sessions if you continue with paralyzing your forehead.  Do you really like the expressionless look of Botox to your forehead?  There are other ways to smooth the skin without loss of animation.

Jeffrey Jumaily, MD · Answer

Lasers and fillers will not help you much. The issue is that you have a little bit of redundant skin over the upper lid. In this photo, you are looking down so I would love to see photos of you looking straight from different angles etc. You are on the younger side for an upper blepharoplasty but we sometimes do it on young women who are bothered by this issue. It has be done really well and very conservative. We are happy to see you for a consultation to give you more information if you wish. Best wishes

Tim Sayed, MD, MBA, FACS · Answer

In my opinion, blepharoplasty is the most important part of a treatment plan for your upper lids, assuming extra hooding is still apparent once the Botox wears off. Botox can lead to heaviness of the BROWS, which means the forehead tissues can settle down and rest on the upper lids leading to more heaviness or bunching of the skin in some patients. Any truly excess skin can be removed in a blepharoplasty but the surgeon would want the brow to be at its natural unaffected position.Lasers do not add much to upper lid surgery in my opinion.Fat grafting is the best approach to filling the upper lid to achieve a more youthful look. I avoid synthetic fillers in this area.

William Portuese, MD · Answer

The photographs presented are not adequate enough to make a surgical determination about a blepharoplasty procedure.  The primary goal for upper eyelid surgery is to remove excess skin creating the hooded look.  Patients must still have enough skin after the procedure to be able close  their eyelids. In our practice, we do not recommend fillers placed around the eyelids

Frederic H. Corbin, MD (license restricted) · Answer

Thank you for the question and I would go on some complimentary consultations with experts and be evaluated in person and compare recommendations and become fully informed what might be the best procedure for you Dr Corbin

Upper bleph, laser or filler for upper eyelid crepiness? (Photo)

Answers (11)