Am I really not a candidate for lower blepharoplasty? (photo)

Question

I photos to an oculoplastic surgeon as an evaluation form before a consultation, and I just got a message back that the doctor does not consider me a candidate for lower blepharoplasty. Based on my pictures does that seem right? It feels hard for me to believe because I feel like my under eyes are some of the worst I’ve ever seen for my age. I know there are probably other factors but I’m just so upset, I was so excited to have a solution to the main thing that’s bothered me my whole life

Chet Mays, MD · Answer

Thank you for your inquiry! By your photos, it looks like you would be a great candidate for a lower bleph procedure as that procedure will remove fullness and excess skin to your lower eyelids. I recommend scheduling a consult appointment with a board certified plastic surgeon like myself so we can assess your eyes, listen to your goals, and create a surgical plan that is best for you and your goals!

Tanveer Janjua, MD · Answer

You have fat bulges in lower eyelids. These can be removed surgically to give you a smooth lower lid. Get an in person second opinion.
Regards
Dr. Janjua

Young Min Im, MD, PHD · Answer

Currently, there is a noticeable tear trough under your eyes, with protruding fat above it. This unevenness creates a shadow effect, which makes the dark circles appear more prominent and gives the under-eye area a tired and aged appearance.
In the photos, there does not appear to be significant skin sagging or deep wrinkles under the eyes.In such cases, surgery can be performed through the conjunctiva (the inner side of the lower eyelid) without any external incision. During the procedure, the tear trough is released, and the protruding fat is repositioned and spread evenly to smooth out the contour.
Since there is no visible skin laxity, a traditional lower blepharoplasty is not necessary. Instead, conjunctival under-eye fat repositioning is recommended for a smoother and brighter under-eye appearance.

Gary M. Horndeski, MD · Answer

In your frontal view, you can see that below your iris there is white sclera showing that is abnormal. A lower blepharoplasty can make it worse and that is why the surgeon said you were not a candidate for lower blepharoplasty.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Michael P. Morrissette, DDS, FACS · Answer

Based on your limited photos, it does appear that you are a candidate for a lower blepharoplasty. In younger patients, it is more of a congenital problem and less of an aging problem.  In patients with a pronounced ligament and tear-trough, I recommend fat transfer and release of the ligament rather than fat removal and fat grafting.  Be sure to discuss fat transfer with your surgeon.

Tanya T. Khan, MD · Answer

Hello, you do seem like a good surgical candidate. You would not do well with fillers or nonsurgical treatment because the extent of fat prolapse visible in your lower eyelids would do best with surgery, not with another form of minimally invasive treatment. Would seek the counsel of an experienced oculoplastic surgeon for best results.

Kenneth D. Steinsapir, MD · Answer

Your lower eyelid fullness appears to be precisely what the transconjunctival arcus marginalis surgery was developed for. The lower eyelid fat making the fullness is slide into a little pocket made at the top of the cheek. This improves the lower eyelid contour and the hollow under the eye. A detailed examination is needed to precisely confirm your anatomy. More than one thing can cause lower eyelid fullness.

Joshua A. Halpern, MD, PA · Answer

You're a candidate for a lower eyelid surgery. This operation removes excess lower eyelid fat and skin. The recovery is fairly quick. You would also appear to benefit from and endoscopic cheek lift, which I helped to pioneer. This helps to rejuvenate your eyes and cheeks. If you are interested in either watching some intra operative videos, please send me your email address.

Am I really not a candidate for lower blepharoplasty? (photo)

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