Lower Eyelid Lift, Maybe Fat Grafting, Filers For Thinner Eyes? (photo)

Question

22 years old male here I am pretty much always squinting to some extent, rarely are my eyes like on first picture (completely relaxed) - Entire area around my eyes looks way better when I squint so over the years it became habit and I am almost never relaxed like on the first picture. I am wondering if there is any surgical procedure that would make my eyes permanently like they are on pic #2 like lifting lower eyelid and then maybe adding some fat to make it look like they are "deep set" ?

Mehryar (Ray) Taban, MD, FACS · Answer

You have inherited lower eyelid retraction with scleral show. Need to see full face photo for better assessment. Fat grafting is unlikely to help. However, lower eyelid retraction surgery with internal graft (with or without midface lift) to elevate the lower eyelids is an option. See an oculoplastic surgeon for evaluation.

Ryan Neinstein, MD, FRCSC · Answer

I dont think adding fat to your lower eyelid or fillers for that matter will give you the look you are interested in. It seems you have overdynamic muscles in your lower eyelid I would try just a little botox to calm down those muscles

Gerard Grau, MD, FACS · Answer

As a general rule we plastic surgeons do not prefer to produce scleral show beneath the limbus following lower eyelid blephs. Except in a small % of facial models where scleral show is apparent, most other people do not like the aesthetic appearance of it nor its long term functional implications.

Naveen Somia, MBBS, PhD, FRACS · Answer

Hi Dannyboy, thanks for sharing your photo.

	Your lower eyelid retracts a lot more than normal. It could be due to a condition such as inherited lower eyelid retraction with scleral show or a Droopy UPPER eyelid. Yes, upper eyelid droop can result in a lower eyelid retraction ( as a compensatory mechanism). You need to see an Eyelid Specialist who can advise you. Fat grafting is not a primary option

Lewis Ladocsi, MD, FACS · Answer

Hi dannyboy. A picture that shows more of your face, as well as a side view would be helpful. From what I can see you have a loose lower eyelid, with an overdeveloped orbicularis occuli muscle from squinting so much. I think you would benefit from an operation which will tighten the lower lid and remove some of the excess muscle. I suggest you see a plastic surgeon who can examine you and recommend the appropriate treatment.

Devinder S. Mangat, MD, FACS (retired) · Answer

You have a normal variant in your lower eyelids where you have a very small amount of scleral show ( white of the eye showing below the iris). When you squint you are contracting the orbicularis muscle and it shows as a slightly prominent ridge below the lid margin. This is normal and should not be corrected. If the prominence of the muscle is severe, the muscle can actually be trimmed surgically. I would not recommend any surgery for correcting scleral show or the slight prominence of the Orbicularis muscle when you squint. You could end up with worse problems.

Lower Eyelid Lift, Maybe Fat Grafting, Filers For Thinner Eyes? (photo)

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