It is possible to lower my eyelid crease?

Question

My eyes often look sunken in because my eyelid crease is higher up, as well as making my eyes look bigger than I would like. Is it possible to have your eyelid crease lowered?

Kenneth D. Steinsapir, MD · Answer

Fillers are helpful to suggest a more full sub brow area and this can help hide the crease.  Generally it is unrealistic to expect a satisfactory result by grafting fat into the upper eyelid.  That is because the fat will cause scaring and be unsatisfactory.  The best resuls occur when there is coexistent upper eyelid ptosis.  Correcting the ptosis creates an opportunity to raise the upper eyelid crease.  In some cases it can also bring orbital fat forward which improve the hollow upper eyelid sulcus.  I recommend a certain level of skepticism of promises.  I would ask to see before and after photos showing examples of what the surgeon is proposing.

David A. Schlessinger, MD · Answer

It is very difficult to assess the problem you are describing without a photograph or an examination. Elevated eyelid creases can be caused by eyelid ptosis (drooping) or hollowness. These problems can be corrected either surgically or with fat grafting or dermal fillers. It would be a good idea to have this evaluated by an experienced Oculoplastic Surgeon.

Bryan Mendelson, MD, FRACS, FACS (retired) · Answer

It is aesthetically desirable and
usually possible to ‘lower’ the eyelid crease. Without further information this
answer is rather general because there are several possible reasons for a
‘high’ lid crease.

Some people are born with a higher
than usual eyelid crease, described as such because the lid fold which is
formed from the lower part of the infrabrow skin above the crease is not
sufficient to hang low enough on the lid to conceal the crease.

An integral part of the aging process
is resorption of some of the original fat here. So, people who had deep-set
eyes when young develop deeper set eyes that can eventually give a gaunt look.
Replacing the missing volume with a small amount of fat injection or filler is
most effective.

The commonest acquired cause seen in my
experience is people who previously had standard upper lid surgery that has
been overdone. As a result the lid fold has been over- reduced. This can
usually be improved with secondary upper lid surgery combining the tarsal
fixation technique to conserve skin, and often adding volume in the form of a
small amount of fat.

In older people, weakness can develop
in the attachment to the lid of the levator muscle that lifts the lid. You can
see this as the edge of the lid sits lower on the eyeball from dropping of the
lower part of the lid. This part of the lid becomes too visible, while the
crease itself is pulled higher by the lifting muscle. This is called lid ptosis
and is correctable

It is possible to lower my eyelid crease?

Answers (3)

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