My upper eyelid has become very hollow making me look older than 35. Besides filler is there any non surgical way to minimise the look? Would Botox work and where would the Botox point be?
Answer: Aesthetic Improvements Through Volume and Proportion This is a great question because it brings up a lot of very important points in regards to dealing with facial aesthetics. The first is that any physician treating an aesthetic concern in the face must be intimately familiar with the anatomy. This is especially true in the periorbital region- the area around the eyes, including the eyelids. The upper and lower eyelid anatomy is such that there are multiple important structures in a relatively small amount of space, and understanding anatomic abnormalities is key to figuring out why a patient looks a certain way or has a specific complaint. In your case, the hollowness you notice is likely due to a shortage of upper lid fat. This is oftentimes seen in older patients- where fat atrophies over time- or in patients who have had a previous upper lid lift whereby too much fat was removed. You are quite young to have significant fat atrophy through aging alone- so genetics may play a role as well. The lack of fat volume and proportion in your upper lid is likely what is causing your concerns. The next important point is that any time a patient has complaints around the eyelids- especially the upper eyelids- it is important for their doctor to be confident in performing an eye exam and diagnosing certain medical conditions that may be causing those complaints. For instance, a condition called ptosis- where the upper lid appears to droop over the pupil- can be due to a weakened muscle in the upper lid, or could indicate more serious problems. (Or, the problem may not be the lids but rather the eyebrows and forehead sagging too much!) Ptosis can cause the upper lid hollowing because of a weakening or detachment of one of the muscles used to lift the upper lid. In that case, simply treating the hollowness is avoiding treating the real cause. Again, it is vital that your doctor be comfortable in diagnosing conditions around the eye. The final point is that a fundamental principle in plastic surgery is to replace like with like. Therefore, if the problem is hollowness- a lack of volume- then the treatment should be to replace that volume. There are many treatment options to consider which may help, starting from the most non-invasive (filler), to replacement with a more permanent solution such as fat, or what I would consider the gold standard- an upper lid lift with fat transfer. Though the last two options are considered "surgery" a well trained surgeon should be able to easily perform these procedures in the office under local anesthesia. Botox, which aims to reduce wrinkles through overactive muscle use, would not be an effective treatment in a patient who presented with complaints similar to yours. A plastic surgeon who is licensed in your state would be able to provide you personalized treatment and medical advice!
Helpful 1 person found this helpful
Answer: Aesthetic Improvements Through Volume and Proportion This is a great question because it brings up a lot of very important points in regards to dealing with facial aesthetics. The first is that any physician treating an aesthetic concern in the face must be intimately familiar with the anatomy. This is especially true in the periorbital region- the area around the eyes, including the eyelids. The upper and lower eyelid anatomy is such that there are multiple important structures in a relatively small amount of space, and understanding anatomic abnormalities is key to figuring out why a patient looks a certain way or has a specific complaint. In your case, the hollowness you notice is likely due to a shortage of upper lid fat. This is oftentimes seen in older patients- where fat atrophies over time- or in patients who have had a previous upper lid lift whereby too much fat was removed. You are quite young to have significant fat atrophy through aging alone- so genetics may play a role as well. The lack of fat volume and proportion in your upper lid is likely what is causing your concerns. The next important point is that any time a patient has complaints around the eyelids- especially the upper eyelids- it is important for their doctor to be confident in performing an eye exam and diagnosing certain medical conditions that may be causing those complaints. For instance, a condition called ptosis- where the upper lid appears to droop over the pupil- can be due to a weakened muscle in the upper lid, or could indicate more serious problems. (Or, the problem may not be the lids but rather the eyebrows and forehead sagging too much!) Ptosis can cause the upper lid hollowing because of a weakening or detachment of one of the muscles used to lift the upper lid. In that case, simply treating the hollowness is avoiding treating the real cause. Again, it is vital that your doctor be comfortable in diagnosing conditions around the eye. The final point is that a fundamental principle in plastic surgery is to replace like with like. Therefore, if the problem is hollowness- a lack of volume- then the treatment should be to replace that volume. There are many treatment options to consider which may help, starting from the most non-invasive (filler), to replacement with a more permanent solution such as fat, or what I would consider the gold standard- an upper lid lift with fat transfer. Though the last two options are considered "surgery" a well trained surgeon should be able to easily perform these procedures in the office under local anesthesia. Botox, which aims to reduce wrinkles through overactive muscle use, would not be an effective treatment in a patient who presented with complaints similar to yours. A plastic surgeon who is licensed in your state would be able to provide you personalized treatment and medical advice!
Helpful 1 person found this helpful
Answer: Filler for eye hallowness The consensus is weighted towards fillers delivered by catheter to the orbital rim to create or restore volume. This will camouflage the visible bone or "A" deformity. I would recommend the type filler with less water traits such as Restylane silk or Boletero. Please consult with someone with experience in this higher risk area. Good Luck Smythe Rich, MD Facial Plastic Surgeon
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Answer: Filler for eye hallowness The consensus is weighted towards fillers delivered by catheter to the orbital rim to create or restore volume. This will camouflage the visible bone or "A" deformity. I would recommend the type filler with less water traits such as Restylane silk or Boletero. Please consult with someone with experience in this higher risk area. Good Luck Smythe Rich, MD Facial Plastic Surgeon
Helpful
June 10, 2017
Answer: Correcting hollow upper eyelids I would certainly consider fillers such as restylane or juvederm for that area. The advantage of that treatment is that if you do not like the results, it can easily be dissolved with the use of hyaluronidase. Botox will not help the hollowness and there are no great surgical options at this time.
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June 10, 2017
Answer: Correcting hollow upper eyelids I would certainly consider fillers such as restylane or juvederm for that area. The advantage of that treatment is that if you do not like the results, it can easily be dissolved with the use of hyaluronidase. Botox will not help the hollowness and there are no great surgical options at this time.
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June 7, 2017
Answer: Hollow sunken upper eyelids, benefit from filler injection Yes, filler injection can be done to improve the upper eyelid hollowness you have. See following website link and corresponding gallery for multiple examples, including Asian eyelids. Also see following video.
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June 7, 2017
Answer: Hollow sunken upper eyelids, benefit from filler injection Yes, filler injection can be done to improve the upper eyelid hollowness you have. See following website link and corresponding gallery for multiple examples, including Asian eyelids. Also see following video.
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June 7, 2017
Answer: Improving Upper Eye Hollowing -- Fillers (Belotero, Volbella, Restylane Silk), Fraxel, Microneedling/PRP A combination approach would give the most improvement. Fillers, lasers, and microneedling/PRP can improve this area. I recommend injections with cannulas to limit complications. See an expert for a formal evaluation. Best, Dr. Emer
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June 7, 2017
Answer: Improving Upper Eye Hollowing -- Fillers (Belotero, Volbella, Restylane Silk), Fraxel, Microneedling/PRP A combination approach would give the most improvement. Fillers, lasers, and microneedling/PRP can improve this area. I recommend injections with cannulas to limit complications. See an expert for a formal evaluation. Best, Dr. Emer
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