Would I be a good candidate for an upper blepharoplasty? Or would I benefit from a different treatment like Botox? (Photo)

I am only 25 but I feel like my eyes make me look much older. I have different amounts of excess skin on each of my upper lids and it makes my eyes look uneven. I want to open up my eyes for a refreshed look without looking fake or unnatural. Would I be a good candidate for an upper blepharoplasty?

Doctor Answers 17

At 25, good candidate for an upper blepharoplasty? Or would I benefit from a different treatment like Botox?

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 Hi, I have performed many Brow Lifts and Eyelid Surgeries over the past 30 years.  From the photos, your eyebrows appear to be low which is what is causing the upper eyelid fullness.  Upper eyelid excess skin would not be expected in a 25 year old.  In your particular case you might try Botox to raise the eyebrow but this will not eliminate all the upper lid fullness.  I have performed Brow Lifts on 27 year old women with very low brows and this might be an option for you in the future.

  As a matter of reterence for women in their mid thirties or older, the following explains how it can be determined whether an upper eyelid surgery, Brow Lift or a combination of both are required.  During your consultation, the surgeons should stand behind you as you look into a mirror and elevate your eyebrows into their proper aesthetic position as outlined in my book on face and body beauty.  When this is done there are three possible outcomes that decide what should be considered, Brow Lift, Eyelid Surgery, or a combination of both.

  1. All the excess upper eyelid fullness is gone when the brows are elevated to their proper aesthetic position. This means all the laxity is due to the low eyebrows and a Brow Lift is recommended alone. Should upper eyelid skin be removed in this scenario, the eyebrows will be pulled down further as the incision is closed, which should be avoided.  In women younger than 30 this would be the expected outcome.  This would apply in your particular case.
  2. None of the upper eyelid fullness is reduced.   This means that the eyebrows are in the proper aesthetic position and all the fullness is due to excess upper eyelid skin and an Upper eyelid surgery alone is recommended.
  3. The most common in women over 50 years of age is when the brows are lifted, some but not all of the upper eyelid fullness is removed.  This means the eyebrows are low and there is excess upper eyelid skin.  For complete upper eyelid rejuvenation both a Brow Lift and upper eyelid surgery is required.  If only a Brow Lift is performed some but not all of the upper eyelid fullness is reduced.  If an upper eyelid surgery alone is considered, only the remaining amount of excess upper eyelid fullness shown with this maneuver can be removed. If more is removed, the eyebrows will be pulled downward.  Hope this helps.

Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 28 reviews

Would I be a good candidate for an upper blepharoplasty?

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For best results I highly recommend removing both excess skin and fatty tissue.

Blepharoplasty is a primarily cosmetic surgical procedure that reduces bagginess from lower eyelids and raises drooping upper eyelids. The procedure involves the removal of excess skin, muscle and underlying fatty tissue.
As key elements in facial expression, the eyes convey messages of emotion, vitality, and age. Over time, the eyes undergo changes that often make people feel as if they appear sad or tired. The aging process can cause the eyelids to sag and droop, which in combination with bags and puffiness can make you look tired and older than you really are.

Eyelid surgery can help freshen and revitalize your face by reducing the appearance of heavy and sagging eyelids, puffiness, and bags under the eyes. While there are several different techniques that a physician can use to alter the appearance of the eyes, the standard surgical technique usually involves removing or redistributing fat deposits, as well as removing excess skin and muscle from regions of the upper and lower eyelids.

Procedure may last approximately one to two hours, depending on the extent of treatment. Although you will feel well enough to return to work in approximately a week, you should continue to avoid strenuous activity such as heavy lifting or exercise for at least two weeks following the procedure. Eyelid surgery can successfully restore a youthful, revitalized appearance to your eyes for years to come.

Michael J. Rodriguez, MD, FAACS
Plantation Facial Plastic Surgeon
4.8 out of 5 stars 86 reviews

Would I be a good candidate for an upper blepharoplasty? Or would I benefit from a different treatment like Botox?

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Based on your photo but without an examination, you appear to be an excellent candidate to cosmetically improve the appearance of your eyelids with an artistically performed conservative upper lid blepharoplasty. Botox may be a reasonable temporary alternative, but will not produce the same cosmetic result.

Following the advice of anyone who would presume to tell you what to do based on a limited 2 dimensional photo without taking a full medical history, examining you, feeling and assessing your tissue tone, discussing your desired outcome and fully informing you about the pros and cons of each option would not be in your best interest. Find a plastic surgeon that you are comfortable with and one that you trust and listen to his or her advice. The surgeon should be certified by the American Board of Plastic Surgery and ideally a member of the American Society for Aesthetic Plastic Surgery (ASAPS). You should discuss your concerns with that surgeon in person.

Robert Singer, MD FACS

La Jolla, California

Robert Singer, MD
La Jolla Plastic Surgeon
4.6 out of 5 stars 22 reviews

Eye surgery or Botox, Its how you inject that counts!

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Carlos Wolf, MD
Miami Facial Plastic Surgeon
4.9 out of 5 stars 70 reviews

Upper Lid Blepharoplasty

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Dear Rina1022, You have a common complaint we see in some young patients. They feel like they "look tired" or "sad" and have begun seeing aging in the upper third of the face and eyes. Often times in young ladies like yourself this is partially related to genetics and is addressed very well with an upper lid blepharoplasy. This is a very rewarding procedure and when performed naturally and by a skilled physician you should have a very nice result. Best regards, Michael V. Elam, M.D.

Michael Elam, MD
Orange County Facial Plastic Surgeon
5.0 out of 5 stars 218 reviews

Upper blepharoplasty candidate for asymmetric eyelids

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  The photographs demonstrate asymmetric eyelids, for which a conservative skin only upper blepharoplasty can improve. Differential amounts of skin would be removed to make them more symmetrical and balanced, but not perfect. A skin only upper blepharoplasty can be performed under local anesthesia as an outpatient surgical procedure.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 158 reviews


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A blepharoplasty removes excess skin folds from the upper and lower lids and trims the bulging fat.  25 year old is young for this; however, often extra lid skin is found in family lineage. Your lower lids show a bit of excess fat bulge and the position of the lower lids may be elevated a bit.  One does not want to have the lids over operated upon.  Scars should be well hidden and the end results for any eyelid surgery must be natural in appearance. Botox is great for wrinkles or to re-position the eyebrows; neither of which you require.


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You do seem to have excess skin that covers your pretarsal skin laterally.  A crescentic excision of skin can correct this.  It can be performed under local in the office. 

Am I a candidate for upper eyelid blepharoplasty?

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You have a heavy brow, yet the position of the lateral brow allows for good aesthetic brow contour. Considering the amount of excess skin that is "hooding" the lateral (outer) part of your eye, you might be a good candidate for an upper eyelid blepharoplasty. See a board certified plastic surgeon for an in person consultation.

Jeremy B. White, MD
Miami Plastic Surgeon

Eyelid Surgery

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Even though you are young, there appears to be some excess skin in both of your upper eyelids. The amount of asymmetry may not only depend on asymmetric skin excess but the position of your eyelid margin (edge of the eyelid on the iris). Its difficult to assess this based on your photos. I recommend seeking the advice of a qualified surgeon who can perform photographic analysis and a good examination.
J. Phillip Garcia, M.D.

J. Phillip Garcia, MD, FACS
Jacksonville Facial Plastic Surgeon
4.8 out of 5 stars 45 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.