Should I do a blepharoplasty now or later? 26 years old (Photo)

Question

Hello, I had a questions regarding the timing of a blepharoplasty. I am 26 years old and my upper eyelids are hooded (mild) and are a mild insecurity of mine. Both my mom, her sister, and grandma all had to get blepharoplastys in their late 40s-50s. My question is if I were to get a bleph in my 20s would this last a lifetime? Or if I were to do it now would I likely end up needing another one in my 50s anyway, in which case I would hold off since it is only a mild insecurity. Thank you!

Eric M. Joseph, MD · Answer

This is true when people have congenital hooding of their upper eyelid skin. It is impossible to determine your candidacy for surgery based on this singular view, however, if your upper eyelid appearance is bothering you, you should feel free to visit with a reputable facial plastic surgeon to discuss your options. Thank you for your question. Sincerely, Dr Joseph

Gary M. Horndeski, MD · Answer

The youngest patient I have done a blepharoplasty on was 32 years old.  You may be a candidate with the excess skin that you have using a blepharoplasty.

Best Wishes,

Gary Horndeski, M.D.

Mats Hagstrom, MD (license on probation) · Answer

The Scandinavian hooded eyelids can be problematic.
I think it’s very important to clearly differentiate brow position versus excess skin of the upper eyelid.
For so many people a brow lift is a better procedure than an upper eyelid blepharoplasty.
Sometimes it is a combination of both procedures that gives the very best outcome.
A brown lift needs to consider many different variables, including the hairline and forehead size.
.
My, best advice is that you’re far too young to have that surgery at this point. I think. To make a quality assessment, we need better information.
A single picture does not give quality assessment for the eyelid because it changes based on the direction of gaze, and as you contract the muscles around your eyes.
An assessment for upper eyelid blepharoplasty needs to always include considering brow position, and a brow lift.You should never think of one procedure without considering the other.
My preferred approach is usually to do a more conservative approach on the eyelid with a slightly more aggressive approach with the brow.
These can either be done together or separately.
Doing a nice brow lift at a young age would be a good option and then wait until you need the eyelids done.
A well done brow lift would hold you off a good amount of time I would think.
It’s also important to differentiate if you have true ptosis and if this is even or uneven. 
This is especially true for people of your ethnic background.
I have the same ordeal and my father had his eyelids done covered by medical insurance as well.
I personally opted for a brow lift and have not had my eyelids done even though I should’ve probably done so several decades ago.
In the end, the most important variable is almost always finding the right provider to work with.
With the right provider you’ll be guided to have the right procedure and the quality of the outcome should be ideal.
Plastic surgery outcomes are generally based on two single variables.
The first is the patient candidacy for the procedure and the second is provider selection.
There isn’t much you can do regarding your own candidacy except understand it.
As I mentioned earlier, candidacy would include having a clear understanding of how brow position affects the eyelid and the implication of having one versus both treated.
Provider selection speaks for its own.
Before even considering having surgery, I generally recommend patients have multiple provider consultations.
To find the best provider usually means having to consult with a number of plastic surgeons.
I generally do not think patience can do a very good job at picking the best provider by using Internet search tools or reading reviews, etc. etc. 
I recommend instead patients schedule multiple consultations with providers in your community.
During each Consultation, ask providers to open up their portfolio and show their collection before and after pictures of the previous patient who had similar facial characteristics.
Take quality set of facial pictures the same way plastic surgeons take before and after pictures and bring those pictures with you to each consultation to use as reference.
Listen carefully and pay close attention to the quality and quantity of before, and after pictures taken.
Most patients do not have a lot of experience consulting with plastic surgeons.
The more consultations you schedule the better you’ll be at the process and the better you’ll get at picking the right provider.
Give yourself a good amount of time for provider selection when the time is right.
I generally recommend a patient spend 6 to 12 months simply consulting with providers to pick the right surgeon.
Consult with one month for half a year and see what they have to say.
The outcome of these procedures is permanent and irreversible.
The biggest mistake I see patients make is having only one consultation and then scheduling surgery.
The second biggest mistake I see patient make is assuming that being board-certified and plastic surgery with a decade of experience and a handful of positive reviews means a surgeon has mastered most plastic surgical procedures.
The majority of plastic surgeons are only average.
Only a handful of plastic surgeons become truly exceptional.
It is the exceptional provider that you’re looking for because this kind of work is by its very nature, difficult and complex.
The implications of having permanent irreversible surgery is quite substantial.
Good luck,
Mats Hagstrom MD

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