Would I benefit from eye bag surgery and can an eyebrow lift be performed on one side only? (photo)

Question

Hello. I feel like over time, my eye bags have gotten more pronounced. It really bothers me. Also, would you recommend an eyebrow lift only on my left side? I feel like my left eyelid is heavier. I had a small eyebrow lift done on both eyes 5 years ago.

Selcuk Inanli, MD · Answer

Hello! Thank you for your question.As far as I can see from your photos you have extra skin both under and above your eyes. Your eye area is upward and your eyes are slant enough so I do not recommend a revision endoscopic brow lift. However, I can suggest you upper and lower eyelid blepharoplasty for more fresh and rounded eyes look. If you can provide photos with better lighting, from the side of your face and 1 meter away I would be able to make a proper evaluation.Best Regards!

Jason Emer, MD · Answer

The eye area needs significant combinations to get improvement. Lasers like erbium, co2, halo, profractional/contour, or Fraxel can all be used to build collagen long term. Plasma pen is a newer less invasive option but will take many treatments and require proper skincare. Plasma Pen is focused electrical plasma energy to tighten skin, producing small columns of energy just above the skin, allowing the skin to tighten to help improve wrinkles. This area will have 3-5 days of small “dots” that will then scab and peel, then the skin will tighter and brighter after. Numerous treatments are needed over lasers where only one or two give a bigger result, but more downtime. After plasma pen you NEED peels 2 weeks like later Cosmelan, enlighten or aerify, see emeragecosmetics (link). At home derma rolling should be started weekly even after plasma pen or lasers to further increase collagen, see emeragecosmetics AERIFY x anteagemd stem cell ampules. To properly heal you need light Stim red LED, EmerageSkin refit face, refit eye; AnteageMD serum, silagen silicone gel, jan Marini bioshield, EmerageSkin enzymatic polish, and EmerageSkin hyla b and AOX, and Sente dermal repair. Otherwise there is EXTREME risk of pigmentation issues and “dots” in the treatment area. at home peels like cosmelan, enlighten and aerify along with dermarolling (AERIFY emerageskin roller with Anteage MD ampules) should be started now regardless for antiaging, sun damage, and wrinkle prevention. There are many things you can do to treat under eye hollows and dark circles. A surgical option to remove skin and/or fat will such as eyelid blepharoplasty with or without fat pad repositioning (if doing lower eyelid surgery) will be the best long term. There are many things you can do to treat under eye hollows and dark circles without surgery. Non invasive less downtime options such as fillers, lasers, microneedling/PRP, cosmelan peels, and microneedling RF like Fractora, PiXel8 or morpheus can all help give some improvement. Accutite can often be used or stronger lasers like erbium or co2 spot treatment can tighten the skin and give very quick improvement in wrinkles and texture. I suggest you get a formal consultation to see what is best for you and your goals. Best, Dr. Emer.

Zoran Potparic, MD · Answer

Based on this photo, it does not look like you need additional brow lift;  a small asymmetry can be treated with Botox. I am not sure that upper blepharoplasty would change much? A lower eyelid bulge is either due to mucle hypertrophy or fat. A small amount of Botox can be injected into the muscle and it may significantly reduce the bulk; if bulk does not go away, one could consider a fat  to be a reason and discuss fat removal through an incision placed inside the eyelid. Hope this helps.

James R. Gordon, MD, FACS, FAAO · Answer

Thank you for sharing your question and posting your photo. It looks reasonable to have lower eyelid blepharoplasty, but the asymmetry of your brows is not significant enough for surgery. Make an appointment with an experienced oculoplastic surgeon for comprehensive examination and discussion of treatment options. 
Good luck,

Nelson Lee Novick, MD · Answer

At least from the photo provided, there appear to be what have come to be called "jelly rolls" under the eyes or muscular hypertrophy of the under-eye muscles. If so, then a couple of microdroplets of Botox properly injected in the belly of the muscle can help to shrink it.  As to your eyelid, I can only echo the old adage, "The greatest enemy of success is the pursuit of perfection."   The "heavier eyelid" does not show up in the photo, and I would be concerned that any surgery done in the pursuit of perfection might result in flat out dissatisfaction. Make sure to consult with an expereienced, board certified dermatologist. Best of luck.

John Paul Tutela, MD · Answer

Thanks so much for reaching out. I think you would be a great candidate for lower leg fat removal. It would yield a lasting effect. Alternatively, tear trough filler may give you your desired result without undergoing surgery. Be sure to consult with a board-certified plastic surgeon for best results.

Johnson C. Lee, MD · Answer

Thank you for your photo. The areas under your eyes when you smile are not eye bags but actually your large eyelid muscle contracting. This is more prominent in some patients and some ethnicities such as in asians. In fact, it can be considered attractive in Asia and there is a procedure that actually places an implant in the lower eyelid to recreate that bump. If you wish to make the muscles slightly smaller, a small amount of botox can thin the muscle over time. Eyebrow lifting is best done on both sides to allow for better symmetry. Botox can also be done to the eyelids for small adjustments without needing full surgery to correct. Hope this helps!

Johnson C. Lee, MD
Double Board-Certified Plastic Surgeon

Johnson C. Lee, MD
Double Board-Certified Plastic Surgeon

Would I benefit from eye bag surgery and can an eyebrow lift be performed on one side only? (photo)

Answers (7)

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