Multiple Eyelid Creases

I have a lot of eyelid creases/folds. How do I correct this? My eyes protrude and are quite large. To add, while it is not apparent in this picture (due to the angle and the lighting), my facial bone structure causes my eyes to appear sunken in, and I am prone to shadows near the upper nose-eye region. For now, I'd like to tackle the multiple eyelid creases--the extra meat I have above my eyes causes my large eyes to appear even heavier and more unattractive.

Doctor Answers 10

Multiple lid creases

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Dear Interested, You seem to have prominent eyes relative to the surrounding edges of the eye socket bones.  This is more common in persons of color (African American, Hispanic, etc) or people with a thyroid condition.  In any case, surgery around the eyes is fraught with much more complications in patients with prominent eyes.  I would be very careful in choosing a surgeon to help you.  Certainly with the amount of white showing on the bottom of your eyes, you would be at very high risk of not being able to close your eyes if someone raised your lids.  Even removing slightly too much skin, or gonig too deep into the upper lid to get rid of the extra folds may cause you these problems.  Be careful, and see an eyelid specialist. 

Yoash Enzer, MD

Providence Oculoplastic Surgeon

Treatment of Excess Upper Eyelid Skin

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You have a lot going on. Simply put, your eyes are prominent causing the lower eyelid to be lower than normal, and your upper eyelid is too low and with too much skin causing extra creases. First, you need an evaluation to see if your facial bone structure is the cause or you eye prominence or if it is caused by something else, such as hyperthyroid disease. Once this is determined, you can discuss what you wish to do. When you do remove the extra skin in the upper lids, you should, probably, also have the ptosis (upper lid droop) fixed also. Make sure you see a Plastic Surgeon who has extensive experience around the eye.

Robert T. Buchanan, MD
Highlands Plastic Surgeon

You have multiple crease and upper eyelid ptosis.

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Dear Interested

Because you have very prominent eyes and inferior scleral show, whatever is done, must be very conservative.  This discussion is not medical care and is not a substitute for an actual consultation.  It appears that you have excessive skin in the upper eyelid platform.  You would benefit from an anchor blepharoplasty were a small amount of skin is removed on the upper eyelid platform.  The levator aponeurosis needs to be exposed and tightened and the eyelid platform skin and muscle needs to be placed on gentle traction to this structure.  This can and should be done conservatively.  Examples of this type of surgery can be found on my website.

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Midface Hypoplasia

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Before making any treatment recommendations, it's essential to understand the cause of your multiple eyelid creases. Although your pictures are limited to your periorbital region, it's apparent that your inferior orbital rims are recessed and your cheekbones are flattened. These findings are associated with a facial bone abnormality called midface hypoplasia. This condition can be associated with prominent eyes, scleral show and theĀ upper eyelid creases that your pictures demonstrate.

Under these circumstances, it's extremely important to approach blepharoplasty surgery with caution. For this reason, it's important to consult a board certified plastic surgeon with experience in this area. This surgeon should be able to evaluate your boney orbital anatomy before making a definitive recommendation.

Plastic eyelid surgery to correct multiple creases is risky in patients with prominent eyes

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Be careful. Your eyes are prominent, a condition that can be Proptosis. Surgery to remove upper eyelid creases involves removing some of the upper eyelid skin.

The risk in patients with prominent eyes or Proptosis is that removing skin from the upper eyelid may shorten the lid and result in dry eye which is a very serious complication

Eyelid Surgery Specialist for Multiple Eyelid Creases

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Your perception is understandable but there are many factors need to be taken into consideration before you choose to undergo blepharoplasty or upper eyelid surgery. It's best you see a specialist with experience with prominent eyes before you make any decisions.



Amiya Prasad, MD
New York Oculoplastic Surgeon
4.4 out of 5 stars 80 reviews

Multiple eyelid creaes

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I would be very careful with surgery as you are young and also have facial characteristics which are prone to higher rates of complications.  You can certainly have a minor procedure to reform one crease to the upper lids with minimal skin excision (if appropriate on examiantion).  However, this may also lead to a more hollowed look to the upper lid above the crease.  Sometimes fillers can acheive the same result while avoiding surgery (this would require evaluation).

Deep injections of filler (Restylane) over the bone under the eye may lift the lower lids and give your eyes a less prominent appearance.

Please see an well trained oculoplastic surgeon so that you get the best advice

Guy Massry, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 54 reviews

Upper Eyelid Belpharoplasty for Creases

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I would recommend an upper eyelid blepharoplasty . Whether any fat removal is needed is hard to say from the photos. Be careful here because excess fat removal can cause the eyes to look even more hollow and sunken in.

Upper eyelid lift may help you

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You have mild ptosis and also sclera show. You picture does not show the check bone and your eye Bonnie fram. You will need in person consultation and your surgeon should be very conservative with skin removal.

Kamran Khoobehi, MD
New Orleans Plastic Surgeon
4.7 out of 5 stars 152 reviews

Multiple eyelid creases

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You need conservative removal of upper lid skin. The other issues are more complicated and can only be discussed after a thorough examination.

Peter T. Truong, MD
Fresno Oculoplastic Surgeon
4.9 out of 5 stars 42 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.