Would I need upper and lower lid surgery? My lower lid is my biggest problem area (Photo)

I have always hated my eyes. I was born with lower lid bags. Sometimes they are puffier than others. I'm worried about using fillers and the long term cost of using them. Seems like surgery makes more since $ wise. Would this be a simple case or more complicated case on the spectrum of lid procedures

Doctor Answers 6

Lower lid bleph

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The photo is hard to see but if your only problem is baggy lower lids then I think considering a lower lid bleph would be a better bet than fillers.

Upper and lower blepharoplasty

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From your pictures, it looks like you have some fullness in the lower eyelids that could be improved with a lower blepharoplasty.  Since you are young and have minimal skin excess, this procedure could be done without an incision through the skin. This procedure is relatively simple with minimal downtime.  Most patients take 1 week to 10 days off from work.  To improve the eyelid fullness, a lower blepharoplasty tends to be a better choice than fillers, which are mainly a temporary treatment to improve hollowness and volume loss

Lower eyelid fullness is common at a young age! Blepharoplasty/ eyelid surgery is great!

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It is not uncommon to have the lower eyelid fat bulging from childhood. This is a genetic predisposition which you may find several members of the family have the same problem.  The fillers done well will often mask this problem, however, the cost of the surgery will be surpassed in short order by using fillers and the risks of the fillers is present with each injection.  If you are tempted to do surgery, go for it!!! It is a long term solution with one recovery.  You will be VERY happy with the results and the fact that people will stop saying you look tired.  You only need to do the upper eyelids if you have excessive skin there.  If so, it is worth it is probably worth it to do them both and have one recovery. Your photos are inadequate to assess this so you will need to have a consult with the plastic surgeon to best evaluate this need. If you do have excess upper eyelid skin and you do the surgery, you will feel and immediate relief of the tired/aching eyes that commonly happens as the upper eyelid skin accumulates! Good luck!!

Kimberley Lloyd O'Sullivan, MD
Providence Plastic Surgeon

Slight Dermatochalasis with Mild Ptosis

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The upper eyelids appear a little droopy (ptosis) and there appears to be a little extra fat/skin (dermatochalasis.) Surgery can correct both problems. Evaluation of the lower eyelids is not possible in your photos.

Upper and lower eyelid surgery

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The primary goal for upper eyelid surgery is to remove the excess hooded skin creating the "tired look". The primary goal for lower eye lid surgery is to remove the fatty deposits creating the "puffy look". The incision for the upper lids is located directly in the crease, while the incision for lower lid fatty deposits is located on the inside of the lower lid. For many examples of both upper and lower blepharoplasty, please see the video and the link below

You have very complicated eyelids.

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You look like you have congenital ptosis.  The lower eyelids are also complicated.  Without assessing you personally, I would say the fillers might be the way to go for you for awhile.  If you reach a point there the fillers no longer do the trick, surgery would be an option.  I recommend getting several opinions before deciding how to proceed.

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

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