Can the line/crease on the corner of my eye when I smile be fixed after lower blepharoplasty? (Photo)

Question

I had upper and lower blepharoplasty many years ago and have noticed that when I smile a huge unnatural line occurs at the corner of my eyes that never used to prior to my surgery (more pronounced on one side than the other). How can I fix this / is it fixable? When I pull my face up by the temples and smile it appears to be less noticeable. Is my only recourse now an upper facelift?

C. Blake Perry, MD · Answer

Often the these lines can be improved with judicious neurotoxin placement. You have a prominent orbicularis muscle on the lower lid which neurtoxin can improve if placed properly. Your upper lid laterally may benefit from additional skin removal. Best to see an eyelid expert in person.

Gary M. Horndeski, MD · Answer

It appears that when they did your previous upper blepharoplasty, they did not extend enough laterally and this resulted in basically a dog ear. You can revise this by extending it more laterally and removing some excess skin. The other alternative is a mid facelift.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Zoran Potparic, MD · Answer

Dynamic creases around eyes when smiling are natural and they are visible even in babies. However, the appearance of the crease can be changed in time due to presence of the scars, skin laxity(aging), etc. only on the basis of in person evaluation one could give you idea whether surgical treatment would make visible improvement. Hope this helps.

Mats Hagstrom, MD (license on probation) · Answer

Dynamic facial aesthetic issues related to tension and muscles of facial expression are inherently difficult to treat. Because the contour happens when muscles are contracted. It’s difficult to make a clear assessment about the underlying problem is or how it should be addressed since almost all surgeries are done without facial expression. if the problem is related to tension from the orbicularis, oculi muscle, then very small injections of Botox in the right place may conceivably improve your situation. 
There may not be a surgical solution for your concern. I suggest you follow up with your provider or schedule a few in person second opinion consultations with other providers in your community.
Best,
Mats Hagstrom, MD.

Can the line/crease on the corner of my eye when I smile be fixed after lower blepharoplasty? (Photo)

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