39, male. Would a lower bleph work for my eye hollows? (Photos)

Question

39 male here. Lost a little weight, but also just feeling that I look tired. I’d like to address my eye hollows but am unsure if a lower bleph would be appropriate for me, generally, or if I was a good candidate if dermal fillers yield a better result. Thank you all very much for your time .

Ryan Endress, MD · Answer

Great question! It looks like (although hard to tell given no true lateral view) that you might have what is called a negative vector, which is where your cheek is recessed compared to your eye. What would help best in that situation is a small implant to correct that deficiency, +/- bleph depending on what the exam shows for fat/skin excess and correction of the tear trough.

Andrew Miller, MD · Answer

While you do have some protrusion of lower lid fat which can be nicely improved with blepharoplasty, it is perfectly fine to try some filler in the tear trough crease first to see if it can be camouflaged. Be sure to see an experienced injector for this procedure

Gary M. Horndeski, MD · Answer

You would benefit more from a brow lift.  This will decrease the vertical height of the forehead, lower the hairline, and pull up the eyebrows.

Best Wishes,

Gary Horndeski, M.D.

Zoran Potparic, MD · Answer

You seem to have malar hyperplasia, small cheek bones,  what means that in order to correct your problem both lower eyelid surgery and cheek augmentation are needed. Small cheek implants or fat grafts could be considered for cheek enlargement. Good luck.

Nelson Lee Novick, MD · Answer

At least from the photos provided, there appears to be considerable volume deficit in the cheeks, leading to their flattening, the prominence of the smile folds, and (since the upper cheeks are the primary support for the under-eyes) the under-eye hollows that disturb you. Accordingly, the skillful use of an appropriately robust HA volumizing filler for the cheeks will not only restore a more normal contour to that area, but will secondarily soften the smile folds and address the under-eye hollows and create a smoother, more natural transition between the upper cheeks and the under-eyes.
In experienced hands, this nonsurgical treatment should take no more than about fifteen minutes to perform with immediate results and little to no significant downtime. 
You would be wise to consult with an experienced, board certified cosmetic dermatologist filler expert.
Hope this helps and best of luck.

39, male. Would a lower bleph work for my eye hollows? (Photos)

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