6 month post op upper bleph, seem to still have a lot of loose skin on lids hanging over incision line. Any suggestion? (photos)

Question

My eyelid is smaller than once was, concerned inc was made too far down. Also even with eyes closed skin hangs over. Has gotten worse as farther out. Brought up to my surgeon, felt dismissed. Stmt was looks a little better than it did. I don't see much difference now. Have appt plan to discuss with him. Any advice to how to approach and can this be corrected? Was he just to conservative or is the incision off. Pictures included with eyes open and closed.

Kenneth D. Steinsapir, MD · Answer

It will answer many of your questions.  It is normal for the forehead relax after upper blepharoplasty.  This recruits more skin into the eyelid space.  It is impossible to know ahead of time how much skin will come down.  The safest approach is to be conservative and take less skin.  Removing a bit more skin is relatively simple.  Putting skin back into the eyelid is very difficult.  It sounds like your surgeon is not aware of these mechanics.  Essentially they are telling you something about their lack of understanding about eyelid surgery. I do not recommend having that surgeon revise your eyelids.

John R. Burroughs, MD · Answer

From your pictures I can see your concern, but not seeing your preoperative photos then it is difficult to accurately judge your postop result.  I say this as your preop brow positions can determine your postop result to a large degree when it comes to upper blepharoplasty success.  Further skin removal in your upper eyelids can smooth the upper eyelid appearance and sometimes reduce the overhang of persistent skin, but it will cause your brows to fall further as your are removing tissue between the eyebrows and your upper eyelid margin thereby collapsing them together.  The other issue is that you may have had a prominent compesatory eyebrow elevation before surgery as you subconsciously were pulling upward with your forehead muscle to lift the brows and pull the upper eyelid skin out of the way.  Following an upper blepharoplasty the forehead muscle will often relax because the excess skin is no longer causing visual disturbance.  At this point you might benefit from a brow lift surgery (endoscopic, hairline, or browpexy).  Caution is needed following an upper blepharoplasty because if the brows are pulled to much the eyes may have trouble closing, which can be dangerous to the health of your eyes and uncomfortable. The most successful and safe eyelid and brow surgery is achieved through a very thorough understanding of many issues to include the individual's specific anatomy, preoperative measurements, patient goals, presence of dry or other eye issues, and excellent technique.  Best regards.

Bradford A. Bader, MD · Answer

I think a revision is in order for your upper lids. The other issue is descent of your brow which has narrowed the distance between your upper lid crease and the brow. It's always difficult to say for sure based on online photos alone, but I think you would be a good candidate for revision upper blepharoplasty and browlift.

Robert S. Schmidt, MD · Answer

Frequently when patients note persistent extra skin or heaviness following blepharoplasty, it's due to droopiness of your eyebrows. Ideal brow position is sex-dependent, but generally at or just above the orbital rim is desired. If your brows fall a bit, you will have extra skin in your orbits.It may also be that your surgeon was conservative with the skin excision. It's always better to be conservative and need a little correction than too aggressive with eyelid resection- this can lead to inability to close your eyes. It's a little tough to tell on your pictures, but you may have both of these factors contributing to your current result. They can definitely be corrected. Good luck!

6 month post op upper bleph, seem to still have a lot of loose skin on lids hanging over incision line. Any suggestion? (photos)

Answers (4)

Answer: Loose skin following blepharoplasty

Answer: Loose skin following blepharoplasty

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Everything you need to know about Eyelid Surgery

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6 month post op upper bleph, seem to still have a lot of loose skin on lids hanging over incision line. Any suggestion? (photos)

Answers (4)

Answer: Loose skin following blepharoplasty

Answer: Loose skin following blepharoplasty

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Recommended reading

Everything you need to know about Eyelid Surgery

Our mission is to create a world where every investment in modern beauty is Worth It.