My Outer Corner or Tails of my Eyes Are Pointing Downwards. Will a Temporal or Sub Brow Lift Help?

Question

26 years old, female. the tails of my eyes point downwards (same with my mom, hers downslopes as well). other people say i look tired most of the time even though im not! what surgery would you recommend to pull the outer corners up to make my eyes more awake but not like a deer-in-headlights look? please help. thanks.

Richard H. Tholen, MD, FACS · Answer

You do not have the  (higher) visible pretarsal fold present in Caucasian or Occidental upper eyelids (actually, your photograph shows a low and minimally-visible pretarsal fold common in patients of Asian descent). This is what is causing the upper eyelid  lateral "hooding" that bothers you. Your lateral canthus is actually nicely higher than your medial canthus, giving you a true upward eye tilt that is generally considered not only aesthetically attractive, but normal for an attractive young Asian-American.

	The surgical approach to this concern would be to excise the lateral upper eyelid skin as part of an upper blepharoplasty that takes into account your ethnic background, and your wish to either retain or reduce the absent pretarsal fold. This is a specialized procedure somewhat different from a "standard" upper blepharoplasty done in someone with a high(er) Occidental pretarsal fold.

	See several ABPS-certified plastic surgeons experienced in Asian blepharoplasty and consider if having a minimal but present scar in the lateral eyelid skin is "worth it" to reduce the lateral hooding that makes your appearance look "tired." A true sub-brow skin excision will leave an unnatural scar that is much more visible and NOT recommended. A temporal lift will not achieve your goals at all. Best wishes!

Michael A. Epstein, MD, FACS · Answer

If the picture below the posted question matches, it is important that you recognize that

	1.  You do not need a brow lift at all.

	2.  Patient's of Asian dissent have different anatomy then patient's of westernized countries and with this different anatomy, some of the surgical treatments for aging of the eyelids can also be different.

	It is difficult to discern, without examining you in person, whether or not your complaint is related to aging or whether or not it is related to your natural development.  I suspect it's the latter because of your 26 years of age.  I would probably recommend some form of an eyelid lift, otherwise known as a blepharoplasty.

Joseph Rabson, MD (retired) · Answer

From the one view I see, it does not look like you need or should have a brow lift. 

	However, if what you are talking about is the very corner of the eyelids, a brow lift will not help and you should consider a blepharoplasty.  Even though when you lift the brow directly with your finger, it may improve the corner of the eyes, an actual brow lift does not really do that effectively.

	 I suggest you speak with a plastic surgeon and communicate exactly what you want to accomplish using your finger in front of a mirror.  And, as always, make sure you see photographs (before and afters) of other patients with exactly your concern before going through with surgery.

My Outer Corner or Tails of my Eyes Are Pointing Downwards. Will a Temporal or Sub Brow Lift Help?

Answers (3)

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