36 y/o female, my eyes feel heavy and dry! Will bleph help? (Photos)

Question

Wanting to know if upper bleph will help my eyes not feel so tired/heavy? I don’t want to lose my natural hooded shape, but in the last 2y the skin on upper lid has become incredibly thin/loose and heavy. My eyes feel heavy and my eyelids and eye shape has completely disappeared. Also, would I be eligible for any private health or Medicare rebates?

Kenneth D. Steinsapir, MD · Answer

You have an outie upper eyelid fold. The challenge you have is many potential surgeon you might see don’t bother to examine eyelids in a detailed fashion and fail to diagnose ptosis. They thing their job is to simply remove your upper eyelid folds. That will convert your wonderful outie eyelid to an innie eyelid. Likely this will be done without addressing your upper eyelid ptosis. Without you upper eyelid fold, you will look skeletonized and older. Don’t let that happen. You need a ptosis surgery repair and preservation of the upper eyelid fold. The key is that the fold will need to be conservatively trimmed. It is possible to get what you need to get a wonderful result but finding the right surgeon is challenging.

John Michael Thomassen, MD · Answer

An upper eyelid blepharoplasty, only removing skin, would brighten your eyes and restore their prior look.  This can be done quite straightforwardly in an office setting under local with 1 week recovery.

James C. Marotta, MD · Answer

A few things come to mind when I look at your questions and photos.   Upper blepharoplasty or eyelid lift gets rid of the redundant skin or "hooding" so if you do not want to get rid of your natural hooded shape I would be wary at 36.   Upper blepharoplasty does not relieve eye dryness.   In the photos, you appear to be squinting a bit which draws the brows down and creates more hooding.   An in person exam would be important to determine if you are really a candidate and you can get what you are looking for....

Camille Cash, MD · Answer

An upper blepharoplasty would remove excess skin from the upper eyelid which would relieve the heavy appearance.  It may however affect the "hooded" appearance that you mentioned that you like.  It will not address dryness, and in some cases may make it worse temporarily.

Mats Hagstrom, MD (license on probation) · Answer

Do you have a very good point when you mention that you don’t want to lose the natural footing of your eyelids. For that reason, a brow lift may be a far better operation for you. It leaves the natural eyelids the way they are and gives you relief from the hooding while at the same time giving you were more youthful appearance, and a feminine higher set brow. To make the quality assessment, we need to see your entire face, or at least your entire forehead. When making an assessment, we need to see the size of your forehead, what your hairline looks like and other variables because this all has an impact on how we approach recommendations for surgical procedures.
There are three techniques of doing a brow lift. They are actually more than that, but most plastic surgeons will either do the procedure as an endoscopic procedure, or with an open incision, either in the hair, bearing scalp, or at the hairline.
The hairline incision is excellent for individuals who want to create a smaller forehead, and who have a large forehead to start with.
There are potential drawbacks, including a potentially visible scar and numb scalp.
When done by a sufficiently talented providers, discard can be made very natural and almost invisible. I have this incision myself and it’s never bothered me.
Blepharoplasty is inevitably going to alter the amount of hooding of your upper eyelid because that’s what the procedure does.
With your eyes wide open, it may still look fairly natural, but as you close your eyes, it sometimes has a surgical appearance after upper eyelid blepharoplasty.
Expect to get different opinions from different providers, depending on their personal philosophy, training, skills, experience, etc. etc.
There’s no right or wrong way to approach this. Sometimes a conservative brow lift, with a conservative blepharoplasty can together give the perfect balance.
Schedule multiple in person, consultations with experienced board-certified, plastic surgeons, facial plastic surgeons, or conceivably oculoplastic surgeon as long as they have experience, both with brow, lift and blepharoplasty.
It’s important providers have experience with both procedures, or they will naturally be inclined to do the one they can offer.
Continue having consultations until you feel very comfortable. You found the right provider for your needs. During each consultation, ask each provider to open up their entire portfolio and show you all of their before and after pictures of previous patients with similar facial characteristics to your own. An experience plastic surgeon should have no difficulty showing you the before and after pictures of at least 15 previous patients.
Continue having consultations until you find the right provider.
Best,
Mats Hagstrom, MD

36 y/o female, my eyes feel heavy and dry! Will bleph help? (Photos)

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