Do You Recommend Upper Eyelid Surgery For Me? And How Can I Improve Texture Of My Skin? (photo)

I'm interested in upper eyelid surgery, I have had some under eye and laugh line injections recently (but I think I need some more), and I'm looking for other procedures to help improve my appearance. The doctor who did my injections is a freind and gave me a deal, but I think I need more under eyes to make them look even better. Any opinions? Also, what can I do (IPL, chemical peel, etc. ) at my local salon to help improve the texture of my skin? I'm a little bit sensitive and red, just dull. ?

Doctor Answers 11

Don't do the upper blepharoplasty

Hi Tony,


I wanted to just comment on the upper blepharoplasty question.  First off, I think you are a good looking man. I can see the area which is bothering you on the upper eyelid.  Would there be some skin that could be removed with a conservative upper eyelid surgery? Sure, I agree it is a potential procedure, but I wanted to play Devil's Advocate against having it done, just to give you a different point of view, and something to think about before considering surgery (having more knowledge and reference points to help you make the best decision for yourself.)  



Men's eyes look more masculine when there is a slight bit of hooding.  Your entire upper eyelid is showing and not touching your eyelashes.  Google Image George Clooney and Tom Cruise.  Both have some slight hooding of the upper eyelid, and for Mr. Clooney the hooding touches the upper eyelashes.  Both men have been considered the "Sexiest Man of the Year" by People magazine (I think), so I would not try to eliminate a slight bit of hooding, especially when taking into consideration that none of the eyelid skin is touching your eyelashes.  


Why does the media make fun of Bruce Jenner looking like an old woman?  He is known to have had a facelift and probably an upper eyelid surgery.  I'm sure he has access to the best of plastic surgeons, but when discussing any plastic surgery procedure, one of the alternatives to doing the procedure (other than injectables, lasers, chemical peels, etc) is to not do the procedure.  He has too much upper eyelid showing, which makes him look more feminine.  If some hooding were able to be restored to his eyelids, and reduce the amount of eyelid showing, he could look more masculine again.  


Hooding = more masculine and older, No hooding and very parallel eyelid crease to eyelash line = more feminine and younger.


For men, women often comment that their husbands actually look more handsome as they get older than when they first got married.  Why?  When they were younger, their eyelids were likely not hooded at all, and as they got older, their "baby face" looked more masculine.  Yes, removing some eyelid skin may try to make men look younger, but at the same time risks looking feminine. A win-lose.


For the women, aging works against them in more than one way.  They not only look less feminine and more masculine, but they also look older.  So upper eyelid surgery on women makes them look younger and more feminine.  A win-win.


Distance between Eyebrow and Eyelashes is fixed

The distance between the upper eyelashes to the eyebrow is fixed.  If a surgeon removes skin using and upper blepharoplasty procedure, the eyelid crease will move towards the eyebrow, and potentially reduce the amount of skin showing below the eyebrow and can make the eyebrow look lower.  Google Image Kenny Rogers plastic surgery and you will see that he had a natural hooding with almost no upper eyelid showing before surgery, then after surgery he shows so much upper eyelid and has minimal to no skin showing above the eyelid crease to the eyebrow.


The distance is fixed unless a browlift is performed, but don't get me started on browlifts .... :)




Dr. Yang

New York Facial Plastic Surgeon
4.8 out of 5 stars 33 reviews

Upper Eyelid & Facial Skin Rejuvenation

Although the picture is not ideal, you seem to have several problems that are treatable. You do have some excess skin in the upper eyelids that could be treated with a carefully done blepharoplasty. You can also take care of the frowning and lines between the eyebrows through the same incision. You also appear to have a mild ptosis (droop) of the upper lids. This needs further evaluation, as it may only be from descent of the brow or the excess skin. If from the brow, you could also need a brow lift. If from the excess skin, the blepharoplasty should take care of it. If it is true ptosis, you will need an elevator muscle shortening also. Make sure whomever you see for this has significant experience in eyelid rejuvenation and can deal with any problem you may have on exam. As for the skin, you appear to have significant sun damage with pigmentary problems, dullness and small cysts as well as the large pores. The majority of this is easily treated with a skin care system such as the Obagi® system that I have personally been using for quite some time for similar problems. If this does not solve all your problems, you then have more options with fewer risks.

Robert T. Buchanan, MD
Highlands Plastic Surgeon
5.0 out of 5 stars 6 reviews

Options for smoother skin

Hi Tony,

I would leave your eyes alone for now. Performing upper eye lid surgery now, would be overkill in my opinion. Botox is a good easy fix for now. I see that some of your pores are quite large and deep. Chemical peels will not do a thing for those. IPL may give you some improvement, but will require many treatments. Dermabrasion (not micro dermabrasion-a scam in my opinion) although a bit barberic will give you the best results. That being said, it basically sands off the top layer of skin and you look awful for 3-5 days. The benefit of this procedure is that its done under general anesthesia and your skin is taken off day one instead of waiting for it to peel off with IPL.

Please keep in mind that if you opt for IPL or dermabrasion, you will be more susceptible to skin cancers if you do not take measures to protect it.

Hope this helps.

Kind regards,

Dr. H

Gary M. Horndeski, MD
Texas Plastic Surgeon
4.6 out of 5 stars 222 reviews

Improving eyelids and skin (photo)

If you have upper lids done, be sure the surgeon incorporates levator advancement or another technique to open the upper lids a bit, and help you appear more awake and youthful.  Skin removal only will not do it for you, in my opinion.  Can't see lower lids well enough in photo to offer an opinion about that.

Regarding skin texture, try using TDWskincare Menthe Blanche exfoliator to wash your face each morning.  You will love it, and glow.  Also unroofs hairs for a closer shave.

Steve Laverson, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 46 reviews

Improving the area around the eyes

Texarkana, TX!  I grew up not far from there.


Anyhow, I see it like this.  Your upper lids are not bad, at a minimum some skin come be removed but keep in mind that over doing your upper lids can give the male face a bit of a feminine look.  So keep that in mind.  I'd probably have you wait a few years for the uppers.


Here's what I can see with the lower eyelids (and this is limited by the photo a bit).  I see some volume loss in the cheeks and the area just below your lower eyelids we call the midface and/or malar area.  I think 4+ vials of Sculptra or (if you have enough in your abdomen) some fat transfer would look excellent.  


As a rule, for men, don't over do it as you may end up looking a little feminine after a while.  As for the peels, etc.  Go for it.  Conservative peels and IPL as maintenance work is a great idea.  


On a medical note, you're a relatively fair-skinned Gent in Texarkana. . .it's sunny and only about 105 degrees there everyday from June  to September so if you do have some rough patched on your skin that don't go away make sure you get them looked at by your dermatologist. . .could be precancerous sun damage.


Chase Lay, MD

Chase Lay, MD
Bay Area Facial Plastic Surgeon
4.9 out of 5 stars 75 reviews

Upper eyelid surgery

Since so many of the doctors are suggesting Botox, try it. It will not be permanent and if you don't  like the result , I think conservative upper blepharoplasties will give you a fresher more youthful appearance. 

Sheldon S. Kabaker, MD FACS
San Francisco Facial Plastic Surgeon
4.4 out of 5 stars 35 reviews

Facial improvement

based solely on your photo, it looks like you are borderline to have your upper lids done at all. Botox may help lift them a bit on the sides to open it up a bit. As for facial texture and skin tones, it is difficult to see in the photos so an in office evaluation would be necessary.  Good luck.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 28 reviews

Upper Eyelid Rejuvenation

Although it is difficult to tell from the angle of the photo, you may have a mild element of upper eyelid drooping that can be improved with an upper lid advancement procedure. What I also see in the upper eyelid area is some thinning of the skin. This could be improved with some fractional laser resurfacing. I don't feel that you have enough laxity to perform an upper lid blepharoplasty yet, but it is hard to tell from the photo. A good skin care program consisting of a good facial cleanser, moisturizer, sunscreen, and retinol will help to preserve and restore your skin quality. Other treatments, such as IPL, chemical peels, laser may help but I would recommend an evaluation with a physician as photos can be misleading with respect to small details like skin quality and coloring.

Gregory J. Vipond, MD, FRCSC
Inland Empire Facial Plastic Surgeon
4.5 out of 5 stars 6 reviews

Do You Recommend Upper Eyelid Surgery For Me? And How Can I Improve Texture Of My Skin?

 No, aesthetically your eyebrows and upper eyelids are consistent with the ideal position and shape for a male.  In fact, IMHO if you were to have an upper eyelid surgery, the eyelid crease would be wide open and appear feminine.  I'd leave your eyes alone.  I also  do not see any evidence of true eyelid ptosis.

 Fot the texture, of your skin, I' would not do anything invasive but would recommend a 30% TCA face peel(not the neck) that quick, easy and effective at reducing lines, wrinkles and uneven pigment/rough skin.  Hope this helps.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.6 out of 5 stars 24 reviews

Extremely subtle ptosis

To be honest, you look quite good. There are some subtle changes that I notice:

1. Your upper eyelids are very mildy ptotic [droopy]. Raising them by about 1 mm will give you a slightly more awake look.

2. Your upper eyelid skin seems pretty natural, though if you raise the eyelid [ptosis repair] the skin fold may be a bit more prominent and a very conservative blepharoplasty [skin removal] might be helpful.

3. Your lower lids seem okay. I see a subtle asymmetry on the right side. Was a filler injected into this area? A touch up, or massage might improve that. Take this with a grain of salt, as the photo you have provided is not ideal.

Is your friend an experienced surgeon/injector?

If you decide to explore this further, I would recommend consultation with an ASOPRS trained Oculoplastics surgeon. You can find one close to you on the ASOPRS dot org website.

A.J. Amadi, MD
Seattle Oculoplastic Surgeon
5.0 out of 5 stars 37 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.