What is the cause for needing a bleph? (Photo)

Question

Hello! I have hooded eyes and deep tear troughs. I am trying to figure out if an upper and/or lower bleph would be right for me but I have some questions. What is the cause for hooded eyes and/or tear troughs? Is it excess skin? Is it excess fat? Or is it just fluid? I see people getting rid of hooded eyes through lymphatic massages, and my eyes are extra hooded in the mornings. I am worried this procedure will make my eyes too hollow. Please give me advice and educate me :)

Jason Emer, MD · Answer

Hello and thank you for your question. A formal evaluation would be needed to determine the best treatment. There are both surgical and non-surgical options to correct this, depending on your particular situation.

UPPER EYELIDS:
-NON-SURGICAL: For less significant upper eyelid skin excess or more mild improvement, there are nonsurgical treatments: Radiofrequency (Thermage or Venus Legacy/Viva), injectable fillers, and a Botox brow lift can help contour the eyebrows and lift the eyelid skin.
-SURGERY: browlift and/or upper blepharoplasty is a great option for more significant improvement- for example if the hooded eyelids have more excess skin present.

LOWER EYELIDS:
-NON-SURGICAL: For less significant puffiness and sagging UNDER the eyes, or more mild improvement, there are nonsurgical treatment options: we often use Renuvion helium plasma radiofrequency (RF) energy to achieve incredible results and take years off of your appearance. Combining RF energy and cool helium plasma, the signs of aging (wrinkles, pigmentation, skin laxity) are improved in a ‘Nonsurgical Lower Eyelid Lift.' The focused heating tightens and peels the outer skin layer with extreme precision, leaving the surrounding area undamaged, smoothing and tightening the periorbital skin, and improving the overall skin quality around the eyes. It's an aggressive treatment, and the recovery time is longer than with other nonsurgical procedures, but the results can be life-changing.​ 
-SURGERY: A lower blepharoplasty (with or without canthopexy/canthoplasty or orbicularis muscle suspension) is a great option for more significant improvement- for example if there are more severe lower eyelid bags / bulging present. Sometimes the surgery can also be used to intentionally adjust the shape and/or size of your eyes, or correct any asymmetries!

Dr. Donald Groves is an expert facial plastic surgeon that I work with, who specializes in all these types of procedures. It is important that if you are considering surgery that you go to someone who is well trained and very experienced with these delicate operations to get the best results. I suggest getting a consultation with an experienced cosmetic dermatologist and facial sculpting expert, or an aesthetic facial plastic surgeon like Dr. Groves; we are both located right here in Los Angeles.

Best, 
Dr. Emer

Camille Cash, MD · Answer

There is not one specific cause that leads someone to have hooded eyes.  Many things influence it such as age, environmental factors, genetics, allergic reactions, etc.  I encourage you to begin by visiting with a board certified plastic surgeon near you for a consultation to discuss your specific concerns and learn more about your options.  I've included a video that I hope you find helpful.

Gary M. Horndeski, MD · Answer

I would recommend a browlift.  Your hairline is much too posterior and your forehead is too long vertically.  This will also raise your eyebrows and help with some of the upper eyelid skin.  The incision is at your hair-forehead junction and also in the hairline laterally.  Once this is done, you may consider an upper and lower blepharoplasty.

Best Wishes,

Gary Horndeski, M.D.

What is the cause for needing a bleph? (Photo)

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What is the cause for needing a bleph? (Photo)

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