21 year old considering Upper & Lower Blepharoplasty due to congenital excess eye skin? Open to other suggestions? (Photos)

I am a 21 year old who is considering upper & lower blepharoplasty because of the excess skin around my eyes. I have some puffiness, but mostly just loose skin around the eye area. I know it is genetic because I have looked this way since my early teenage years and because this trend is heavily prominent in my family. I have tried everything, but fail to look youthful and rested with my very tired looking eyes. Should I be seriously considering blepharoplasty? Are there any alternatives?

Doctor Answers 7

Blepharoplasty in young person

You can benefit from transconjunctival lower blepharoplasty and conservative upper blepharoplasty. See following link and video. See an oculoplastic surgeon.

Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 58 reviews

Options for upper eyelid skin redundancy

You have great options for upper eyelid skin redundancy. As has been mentioned, a skin pinch blepharoplasty would resolve your concern. In addition, fillers may help to improve fullness due to a deflated crease. Botox can also help lift the brow. Lastly, laser skin resurfacing of the upper eyelids is a minimally invasive, and nonsurgical option to consider. 

Jose E. Barrera, MD, FACS
San Antonio Facial Plastic Surgeon
5.0 out of 5 stars 36 reviews

Blepharoplasty in young patient

thanks for your questionThanks for your question. This is a common complaint of many patients I see. My recommendation, especially in younger patients, is to forego any surgical lower lid procedure as the issue is typically a problem of volume. Fillers are a great option in your case to help with cheek and lower lid volume.The upper lid could stand to have a conservative skin excision (blepharoplasty). This can be done under local anesthesia in the clinic setting. I would recommend scheduling an in-person consultation with a board certified facial plastic surgeon. With a comprehensive exam, they can help advise you on all options appropriate for you!Best wishes!

Christian L. Stallworth, MD
San Antonio Facial Plastic Surgeon
5.0 out of 5 stars 8 reviews

This under eye circle is best treated with nonsurgical filler.

Voluma is not a good product for this.  The so called smooth fillers are not good either.  I prefer Restylane for the under eye area.  Bottom line is the whoever does your filler needs to be highly experienced.  Fillers are the state of the art treatment for your issue.  Do not get talked into or talk yourself into lower eyelid surgery for the issues demonstrated in these images.  Lower eyelid surgery removed lower eyelid herniated fat.  Arcus marginalis release surgery transfers herniated orbital fat into the top of the cheek to improve lower eyelid contour issues.  Do your own examination.  Put your finger on top of the bag.  What you are feeling is not herniated fat.  What you are feeling is the orbital rim.  It is bone.  Lower eyelid surgery will do nothing for this.  Many of the procedures mentioned including lower eyelid blepharoplasty and tear trough implant have potential complications.  For many years, you can have fantastic results with the hyaluronic acid fillers.  For there eyelid, it is critical that you preserve as much of the upper eyelid fold as possible.  Over aggressive eyelid surgery will be a catastrophe.

Kenneth D. Steinsapir, MD
Los Angeles Oculoplastic Surgeon
4.9 out of 5 stars 23 reviews

Proceed with caution

Your upper eyelids have a minimal amount of excess skin, see someone with experience-you need a very minimal skin excision on the uppers.  You do not have any excess skin on your lower lids.  You have some prominence to the lower eyelid fat pads that could be contoured with filler or removed (without taking too much fat) through a transconjunctival  incision.  Good luck, Jane

Blepharoplasty in a 21 year old

From your photos, a very conservative, skin-only upper blepharoplasty seems like a wise choice of procedures.  In younger patients, under-eye bags is often caused by underdeveloped cheek bones.  A deep filler (such as Voluma) or a small cheek implant can treat these without needing formal lower eyelid surgery.

Jason J. Hall, MD, FACS
Knoxville Plastic Surgeon
5.0 out of 5 stars 10 reviews

Is blepharoplasty appropriate?

Thank you for sharing your question and photos. Upper blepharoplasty is appropriate for you, but use of fillers might be satisfactory for the lower eyelids. See an experienced Oculoplastic Surgeon for comprehensive evaluation and discussion of treatment options.  Good luck,

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.