Is it possible to remove extra skin (not along brow line) without creating a fold on the upper lid?

Hello @jymjym, thank you for your question. To make an informed recommendation, more information is needed. Each patient's situation is unique, and a direct consultation with a board-certified plastic surgeon is necessary to determine the most appropriate plan for your specific case. Best wishes! Alan Gonzalez MD, FACS. American Society of Plastic Surgery Member (ASPS),International Federation for Adipose Therapeutics and Science” Member (IFATS), American Society of Plastic Surgery Member (ASPS), Colombian Society of Plastic Surgery member (SCCP).

For unique cases where a variety of modalities could be used to treat the condition, I would suggest an in person or virtual consultation to develop a custom and effective treatment plan. It is difficult to precisely define the best option without collecting the same information. I suggest reaching out to an expert for a consultation with surgical and non-surgical methods to get a comprehensive option. Best, Dr. Emer.

Any adhesion between the skin and the deeper structures of the upper eyelid is likely to cause a fold or crease. For this reason, it is critical that any potential surgeon carefully listen to your concerns and honestly discuss the likelihood of causing an upper eyelid crease with surgery. It is true that a sub-brow incisions avoid a crease but can cause a visible scar no matter how great the surgeon thinks their skills are. Caution is advised. As an alternative, you might consider accepting a properly designed upper eyelid crease that is symmetric between the two eyelids. There is no substitute for an in person assessment.

Thank you for your question.

An upper blepharoplasty always, if done properly, creates the fold above the upper eyelid lashes. This is called the supra tarsal fold.

This fold is considered an aesthetic or cosmetically desirable finding on the upper eyelid. The fold is caused by the attachment of the muscle which opens the upper eyelid to the skin.