Conservative Eyelid surgery for Scandinavian hooded eyes. (photos)

Question

Hi, I am 29 and of Scandinavian origin which has given me hooded eyes, similar to Rene Zellwegger. As I've gotten older they've dropped some due to weight loss. I can no longer put visible makeup on my eyes and my eyeliner rubs off on my upper eyelid. While I find my eyes pretty and don't want to drastically change them, I feel like at 29 they're just going to become more of an issue for me. Is there any way I could get a very conservative upper eyelid surgery while still remaining recognizable?

Ross A. Clevens, MD, FACS · Answer

Thank you for your question. For women, a good time to seek out eyelid cosmetic surgeries is when it becomes difficult to apply eye shadow on the upper eyelid. This is a clear sign that surgery might help you look more youthful. I suggest that you move forward and consult with a board certified facial plastic surgeon.
Best wishes,

A.J. Amadi, MD · Answer

The short answer to your question is YES. A skin only, or possibly skin with a conservative muscle excision can provide you with an excellent eyelid tarsal platform (area just above your lashes) to apply eyeliner and or eye/shadow. This can be done under local anesthesia with very little down time. I've posted a link to such a surgery I performed on 20 year old. The change in the amount of platform visible doesn't have to be drastic...it can be made much more subtle.Good luck

Mehryar (Ray) Taban, MD, FACS · Answer

You are correct. You want to be very conservative with upper blepharoplasty. See following link. Sometimes small elevation of the eyebrow using botox can also help.

Toby Mayer, MD · Answer

Don't let anyone operate on your eyes. You have very pretty eyes and you would be taking too much risk for too little gain. Once that skin is gone your brows may not be able to be elevated as you age.

Kenneth D. Steinsapir, MD · Answer

That is because this surgery ignores what is going on here.  Rene Zellewger was destroyed by her upper blepharoplasty.  Her anatomy is a little different than yours.  What you demonstrate in your photos mild upper eyelid ptosis and upper eyelid lash ptosis.  You also have a compensatory eyebrow elevation. If you have a "conservative" skin only blepharoplasty, this procedure will remove the upper eyelid fold exposing your long upper eyelid platform.  That will make you look older rather than younger.  If the surgeon attempts to take orbital fat also, the internal scar contracts after surgery and can worsen the upper eyelid ptosis.  The answer is to correct the upper eyelid ptosis and perform a structured microblepharoplasty that makes a hard upper eyelid crease which is used to support the upper eyelid lashes.  This approach emphasizes structure rather than substraction of tissue.  With the ptosis corrected and the eyes more open, the eyebrows will gently relax down complementing your natural subbrow fullness.

Tom D. Wang, MD, FACS · Answer

Hi babyface87, thanks for your question and sharing your photos.  You have lovely eyes that are becoming slightly "heavy" in the upper lid region.  You may benefit from a very conservative upper lid blepharoplasty to help reduce this heaviness.  Please consult with an experienced surgeon to help you determine the best option to match your needs and good luck to you!

Curtis Wong, MD · Answer

have been done but when so subtle as yours appears, I would be suggesting some kind of skin resurfacing to help the skin tighten up a little to let you put your makeup on as you are used to.  And fi this failed, then you either must have the skin removed or if your brows have descended, your brows lifted.  But at your age (pardon my bias), I would still avoid surgery if at all possible as you do have 'pretty' eyes.

Robert Singer, MD · Answer

Fullness of the
upper lids can be cosmetically improved with an artistically
performed conservative upper blepharoplasty.
Following the advice of anyone who would presume to tell you what to do based
on limited photos and more importantly without taking a full medical history,
examining… SHOW
MORE you, feeling and assessing your tissue
tone, discussing your desired outcome and fully informing you about the pros
and cons of each option would not be in your best interest.  Find a plastic surgeon that you are
comfortable with and one that you trust and listen to his or her advice. The
surgeon should be certified by the American Board of Plastic Surgery and
ideally a member of the American Society for Aesthetic Plastic Surgery (ASAPS).
You should discuss your concerns with that surgeon in person.
Robert Singer, MD FACS
La Jolla, California

Katrinka L. Heher, MD · Answer

Yes you have distinctive eyes and need to be careful.  The main issue is that any surgery performed must respect your particular anatomy.  You have what we call an epicanthal fold.  Your upper lid fold extends from your nose and creates a "hooded" look.  I believe you would benefit from an upper lid blepharoplasty but it is absolutely essential that the incision not cross over this fold of skin.  This requires a modification of the classic upper lid blepharoplasty so you need to pick your surgeon very carefully.  I would recommend an oculoplastic surgeon.  Best of luck!

Myriam Loyo, MD · Answer

Hi there, thank you for your questions and photos. You have beautiful eyes. I do see what you are saying about early hooding and how the size of the eyelid that shows your eye shadow has probably decreased.I would urge you to be conservative for now and not pursue skin resection. I suspect that a large part of the change Rene Zellwegger 's eyes was due to an aggressive resection of the tissue in her upper eyelids and to the skin immediately under her brow.My advice right now is to consider trying a lateral brow lift with botox. It is a subtle change that will slightly lift the tail of the brow and will give show a more defined eyelid crease without changing your eyes drastically. Any exam in person by a board certified surgeon will be the best way for you to get advice specifically for your eyes and your goals. Hope this helps. Good luck!

Conservative Eyelid surgery for Scandinavian hooded eyes. (photos)

Answers (12)

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