How to address wrinkles/laxity in lids following upper bleph? (Photos)

Question

I had a conservative upper blepharoplasty for my eyelids that had significant laxity at age 52 and I’m a slim athletic individual. I didn’t do any additional lifting procedures along with it. My surgeon did a beautiful job and for six or seven months my eyes looked great, but I think there was some edema/swelling still, and once that were off about the nine month mark, I noticed significant sprinkling just below my brow and overall laxity in the lid, so the hooded aspect was definitely improved, but now I have the sort of deflated balloon appearance in my upper lids. What would be the best way to address this simply redoing the procedure and taking more skin away?

Gary M. Horndeski, MD · Answer

It appears that your eyebrows are low and you have a lot of wrinkling laterally. You would benefit from a browlift, which will lift your eyebrows higher and more lateral to correct the wrinkling. After the browlift, you may or may not need a revision of the upper blepharoplasty.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Franklin D. Richards, MD · Answer

I can see exactly what you are concerned about after viewing your photos. It appears that you have upper eyelid ptosis. This is a condition caused by loosening or stretching out of the levator oculi muscle of the upper eye. This muscle can be tightened which will raise the upper eyelid to a higher position. It is not part of a normal upper eyelid cosmetic procedure, but can be performed through the incision that was used to do your blepharoplasty. This should correct the "deflated" look you mention.

Raffy Karamanoukian, MD, FACS · Answer

Fractional CO2 laser is an excellent tool for skin rejuvenation in our center in Santa Monica. We use the fractional multi-depth ablative approach to help resurface the skin, recontour acne scars, improve incisional plastic surgery scars, and reduce surface irregularities from skin tone to dark pigmentation. Our approach utilizes a multi-depth approach that targets melanocytes in the epidermis and collagen fibroblasts in the dermis. This approach can be combined with a TCA Peel in a process known as a sapphire peel. Fractional laser is excellent for acne scars and contour scars in the skin. Patients are advised to undergo skin protocols with Melarase creams before and after treatment to help reduce pigmentation. Melarase AM, Melarase PM, and Melapads can seriously improve surface sun damage and UV related pigmentation. After the laser, we expect redness for a few weeks as the skin improves. PRP and Hydrafacial enzyme facials can further improve skin quality after fractional co2.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best,
Dr. Karamanoukian 
Realself100 Surgeon

How to address wrinkles/laxity in lids following upper bleph? (Photos)

Answers (3)

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