What do I need to treat heavy, differently shaped eyes? (Photo)

Question

Trying to avoid wrong procedure, requesting pro opinions on what would be best. Be blunt- not easily offended. eyes heavy on top, dark under, different shape & size for each other (canthoplasty left eye approx 1.5 years ago in attempt to even out from injury sustained in 2019 MVA. Seems worse now). Eyes age me, look tired and sick, heavy. All min invasive hasn’t worked. goals: big, rejuvenated, open eyes. Most effective and perm. option 2 achieve goals? Bleph and brow lift? Thx!

Gary M. Horndeski, MD · Answer

You would benefit from a browlift done in the hairline. This will lower your hairline, decrease the vertical height of the forehead and pull up the eyebrows which will help with the extra eyelid skin. You may also require an upper blepharoplasty done at the same time. You may also benefit from a lip lift to achieve the results similar to the desire photo you have shown.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

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 the situation.

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, or to treat any asymmetries.

Dr. Donald Groves is an expert facial plastic surgeon that I work with, who specializes in 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

William Portuese, MD · Answer

The limited photographs demonstrate what appears to be ptosis on your left eyelid, which is a muscle weakness, and hooded and excess skin on the upper lids on both sides. An in-person examination is going to be required to make a determination about how best to proceed.

Mats Hagstrom, MD (license on probation) · Answer

In your picture, it looks like you are cross eyed or have Strabismus.
It makes your left eye look like it has upper eyelid ptosis.
I see no clear indication for having either upper or lower blepharoplasty nor do I see a good reason to have a brow lift.
I suggest consulting with highly experienced oculoplastic surgeons in your community to get a quality assessment.
It looks like you still have fillers in your mid face.
I’m guessing you’re jumping the gun a little bit for surgical intervention.
The relationship between the eyeballs and the eyelids are highly dependent on how pictures are taken.
An exam is much much better done dynamically because as you turn your gaze in a different direction, the eyeball has a different relationship with the upper eyelid.
I don’t see a clear indication for surgical intervention, but it’s difficult to make an assessment using only Still pictures which does show you have Strabismus. Possibly from previous trauma?
Best,
Mats Hagstrom MD

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