Solutions for Overexposed Upper Eyelids?

Question

Hello, I was wondering if a doctor could answer this specified question of mine. Overexposed upper eyelids are not aesthetic for men and often give the eyes a bulging, strange look. If you pay close enough attention, the most aesthetic eyes often have no upper eyelid visible and instead have a layering of skin/fat to cover the lids. If there any way to fix overexposed upper eyelids? I think fat grafting might work, but it would seem like a surgery with no precedents. Thanks for your time!

Kenneth D. Steinsapir, MD · Answer

Are we answering this for you? If so a photo would be very helpful. In general you are correct that men should have some bulk in their upper eyelids. Celebrities show what happens when this is violated (i.e. Kenny Rogers, Bruce Jenner, Sylvester Stallone, etc.). FIxing the problem is very problematic. Using fat grafting to correct has been tremendously disappointing. The problem is that all of the planes in the upper eyelid glide so that layers slide over each other when the eyes open and close. The grafted fat scars in place and interferes with gliding function. Hyaluronic acid has been helpful in select cases. There are other repair methods but they depend on the unique anatomic issue in a particular patient.

Randy Wong, MD · Answer

Thanks for your very astute observations. I agree that excessive exposure of the upper lids may create a feminizing or unusual appearance in men as seen in some male celebrities with postop remorse. The male orbit should be designed to embrace the masculine features and correction with fat grafting may be possible, but I suggest dermal fat grafting, instead, for more precise correction.

Mehryar (Ray) Taban, MD, FACS · Answer

Overexposed, hollow upper eyelids make someone look more tired and older. You are correct that fat grafting can help. Another option is filler injections. See an oculoplastic specialist for evaluation.

Michael Law, MD · Answer

Fat grafting to the upper eyelids can provide a permanent, month and natural looking result.  The results are subtle, yet dramatic for both men and women. Look for many, many photos and find a very exoperienced plastic surgeoin who will not overfuill.

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