Blepharoplasty maintenance past mid-30s? (Photo)

Question

In my late 20s, I noticed my eyebrow area was sitting on top of my eyelid for the first time. I assume this will only get worse over time. I'm thinking of having blepharoplasty when I turn 34. Will I need upkeep/maintenance surgeries in my 40s, 50s, and/or 60s? If so, is it a bad or good thing? Should I be proactive about this or wait?

John K. Wakelin III, MD, FACS · Answer

While most of our blepharoplasty patients are in their 40's to 70's, I do see quite a few patients seeking improvement of their eyes in their 30's (and sometimes even in their 20's).  This is usually due, at least in some part, to their heredity.  The brow position is also a factor to consider, as a brow lift may be beneficial to consider with blepharoplasty, especially as the brow drops more over the following decades.  Having a blepharoplasty does not stop the aging "clock," but it does "reset" it, so to speak.  Therefore aging will continue after blepharoplasty, and many of our blepharoplasty patients that have a procedure earlier in life will benefit from another procedure (or sometimes more than one) in their lifetime.  Thankfully, there is not a limit on the number of times a blepharoplasty can be performed in most instances.

Amir Nakhdjevani, MBBS, MRCS, FRCS(Plast) · Answer

Thank you for your question and the picture. I would be grateful if you could attach a picture showing your forehead also. With the photo so focused in it is difficult to ascertain whether your brows are lower and you would benefit from a brow lift or there is excess skin between the brow and eyelid alone and you would benefit from a blepharoplasty. Generally, the brows for women are just above the supraorbital ridge (the edge of bone you can feel above your eye socket) - if your eyebrows are in this position then it is unlikely that you need a brow lift. If the brows themselves are lower than this point then a brow lift will help. A blepharoplasty will help to remove the extra skin between the eye brow and the upper eyelash line. You have two fat pockets around your upper eye socket and these can smetimes herniate through causing the increased puffy appearance. This can be addressed at the same time during  a blepharoplasty procedure. My advice would be to see a PS and have the eyes assessed to determine what the best procedure would be for you. I hope this helps

Kenneth D. Steinsapir, MD · Answer

I am not even sure that blepharoplasty is the right procedure for you let alone if it might need to be redone in 20 years! The journey of 1000 miles begins with a first step.  For you, that first step is to determine why you have upper eyelid retraction. I recommend starting with a assessment by an oculoplastic surgeon in your area. The American Society for Ophthalmic Plastic and Reconstructive Surgery maintains a regional directory on their website that can help you find a highly qualified surgoen close to home.

Sanjay "Jay" Keni, MD · Answer

Hi SouthernBelle,
Blepharoplasty may help the skin hanging over your eyelids, but from your photo, it seems like you might be more of a candidate for a brow lift.  This will help lift the eyebrows to a position at or just above the bony orbital rim, and has the added benefit of lifting the upper eyelid skin as well.
Go for a consultation with a trusted facial plastic surgeon with experience in upper blepharoplasty AND brow lifting.
And yes, you may need maintenance in 10-20 years, the timeframe depending on your health habits, genetics, and lifestyle.
Best wishes, 
Dr. Jay

William Portuese, MD · Answer

A full set of facial photographs are required to make a determination about how to proceed with two different surgical procedures based on your pertinent anatomy. It appears that the eyebrows are quite low in relationship to your eyelids. A brow lift procedure accomplishes elevating low set  eyebrows. A blepharoplasty procedure accomplishes removing excess skin creating the hooded appearance on the upper eyelid. For many examples of both procedures,  please see the  link and the video below

Jason J. Hall, MD, FACS · Answer

Exactly when you seek a cosmetic change depends on how much your eyelids bother you.  A blepharoplasty will remove the extra skin/fat that is causing your eyelids to droop; your body will continue to age.  Factors like diet, UV radiation, and genetics will all affect the rate at which your face ages.  In short, a blepharoplasty can and will help now, but there is a chance you may need a second surgery in 20 or so years.

Blepharoplasty maintenance past mid-30s? (Photo)

Answers (6)

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