Do eyes with a more visible upper lid always look better than eyes with a slightly smaller visible upper lid and extra fat?

Standard, subtractive upper blepharoplasty will be the biggest mistake of your life.  Your multiple posts about the same issues despite very sage advice by the big cutters of North America, suggests that you may have body dysmorphic disorder (BDD).  That would be a condition where you have an excessive obsession to think about appearance issues that actually interferes with your ability to meet social or work responsibilities. Typically individuals with BDD spend many hours a day thinking about subtle issues with their appearance.  They have trouble having social relationship due to concern about how other perceive their appearance such as a belief that people are rubbing or touch their faces, or making jokes or talking about the perceived issues. If this description fits you, what you need to know is that studies have shown that surgeons seldom understand the concerns of those with BDD.  This leads to a situation where you end up with a surgery that does not accomplish what you were looking for.  These can be devastating.  Treatment for BDD is aimed at increasing insight and disrupting the thought pattern that causes to spend all of your time focused on these physical concerns.  I see many patient from your area who need to have eyelid surgery revised.  I continue with the opinion that you are beautiful and do not need surgery.  The risk of harm rather than benefit is very high.

Eyes are in the "eyes of the beholder."  The more youthful look is a full upper eyelid and the trend in upper eyelid surgery is to maintain this fullness. However, some people are not born this way and have a more hollow appearance.

Dear 13almw,

Thank you for your clinical post. There is a huge variation in the appearance
of the upper lid skin and fatty tissue particularly amongst Caucasian eyes. They are very attractive women with full
“bedroom eyes” with fatty tissue and excess skin with very little upper lid
show and there are also very attractive women that have a tremendous amount of
upper lid show and very little extra flesh and fatty tissue of their upper
lid. In general, the trend in upper lid
blepharoplasty over the last decade is to preserve fat as one ages. Excess fat that obscures the entire upper
lid, however, can benefit from a modest removal with preservation of skin. Avoiding the “deer in the headlight syndrome”
is important and ensuring you seek out a surgeon that will adapt and customize
the aesthetic outcome to be accepting of your unique facial features and avoid
at all costs removing too much fat from the upper lid.

At the end of the day, beauty truly
is in the eyes of the beholder. Many
male and female upper lid forms do not ever require surgery, but simply the
confidence to express one’s natural genetic beauty.

I hope this information is of some assistance
and best of luck.

To find out more, please visit the
link below.

R. Stephen Mulholland, M.D.

Certified Plastic Surgeon

Yorkville, Toronto