Would I be a good candidate for Upper Blepharoplasty? If not, what options are there? (photos)

Question

When looking up before and after’s of this procedure, I never see eyes like mine. I don’t really have hooded eyelids, but my upper eyelids have always been really puffy. And I’m hoping a procedure like upper blepharoplasty would decrease the puffiness. But I’m not sure if I’ll be a good candidate for it, If not, are there any other procedures that could help? Not sure if I really have compensatory eyebrow elevation, but I’m not an expert so I don’t know. My eyebrows are completely relaxed in all these photos, but they are styled with a very high arch which is why they might look “raised”.

A.J. Amadi, MD · Answer

Based on your photo, you are demonstrating compensatory eyebrow elevation. This happens when you have a droop of the eyelid (ptosis) which is due to slippage of the muscle that opens the upper eyelid (levator disinsertion). Another clue to this anatomic change is the fact that you do not have a single, strong eyelid crease. Other anatomic features illustrated in your photo are a prominent globe and left medial upper eyelid fat prolapse (slight bulge in the left upper eyelid towards the nose).
You are correct that your anatomy is not what you commonly see in before and after photos. Your anatomy is challenging and needs an eyelid specialist for the best possible results. Most general plastic surgeons do not have the necessary training and/or experience to give you the ideal results. 
Seek out an experienced Oculofacial plastic surgeon (Oculoplastics). Virtual consultations are available.

C. Blake Perry, MD · Answer

Upper eyelid surgery would allow the reduction of some of your eyelid fat. This has to be done judiciously to ensure you don’t get a hollow look. Best to see an eyelid expert.

David K. Isaacs, MD, FACS · Answer

It's difficult to assess your upper eyelid skin because you are raising your brows and it's redistributing the skin. 
You also appear to have prominent eyes and this is extremely important to evaluate and take into consideration when considering upper (or lower) blepharoplasty. 
Blepharoplasty doesn't necessarily treat "puffiness" or swelling.
Prominent eyes and puffiness can be due to various medical conditions. One example is thyroid eye disease. 
You should have a proper evaluation with an Oculoplastic surgeon.

Kenneth D. Steinsapir, MD · Answer

You have relatively prominent eyes. The upper eyelid have a very long eyelid platform and a complicated upper eyelid crease. Extra skin, muscle, and fat is what is addressed with standard blepharoplasty. You appear to have a central levator disinsertion and a significant compensatory eye brow elevation. The right upper eyelid appears to have a herniation of the lacrimal gland. Caution is advised.

Suk Ho Yoon, MD - Account Suspended · Answer

Thank you for your question. 
This is Dr. Yoon Sukho, a board-certified plastic surgeon in Korea.
Judging from the photo, there is fat on the eyelids, which makes you look puppy, and there are several layers of eyelid lines that makes you look tired.
If we remove the eyelid fat and make the double eyelid line into one, you can improve your eyes to look clearer, younger and more beautiful.
After enough consultation with the surgeon in charge, various surgical methods such as upper blepharoplasty surgery, eyelid correction surgery, double eyelid surgery, and fat removal can be suggested.
We hope that you will visit a doctor who has experience in eye plastic surgery to receive examination and consultation, and find the best surgical method for a successful operation.

Robert T. Buchanan, MD (retired) · Answer

You are correct. You appear to have a very unusual problem. Although an in person exam would be required to know for sure, you appear to have asymmetrically enlarged upper lid fat pads, the lateral one on the right and the medial one on the left. Though I almost never remove fat from the upper lid, it appears that trimming the excess fat would improve your symmetry and restore normalcy. Make sure you see a plastic or ophthalmic plastic surgeon very experienced in eyelid rejuvenation.

Would I be a good candidate for Upper Blepharoplasty? If not, what options are there? (photos)

Answers (6)

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