What can be done to solve bad result from upper bleph? (photo)

Question

I had an upper blephoroplasty done 12 years ago and hated the result from day 1. I feel the surgeon was very aggressive removing too much fat and skin which left me with very small weird shape eyes, and low eyebrows. Each year it’s getting worse and worse. Eyes are very hollow and I appear angry. Is there a safe solution to get normal looking eyes again? Very unsymmetrical as well

Michael I. Echavez, MD · Answer

I understand that you appear to have an angry appearance after your upper blepharoplasty 12 years ago.  I would say the factor that most influences your angry appearance are the frown lines between your eyebrows.  This is something that is normally easily improved with Botox.  I would consider trying that first to see if it produces a result that is pleasing to you.

Thomas A. Mustoe, MD, FACS · Answer

At this point 12 years later I am sure the skin has relax d enough to perform a browlift which in my hands is done through a temple incision without visible scar and can easily be done in office under local anesthesia combined with a surgical weakening of the frown muscles through and upper blepharoplasty incision.  It would be helpful to look at old pictures prior to blepharoplasty to see how much fat was removed.  Sometimes fat grafting to upper eyelids can be very restorative.

Mehryar (Ray) Taban, MD, FACS · Answer

Upper eyelid filler injection is an effective treatment to correct hollowness after blepharoplasty. You also appear to have mild right upper eyelid ptosis.

Kenneth D. Steinsapir, MD · Answer

Your surgeon probably considered this a very good result.  That put you and your surgeon on two completely different wave lengths: You say bad and he or she says good. I am in the business of fixing these post blepharoplasty eyes.  I call your result the Post-Upper Blepharoplasty Syndrome (PUBS). The good news is that these are fixable. The upper eyelid creases need to be lowered, the upper eyelid tendon is generally disinserted and this needs to be lowered to the new crease.  Orbit fat is mobilized from the scar tissue and repositioned into the upper eyelid fold, and the upper eyelid lash ptosis is corrected with an anchor blepharoplasty. Individuals who travel to see me for this spend about a week in Los Angeles.  I see many folks from your area for aesthetic reconstructive eyelid surgery.

Sanjay "Jay" Keni, MD · Answer

Hi Lolo6666,Sorry to hear your upper blepharoplasty results were not to your liking.  It must have been hard carrying that with you for the past 12 years.At this point, I suggest looking forward.  Before you consider any surgical procedures, try some Botox to your frown lines to help alleviate the angry look.And let me reassure you, you have normal looking eyes.  There is nothing odd or glaringly asymmetrical about your appearance from the photo you posted.Best wishes on your journey,Dr. Jay

Amiya Prasad, MD - Account Suspended · Answer

Thank you for your question. You are asking about what you can do about an upper eyelid blepharoplasty you had 12 years ago which you weren’t happy with from day 1. You feel that your surgeon removed too much skin and fat, so your eyes look hollow, small, and with low eyebrows.
I can certainly guide you with this in the absence of a physical exam, and with just your photos for reference. I’m Dr. Amiya Prasad. I’m a Board Certified Cosmetic Surgeon and Fellowship-trained Oculoplastic Surgeon. I’ve been in practice in Manhattan and Long Island for over 20 years. As an Oculoplastic surgeon, I specialize in upper and lower eyelid surgeries, as well as revision surgery for procedures originally performed by other doctors.
On your right upper eyelid, I can see some some hollowing, which may also account for your lowered eyebrows. For people who have too much fat removed above the upper eyelids, we can place a cosmetic filler, or in some cases do a fat transfer to treat the hollowness. If this is not the cause of your eyebrows looking lower, I would have to see what you looked like prior to surgery, as well as examine your brow to see if this is due more to natural facial aging rather than your previous surgery. Upon closer examination, I would then recommend a procedure like a surgical brow lift, or even a non-surgical brow lift using Botox.
As for eyelid skin shortage due to too much skin being excised, this is not apparent in your single picture. One way to immediately determine if too much eyelid skin was excised is by seeing you close your eyes - if the eyes can’t close fully, then there is a skin shortage, and too much skin was removed. In these cases, I would perform a skin grafting, or grafting material procedure such as Enduragen to reconstruct the upper eyelids so you regain complete eye closure. Again, I would have to physically examine your eyelids to see if there is enough of a skin shortage to do this.
If you are unhappy with your original surgeon, especially this long after your original surgery, I advise that you meet with cosmetic eyelid specialists such as oculoplastic or oculofacial surgeons who perform revision surgery. They can properly assess your situation, and give you the best guidance for having eyelid revision and reconstruction procedures. I hope you found this information helpful. Thank you for your question.

What can be done to solve bad result from upper bleph? (photo)

Answers (6)

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