Upper Anchor Blepharoplasty? (Photos)

Multiple opinions never hurt.  Fat simply does not do what we want it to do in the upper eyelid.  Having fat place in your delicate eyelid is only going to cause scar tissue in the delicate glide planes of the upper eyelid.  Anchor blepharoplasty is a fussy procedure that is very helpful for forming a new eyelid crease.  Certainly if I opened your eyelid, and it would not be for placing fat, I would perform an anchor blepharoplasty in closing the eyelid.  This is where the skin of the eyelid platform below the cut edge of the eyelid incision is anchored to the levator aponeurosis.  It is important to understand that very few oculoplastic surgeons and even fewer general plastic surgeon successfully employ this technique.  The simple reason is that is very fussy and precise.  However, your major issue is upper eyelid ptosis.  You appear to have an early levator dehisence ptosis.  It is possible that by performing an anterior levator resection, this will bring orbital fat forward with the advance levator aponeurosis making the hollow upper eyelid better.  Even without examining you, I don't recommend the plan outline by the surgeon you have seen.  I encourage you to find a surgeon you are comfortable with.  Consider using the geographic directory on the asoprs (American Society for Ophthalmic Plastic and Reconstructive Surgery) website.

Anchor blepharoplasty and upper lids are probably not for you. Get a second opinion from an experienced plastic surgeon.

"Anchor" blepharoplasty is a term that not very commonly used, and honestly, I'm not quite sure what your surgeon meant by that. He/she may mean reformation of an upper eyelid crease.

Looking at your photos, though a bit blurry, it seems to me that you have a mildly "Asian" look to your eyelids. This is partially because you have mild upper eyelid ptosis [droopiness], with a mild amount of excess skin, and poorly formed, if any, upper eyelid crease.

You might want to consider a subtle ptosis repair, with conservative skin incision and re-establisment of symmetric eyelid creases, if you have any. Again, with poor photo quality, it makes it difficult to say whether you would need fat grafting as well.

I would recommend another consultation with an ASOPRS trained Oculoplastics surgeon. You can find one close to you on the ASOPRS dot org website.

The primary goal of an upper blepharoplasty procedure is to remove excess skin on the upper lids.  From the picture shown there is a small amount of skin present but it does not appear that there are any fat issues on the upper lids.  We do not perform fat injections in the lower lids due to the lumpiness, unevenness, and unpredictability of the healing process related to fat grafts.

Keep interviewing plastic surgeons. For many, fat grafting in the brow / upper lid junction can produce very pleasing, natural looking and youthful results.

The upper eyelid is a thin structure that normally does not contain any significant amount of subcutaneous fat.  So fat grafting of the upper eyelid itself would not produce an aesthetically pleasing result, and would in fact be quite dangerous to attempt. The area between the brow and the upper eyelid crease, on the other hand, is full of subcutaneous fat in most young people, and that fullness looks youthful.  I refer to this area as the ‘brow-upper lid junction’, and I add fat to make it fuller in the majority of patients for who I perform eye-area rejuvenation surgery.
Take a look at the eyes of fashion models in advertisements: in most cases you actually see little to none of the upper lid.  What you see is a youthful soft tissue fullness that extends from the brow to the upper lid lashes. As we age, this fatty fullness atrophies and the brow-upper lid junction gradually becomes hollow.  The outline of the bony structures below the brow (the superior orbital rim) becomes visible, and one begins to look older, sometimes even ill, and in advanced stages even skeletal.  In some patients that I treat this appearance is inherited and they have a hollow look at their brow-upper lid junction at a young age.  It is also an appearance that some people have following an overly aggressive upper blepharoplasty, where the surgeon inappropriately removes fat from the brow-upper lid junction.