Second Upper and Lower Eyelid Surgery Recommended?

Question

I have been told that once upper and lower eyelid surgery has been performed, that subsequent eyelid surgeries are not recommended as they often do not go well. Is that true? I had an upper and lower bleph done 20 years ago and it looked great for many years. Now at 63 years old, due to aging and a bad fat transfer procedure, I am considering a 2nd upper/lower bleph... but am worried about trying it a 2nd time. What are your thoughts on 2nd bleph surgeries?

Kenneth D. Steinsapir, MD · Answer

Your upper eyelids are sunken.  This can occur over time but removal of the upper eyelid fold at the time of blepharoplasty can certainly contribute to the process.  There is essentially not a drop of spare skin in your upper eyelids.  However your upper eyelids are droopy or ptotic with the upper eyelid margin encroaching into the pupillary axis.  The hollow upper eyelids are consistent with a particular type of upper eyelid ptosis known as levator dehisence ptosis.  Will you benefit from ptosis surgery?  The answer yes must be also weighed against how dry your eyes are.  Right now the heavy upper eyelids protect the corneal surfaces. When the upper eyelid margin is lifted with ptosis surgery, more of your cornea will be exposed to the air which can contribute to drying.  A detailed consultation is really needed to accurately address this question to be certain that performing this type of surgery will not cause excessive eye dryness.  Regarding the lower eyelid, again from the photo I suspect that a chemical peel rather than surgery might be a better approach for you.  Can eyelids benefit from more than one surgery, The answer is yes, but it is wise to have things done right the second time around.

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

It is perfectly safe to do revision surgery on the eye's. More care and attention needs to be taken however as it depends on an individual skin muscle and fat components that need to be addressed either independently or together to achieve the desired resultDiscuss with your plastic surgeon and ask of the experience of doing revision eye lid surgery.

A.J. Amadi, MD · Answer

Eyelid ptosis and volume loss is the problem most obvious in the photo you have posted. The eyelids are droopy. You are obviously compensating on the left eyelid with your brow elevation.

	Addressing the eyelid ptosis may also improve the hollowness of the upper eyelids, but certainly fillers or fat grafting [done appropriately] would also improve this hollowness.

	 

	

	If you decide to explore this further, I would recommend consultation with an ASOPRS trained Oculoplastics surgeon. You can find one close to you on the ASOPRS dot org website.

Toby Mayer, MD · Answer

Secondary blepharoplasty should give good results if you have an experienced surgeon. Make sure that a forehead lift is not what you need-cannot tell from photos.

Mark Beaty, MD · Answer

There is no specific problem with performing a second blepharoplasty procedure, especially 20 years after your initial surgery.  With any revision surgery changes resulting from the previous procedure must be taken into account so you should consult with a surgeon with experience performing second blepharoplasties.  Additionally, the aesthetic considerations will be different for you now since you are 20 years older and have had fat transfer.  All of this needs to be discussed to determine which procedures are best for you.

Second Upper and Lower Eyelid Surgery Recommended?

Answers (10)

Answer: Secondary blepharoplasty should give good results.

Answer: Secondary blepharoplasty should give good results.

Answer: Secondary blepharoplasty

Answer: Secondary blepharoplasty

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Everything you need to know about Eyelid Surgery

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Second Upper and Lower Eyelid Surgery Recommended?

Answers (10)

Answer: Secondary blepharoplasty should give good results.

Answer: Secondary blepharoplasty should give good results.

Answer: Secondary blepharoplasty

Answer: Secondary blepharoplasty

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Recommended reading

Everything you need to know about Eyelid Surgery

Our mission is to create a world where every investment in modern beauty is Worth It.