Hi, I'm 31 years old and feel that my upper eyelids are already sagging, making me look tired and old... It runs in my family - my mother has a similar problem, developed much further. Am I too young for eyelid surgery? If its genetic, will correcting it early be good - or should I too it as late in my life as possible? Many thanks!
31 Too Young for Upper Eyelid Surgery?
Doctor Answers 19
While you are not too young, you must be very careful. Many surgeons will quickly offer you an upper lid blepharoplasty but this procedure alone would be misguided in your case. You have what is called compensated brow ptosis which means your brows are already in a very low position and your brain is constantly activating the frontalis muscle to keep your upper eyelid skin out of your eyes. If you get an upper blepharoplasty alone your frontalis tone will likely drop giving you a very unaesthetic brow position. For your upper eyelids you should have a lateral hood lift to support your lateral brow and actually keep it elevated without frontalis tone, A lateral hood lift will also clean up the fullness next to the side of your eye. For your lower lid I would recommend a subcilliary blepharoplasty with fat conservation and transposition, a lateral canthopexy and a lateral retinacular suspension of the orbicularis muscle to give you a beautiful and lasting result. Fat grafting may also be combined to improve your cheek contour. I hope this helps!
All the best,
Rian A. Maercks M.D.
Too Young for Eyelid surgery?
In my experience this is not as much age-related as it is genetics and facial type. As you've pointed out, some individuals have more skin excess at age 30 than others will have at age 40. I might recommend eyelid surgery but would want to examine you and your skin and would like to see a photo of your mother to give me a better idea of what I'm working with. An advantage to earlier surgery is that you enjoy it for a very long time—especially because results in young skin tend to be longer lasting.
Too Young for Upper Eyelid Surgery?
No, you are not too young. Though the aging process continues, the procedure will set you back in time and you will always look better than you would have had you not had the surgery. If it bothers you now, there is no sense in waiting.
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Less is more.
Yes you can and should have eyelid surgery. There are other options as well. The challenge you have is finding a surgeon who will do what I call a micro-blepharoplasty. This is a very precise anchor blepharoplasty, the goal of which is to preserve the upper eyelid fold but expose a uniform amount of upper eyelid platform. This surgery also removed a small amount of eyelid platform skin just below the upper eyelid fold and anchors the skin of the eyelid platform and the underlying muscle to the tendon of the levator labii superioris muscle that is responsible for lifting the eyelid. However this muscle is also responsible for forming the upper eyelid crease. By creating a very precise support for the upper eyelid platform skin and muscle, the upper eyelid platform skin is smoothed and taut and the upper eyelid lashes are supported making them look perky. There are very few surgeons who understand these details. Below is a link to my website showing the results of this kind of eyelid surgery.
Upper Eyelid Surgery
You may be a better candidate for a brow suspension. It is hard to tell from this singel photograph if anything else would be necessary after the brows are placed in a better position.
Genetics play a role in timing for surgery
Many patients are born with heavy upper eyelids, others may acquire it early because of genetics. Either way, restoring a more youthful open eyelid can be a very rewarding procedure.
Many people set arbitrary ages for having procedures done. In reality we do not age according to external time lines. The best way to think about it is, to have the procedure when it becomes a concern to you. You get to enjoy it for so many more years.
Brows and eyelid skin
Your situation seems more genetic endowment versus skin changes from maturational processes. While your photo doesnt appear to demonstrate eyebrow issues, but do you feel that the sagging of your eyelid and subbrow tissue is primarily at the end of the day? It is worth a visit to an ASOPRS-credited oculoplastic surgeon to help discuss your concerns.
Botox instead of eyelid surgery?
There is no right or wrong age for having eyelid surgery as long as its being performed for right reason. A blepharoplasty is usually performed to remove extra skin and sometimes fat from the eyelid. Your photo however doesn't show that much. What it does show is a slightly low eyebrow that gives the illusion of fullness of the eyelid. This can be corrected simply with Botox injections just below the side of the eyebrow which will lift the brow and pull up some of the skin currently overlying your eyelids. This will buy you time for a few more years then you may consider surgery. At that time I would recommend an endoscopic browlift in addition to a blepharoplasty.
What age should I be for eyelid surgery
There is no magic age for eyelid surgery. The time to consider plastic surgery is when something really bothers you. A consultation with a board certified plastic surgeon would be your first step. In fact, consulting with several surgeons may be worthwhile. They will give you an honest assessment, and discuss options. There may be nonsurgical options available such as Botox. Upper eyelid surgery is typically done on an outpatient basis, and it is generally best to take 7-10 days off to allow for your recovery. Best wishes.
Michael Vincent, MD, FACS