What are my best options to fix my Multiple Eyelid Folds/Excessive Eyelid Skin? (photos)

Question

I have looked into blepharoplasty and based on the photos I attached, I want to know if that is likely my best option. (In my opinion) I have extreme upper eyelid folds/creasing and lots of excess skin. I have gotten Botox to try and lift but that never did anything.

Kenneth D. Steinsapir, MD · Answer

There is no substitute for a personal examination.  However, you have slightly heavy upper eyelids, a compensatory brow elevation, and a hollow upper eyelid.  You also have upper eyelid lash ptosis due to lack of support in the upper eyelid lashes.  This shades the upper part of the cornea and makes the eyes look dull rather than jewel like.  What you see as "extra" skin is a collapse of your upper eyelid fold.  Most eyelid surgeons you will see will blithely remove this skin with blepharoplasty.  Unfortunatley this will skeletonize your youthful eyelid.  What you need is what I call an anchor microblepharoplasty.  This procedure is about structure not removing skin, muscle, and fat.  You elevator aponeurosis, the tendon of the muscle that opens the upper eyelid, it partially disinserted.  When this occurs, it takes the anterior orbital fat that normally provides volume to the upper eyelid fold back into the orbit.  By reattaching the levator aponeurosis to the upper eyelid tarsus, the volume to the upper eyelid fold is restored.  Additionally, the properly positioned levator is used as an anchor to support the upper eyelid platform skin which is snugged up like one snugs a bed sheet.  That in turn supports the upper eyelid lashes.  Study the attached video and my free ebook cited below.

Natalie Ngan, FRACS (Plast) · Answer

Blepharoplasty surgery looks like it would be a good surgical option for you based on these photos. The surgery involves removing the excess skin as well as fat in the eyelids to give a rejuvenated appearance. I suggest finding a specialist plastic surgeon in your area to consult on possible treatment options.

Athanasios Christopoulos, MD · Answer

I believe that trying to correct your problem with non invasive methods as botox, is going to fail.

The only solution that you have is to do an upper lid blepharoplasty. This is a very small procedure, office based, and the only problem that you are going to have is the black eyes for one week. The result, usually lasts for many years.

Dilip D. Madnani, MD, FACS · Answer

Than you for your pictures!. You have excess skin of the upper eyelids and would do very well with an upper eyelid blepharoplasty. These procedures are performed under local anesthesia in the office and take about an hour to perform. This will clean up the excess eyelid folds and make the eyelids appear more open and less tired.

Richard W. Westreich, MD · Answer

For excessive skin and multiple folds, an upper eyelid lift is a great option. It is minimally invasive, in that the surgery and recovery are much quicker than other facial procedures - days not weeks. If you have been considering this, I strongly recommend you get it done rather than look for other non-surgical options. You will be happy for many years with your choice.

Prashant Soni, MD · Answer

Based on your photos, it seems you are a good candidate for an upper lid blepharoplasty. It seems that all you would need is a strip of excess skin removed with no removal of muscle or fat . I generally perform this in the office with local anesthetic alone. However you may choose to have it done in the Operating room as well.

Best regards, prashant Soni md

Best regards, prashant Soni md

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. Based on your
photograph, you may be a good candidate for an upper eyelid blepharoplasty.  This can be performed with scarless result.  Make sure you
specifically look at before and after pictures of real patients who have
had this surgery performed by your surgeon and evaluate their results.  The
most important aspect is to find a surgeon you are comfortable with. I
recommend that you seek consultation with a qualified board-certified plastic
surgeon who can evaluate you in person.
Best wishes and good luck.
Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Brian A. Pinsky, MD, FACS · Answer

Thank you for your question.  It is difficult to tell from your photos, but you appear to be very young.  In general, an upper blepharoplasty is a great operation for reducing excess skin of the upper eyelids.  It is minimally invasive with only modest downtime and recovery.  You may have early levator dehiscence, or separation of the upper eyelid muscle from its normal insertion point on the upper eyelid tarsus.  This would result in a high-riding eyelid crease and worsen the redundant appearance of the upper eyelid skin.  It usually also results in a degree of ptosis, or droopiness of the upper eyelids.  You may have been born with this as congenital ptosis is not uncommon.  Both the eyelid muscle and any excess skin present can easily be treated in the same operation.  It's critical not to skeletonize the eyelid and remove any fat to maintain a youthful upper eyelid.  The best thing to do is see a board certified plastic surgeon for a consultation.  Good luck!

William Portuese, MD · Answer

The photographs demonstrate hooded and excess eyelid skin on the upper eyelids for which an upper eyelid blepharoplasty procedure can accomplish removal.   Look  for a experienced  eyelid surgeon for best results.

Robert Schwarcz, MD · Answer

From your photos it appears you would be a good candidate for an upper eyelid Blepharoplasty.  This could address the issue of the redundant skin you have in your upper eyelids. Based on your photos I would caution in removing  much fat or muscle from the upper eyelids. This could result in  your eyes having a hollowed look in the future which could make them look older.   Eyelid surgery should be approached in a custom like fashion I always have an in-depth  consultation with the patient evaluating old photos to examine contour and fullness of the eyelid as well. I would recommend seeking an oculoplastic surgeon or someone with a focus on eyelids but most importantly a surgeon you are comfortable with.

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