Is Blepharoplasty something to consider for me?
Will it have strong potential to ameliorate the appearance of my eyes?
It appears from this that the upper eyelid has a lot of excess tissue and may be causing
asymmetry as well as a droopy/tired appearance.
Does this seem to be the case and does this seems like exactly the job for an upper eyelid
surgery and would it be minimal?
If so, what sort of improvement/alterations could be done and what would be involved?
Thank you for your question!
In the question you submitted, you are describing excess skin over your eyes and whether or
not that excess skin is responsible for your tired and drooping appearance.
Now you submitted one photo and that one photo, I can appreciate that there are some skin
fold over your eyes.
But I think it's important that you learn a little bit about distinguishing an issue
related to excess skin versus an issue related to the muscle that lifts the eyelid.
What I'm talking about is ptosis or drooping eyelid versus dermatochalasis or excess skin
over the eyes.
With the photo you submitted, your upper eyelid look a little bit lower than what would be
typical and I suspect, what you are concerned about is more likely related to a condition
called ptosis.
Ptosis means drooping.
So when we talk about eyelid drooping called eyelid ptosis.
So let me help you understand a little bit about how I evaluate ptosis versus dermatochalasis
or when there's a combination of the two.
On examination of the eyelid, we do something like a ptosis evaluation.
We look at the several things.
We look at the center of the pupil and how it relates to the upper eyelid.
We call that the margin to reflex distance.
And when it's above a certain level, there is not ptosis.
When it's below a certain level, there is ptosis.
Now ptosis is also graded.
There can be mild, moderate or severe ptosis.
Before you move forward, I think it's important that you get a proper diagnosis.
As a cosmetic oculofacial plastic surgeon, which is a combination of background training
in eye surgery followed by specialized training in plastic surgery of the eyes, I can tell
you that I've seen many patients who had upper eyelid surgery where the plastic surgeon removed
skin in the upper eyelids to try to treat this drooping eyelids and yet the person still
looked tired.
And a significant percentage of those cases, it was due to the fact that the patient actually
had ptosis or drooping of the eyelid.
When I look at your photo, I noticed that the creases are very high and there is slight
difference of skin between the two eyes but if you could imagine, if that skin was not
there which would be a typical eyelid blepharoplasty, would that make a significant difference.
From one photo you submitted, I would say there would not be a significant difference.
In order to properly diagnose ptosis and come-up with a plan of how to address this ptosis,
there are some critical elements of the examination that have to be done.
I have to mention the margin to reflex distance and then we look at the activity of a muscle
called levator muscle.
The levator muscle is like the world elevator without the letter "e".
that is the muscle that is responsible for most of the function of the elevating your
eyelid.
I think your next step would be to meet with an ophthalmologist or an oculofacial plastic
surgeon and get an evaluation.
A proper examination to diagnose your situation is critical.
Otherwise, you may end up getting a cosmetic procedure when you may need a combination
of a muscle procedure or levator muscle procedure otherwise known as a ptosis correction to
help you improve that tired look.
In addition, it's very important when we evaluate ptosis to look at the history.
Look at your old photos.
Is this a change in your appearance?
That is also an element of the history that's very important for us to diagnose the cause
of the ptosis properly.
So, I think that you should not be hung up with just the extra skin over your eyelid
but also consider the diagnosis of ptosis.
So I hope that was helpful, I wish you the best of luck and thank you for your question.