Eyelid Surgery to Tighten Excess Skin?
I am wondering what would be the best treatment, surgically or otherwise for my upper eyelids?
I am scared surgery will leave me with a lot of lid just above my lash line and will make
my eyes appear more bulging with little volume in the area below my brow.
Would pixel laser treatments be able to tighten this excess skin?
The side view is taken in the morning and looks a little puffier than it normally does.
Thank you for your question!
You submitted questions with photos and you've asked about a pixel laser and about your concern
about having eyelids surgery to help tighten up the skin over your eyes.
And one particular concern you have now is the eye not looking too bulgy.
So as a cosmetic ocular facial plastic surgeon, I deal with this question everyday and it
is important to really understand the limits the lasers, surgeries and also have a clear
understanding of outcome that's why you submitted the question.
But there is a 3 dimensional aspects of this that we can't address without a physical exam.
So when someone like yourself comes to my practice, this is what I typically do.
I'll have them sit down and I'll apply a cue tip and just kind of roll the skin underneath
to show what would the strategic reduction of excessive skin to change the appearance.
I also noticed there is a little puffiness in the inner corner of the eye so if you are
considering just a laser procedure you would not be able to address that puffiness because
that puffiness in the inner aspects represents the inner eyelid fat prolapse so since you
can't laser off fat from the outside.
You will need surgery to reduce the fat so it's very important to have a clear expectation
of what you will look like after a procedure.
Now people have tried to address upper eyelid excess skin with laser.
What are we doing when we are applying laser, we are applying thermal energy heat to try
to get the skin to contract in a way and smoothen to the point where a lot of that extra skin
gets tighter.
The thing is when you try to apply heat aggressively; it becomes difficult to predict how much skin
you'll tighten into what degree so you could consider try a laser like a CO2 laser.
People have done that and invariably there is improvement.
The question you have to ask yourself is to how much improvement would be acceptable to
you.
So I think a consultation with a qualified surgeon would be very important.
And looking at yourself with the rolling of the skin so you could see how much eyelid
would show.
The reality is you can have a certain range of skin that can be addressed.
You have to understand, your eyes are prominent when you close your eyes you have to have
enough skin to be able close your eyes so if you're trying to just basically cover a
round shape, you can't just aggressively take so much skin that you will have difficulty
with eye closure.
So there is a range you can be conservative or slightly more than conservative but you
can't be too aggressive.
So a lot of times patients like yourself, I would do a combination if its textural issue
of the skin is part of this I would do a conservative removal of skin and I would do fractional
Co2 laser this way we address both and I will take a little of the fat pocket and give you
a nice smooth contour.
I think sometimes we need to look at ourselves from the big picture rather than focusing
on the little details and get a sense what does your face look like in terms of the appearance
that you project and use that as a measure instead of just isolating on the eyes alone
because it's in context when people see you they looking at the whole picture and when
your eyes look brighter and more open then that certainly won't make it too bulgy.
So again meet with the qualified eyes specialist and learn about your options and get a sense
of what you can expect from a procedure like upper eyelid surgery conservative and combination
with CO2 laser but I probably would advice against doing just the laser alone again this
is all based on just the photos and not the physical exam so I hope that was helpful and
thank you for your question.