"My eyes look droopy." "My eyelids are hooded." "I just look tired all the time."
I hear some version of this in nearly every upper eyelid consultation. The patient has done their research, they've watched the videos, and they've already decided they need an upper blepharoplasty — eyelid skin removal.
Sometimes they're right. But more often than I think people expect, the droopy appearance they're seeing isn't caused by one thing. It's caused by several things happening at the same time, and if you only address one or two of them, you're going to be disappointed with the result.
This is the conversation I have with patients every day, and it's the one I rarely see covered well online. So let me walk you through how I actually evaluate an upper eyelid — not the textbook version, but the way I think about it in real consultations — and why it matters for your outcome.
The "ingredients" approach: why droopy eyelids are far more complicated than they look
I explain this to patients using a cooking analogy. When you taste a dish, you experience the final flavor — but that flavor is made up of individual ingredients. Change one ingredient and the whole dish tastes different.
Your upper eyelid appearance works the same way. What you see in the mirror — that heavy, hooded, droopy look — is the "dish." But the ingredients creating that look can include any combination of these distinct factors:
- Eyelid ptosis — a weak or stretched eyelid-opening muscle
- Dermatochalasis — excess eyelid skin
- Low eyelid crease — the fold that defines the upper lid sits lower than ideal
- Skin quality changes — thinning, loss of collagen, and reduced elasticity over time
- Upper eyelid and brow volume loss — orbital fat depletion and soft tissue deflation
- Brow ptosis — the eyebrow dropping from its youthful position
- Orbital shape changes — the eye socket transitioning from a round, full contour to a more squared, hollow appearance
- Muscular function changes — shifts in how the frontalis (forehead muscle) and orbicularis oculi (eyelid-closing muscle) behave over time
Each of these ingredients has a different cause, a different treatment, and a different expected outcome. Most online resources reduce this down to "excess skin" and maybe mention ptosis. But the reality is far more layered, and understanding the full picture is what separates a good result from a great one.
Ingredient #1: Eyelid ptosis — the one that gets missed most often
Eyelid ptosis is a weakening or stretching of the levator muscle — the muscle responsible for actually opening the eyelid. Think of it like a garage door that only opens three-quarters of the way. The door itself (the skin) might look fine, but the mechanism that lifts it isn't working at full strength.
This is one of the most commonly missed diagnoses in cosmetic eyelid surgery. A patient comes in with what looks like excess skin, and it may be — but the reason that skin looks so heavy is partly because the eyelid itself isn't opening all the way.
If you remove the skin but don't address the weak muscle, the eyelid still sits lower than it should. The patient may look a little better, but they often feel like something is still "off."
How I test for ptosis
In my consultations, I measure the margin reflex distance — how high the eyelid sits relative to the center of the pupil. I also assess levator muscle function to understand how strong or weak the opening mechanism is.
For patients who do have ptosis, I use a diagnostic tool called the phenylephrine test. I place a drop of phenylephrine on the eye, which temporarily stimulates a secondary eyelid-lifting muscle called Müller's muscle. If the drop lifts the eyelid to a good position, it tells me that a procedure called a conjunctivomüllerectomy (CME) — performed from the inside of the eyelid with no visible incision — is likely to work well.
If the phenylephrine test doesn't produce enough lift, I know the patient needs an external levator surgery, which involves tightening or reattaching the primary lifting muscle through an incision in the eyelid crease.
Two patients can both have eyelid ptosis but need entirely different surgeries based on how their muscle responds. Getting this evaluation right is the difference between a result that looks natural and one that doesn't quite work.
The Hering's law surprise
Here's something that catches patients off guard: if one eyelid is ptotic, the brain often compensates by maximally stimulating both eyelid muscles. This is called Hering's law of equal innervation.
What this means in practice is that sometimes the "good" eye is actually being held up by extra effort from the brain. When you fix the droopy side, the brain relaxes its overdrive — and the other eyelid can drop.
Patients sometimes actually prefer the appearance of their ptotic eye because the compensation has given it a higher crease or a more elevated brow. I always discuss this possibility before surgery so there are no surprises.
Ingredient #2: Dermatochalasis — the familiar one
This is what most people picture when they think of upper blepharoplasty. Over time, the thin skin of the upper eyelid stretches and becomes redundant. It folds over the eyelid crease, sometimes draping all the way down to the eyelashes.
Dermatochalasis is the ingredient that upper blepharoplasty directly addresses. The surgery removes the excess skin and restores a visible eyelid crease and a more open appearance. But there's more nuance to the procedure than most patients realize.
What happens beyond the skin
Upper blepharoplasty isn't just about skin. During the procedure, I'm also evaluating and managing the orbital fat and the orbicularis oculi muscle — and how I handle these tissues matters significantly for the long-term result.
The upper eyelid has two main fat compartments: the nasal (inner) fat pad and the central fat pad. They behave very differently over time. The nasal fat pad is richer in stem cells and tends to herniate forward as the tissues weaken with age — so some patients develop visible fullness or puffiness on the inner part of their upper lid. The central fat pad, by contrast, tends to lose volume over time, contributing to the hollow appearance that many patients develop.
If there is a true excess of nasal fat, I can reduce it — but conservatively. Removing too much orbital fat is one of the mistakes that leads to a hollow, skeletonized, "surgical" look that's very difficult to reverse. In some cases where there's enough nasal fat excess, I can actually transpose that fat centrally — moving it to the area where volume is naturally depleted. This borrows from the surplus to fill the deficit, improving contour without any additional grafting.
I also almost never remove any of the orbicularis oculi muscle during blepharoplasty. This muscle weakens naturally with age, and it provides important volume to the eyelid. Preserving it helps maintain a natural, full appearance rather than creating the thinned-out look that can result from overly aggressive tissue removal. In selective cases, I may strategically weaken a small lateral portion of the orbicularis — the same area where Botox is injected for crow's feet — to help elevate the outer part of the eyelid and brow, though the effect is modest.
Lateral upper eyelid fullness
Some patients come in with noticeable fullness or puffiness on the outer (lateral) portion of their upper eyelid. This is a distinct finding that can have two very different causes, and distinguishing between them matters.
The first possibility is lateralization of the central fat pad — the fat has shifted outward from its normal position. If this is the case, a small portion can be removed or repositioned back toward the center where volume is often needed.
The second — and less commonly discussed — possibility is prolapse of the lacrimal gland. The lacrimal gland (the tear-producing gland) normally sits tucked in a small depression called the lacrimal gland fossa, just behind the upper outer rim of the eye socket. It's held in place by retaining tissue. Over time, that retaining tissue can weaken, and the gland slips forward, creating a visible bulge in the outer upper lid.
When this is the cause, and I've confirmed it's not related to any underlying condition, the gland can be reduced by a small amount and repositioned back into the lacrimal gland fossa. This is a more specialized aspect of upper eyelid surgery that requires careful evaluation — the lacrimal gland serves an important function, and its management needs to be thoughtful.
When dermatochalasis is the only ingredient contributing to a patient's droopy look, an upper blepharoplasty alone can produce a very satisfying result. But dermatochalasis is frequently not the only thing going on — it's just the most visible thing.
Ingredient #3: Eyelid crease position — too low or too high
The eyelid crease — the fold where your upper lid skin transitions from the eyelid to the area below the brow — plays a major role in how open and defined the eye appears.
Low eyelid crease
When the crease sits lower than ideal, the eyelid looks heavier and more hooded, even if the actual amount of excess skin is modest.
A low crease can be congenital (some patients are simply born with a lower-set crease, which is particularly common in Asian eyelid anatomy), or it can develop over time as the tissues stretch and the crease attachment weakens.
Upper blepharoplasty can address a low crease by resetting the crease position — removing skin and setting the fold at a more aesthetically favorable height. This is one of the reasons the same operation can look dramatically different between two patients: one is primarily removing excess skin, while the other is also redefining crease height and shape.
High eyelid crease
What many patients don't realize is that the crease can also sit too high — and this is its own distinct problem with different causes.
A high crease is most often the result of eyelid ptosis or loss of orbital fat volume. When the levator muscle is weak (ptosis), the way it attaches to the skin can change, pulling the crease up. When orbital fat deflates, the skin folds in on itself at a higher position simply because there's less tissue underneath to support it.
Most patients with a high crease don't ask to lower it — they're used to how it looks and may not even realize the crease position has changed. But when ptosis surgery is performed, it's often best to set the crease at a more anatomic position, usually at about the height of the upper eyelid tarsus (the firm cartilage-like plate that gives the eyelid its structure). If the high crease is primarily related to volume loss, I typically use the patient's lowest crease as the reference for their natural crease height.
When a patient wants to change their crease height
Whether the goal is raising or lowering the crease, this is a procedure that needs to be approached carefully. Changing crease height alters the overall character of the eye, and the result has to be compatible with the patient's facial features as a whole — not just the eyelid in isolation.
Lowering a crease that's high from prior surgery or patient preference is technically more challenging. It requires that orbital fat and orbicularis oculi muscle are still present to some degree, because these tissues are needed to prevent the old, higher crease from reattaching. Without them acting as a barrier between the skin and the deeper structures, the prior crease can reform.
This is another reason I take a conservative approach to removing tissue during any eyelid surgery — preserving fat and muscle gives us more options for the future if crease adjustments ever become necessary.
Ingredient #4: Skin quality changes
This is the ingredient most patients can feel but don't know how to describe. Over time, the skin of the upper eyelid loses collagen and elasticity. It becomes thinner, crepe-like, and less resilient. Sun damage, genetics, and the natural aging process all contribute.
What makes skin quality tricky is that surgery doesn't fix it. You can remove excess skin, but if the remaining skin is thin and inelastic, the texture and surface quality of the eyelid may not look as youthful as the patient hopes.
This is where nonsurgical treatments play an important role alongside or instead of surgery. Laser resurfacing, chemical peels, and mesotherapy can improve skin texture, stimulate collagen production, and restore some of the thickness and tone that aging takes away.
But honestly, the most important thing — and probably more important than any of those treatments — is what you do every day. Good daily skin care is the foundation. That means consistent sunscreen use, quality serums, moisturizing, and controlling any underlying inflammation like rosacea or allergies that chronically stress the skin. No laser or chemical peel will outperform daily neglect, and no surgery can replace the cumulative benefit of years of good skin care habits.
I often discuss these as complementary layers: daily skin care as the foundation, in-office treatments like lasers and peels as periodic boosters, and surgery for the structural changes that neither can address.
Ingredient #5: Upper eyelid and brow volume loss
As we age, we lose volume in places we didn't expect. The fat pads in the upper eyelid and around the brow deflate over time, and the result is a hollowed, skeletonized appearance — particularly noticeable at the outer corner of the brow and above the eyelid crease.
This volume loss contributes to the droopy look, but it's different from excess skin. In fact, some patients who feel like they have "too much" eyelid skin are actually experiencing volume deflation that makes the existing skin drape differently. Volume loss also directly contributes to brow ptosis — when the brow deflates, it loses structural support and falls.
The treatment here is volume restoration — typically through fat grafting to the brow region. The goal is to reinflate the brow three-dimensionally, restoring the fullness and support that aging has taken away. This does double duty: it improves the volume itself and provides some lift to the brow by restoring the scaffolding that was holding it up.
For patients with hollowness in the upper eyelid, fat can also be placed along the bone of the superior orbital rim — the ridge just above the eye socket — which softens that sunken appearance without injecting directly into the eyelid or orbit itself. I'm cautious about placing fat within the orbital space. The anatomy is intricate, and I prefer to restore volume in areas that are both safer and more predictable.
Fat grafting is rarely done in isolation. When I'm grafting the brow, I'll typically evaluate and treat the surrounding areas at the same time — the forehead, the temples, and any other adjacent structures that have lost volume. The face ages as a connected whole, not in isolated zones, so restoring volume in one area while ignoring the deflation around it can look unbalanced.
The key to natural fat grafting is placing it in the right layer — either in the tissue plane where the volume was originally lost, or in a layer that will look and feel natural once it integrates. Fat placed in the wrong depth or the wrong plane can look lumpy, uneven, or simply wrong. This is a technique-dependent step that makes a significant difference in the final result.
Ingredient #6: Brow ptosis — the hidden contributor
The eyebrow plays a bigger role in upper eyelid appearance than most patients realize. But here's something most people haven't considered: the brow is just a collection of hairs. It gets the blame for drooping, but the brow itself isn't the problem — it's a passenger, not the driver.
What actually causes the brow to drop is the tissue above it. There are strong retaining structures along the brow area that anchor it to the bone. As we age, the scalp and forehead descend — pulled down by gravity and the weight of the tissue — and that descent pushes the brow down with it. Combined with volume loss (which removes structural support) and changes in muscle function, the brow gradually settles lower than where it started.
This is why some patients who've already had an upper blepharoplasty still feel like their eyes look hooded. The skin was addressed, but the real issue was brow position — or more precisely, forehead and scalp descent pushing the brow down onto the eyelid.
Brow ptosis is also a compensatory clue. In patients with eyelid ptosis, the brain recruits the frontalis muscle to elevate the brow, which indirectly lifts the eyelid skin out of the way. These patients develop deep forehead lines — not from expressiveness, but from working overtime to keep their eyes open.
How a brow lift actually works
A brow lift is less about positioning the brow where you want it and more about restoring it to where it used to be.
The procedure — which I perform endoscopically through small incisions hidden in the hairline — works by freeing those strong retaining attachments that anchor the brow, forehead, and a large portion of the scalp to the underlying bone. Once freed, the entire tissue layer can be reset and redraped back to its original position. Think of it less like pulling something up and more like releasing something that's been pulled down.
This distinction matters for how I handle asymmetry during a brow lift. When one brow sits lower than the other — which is very common — the correction isn't about pulling the lower side harder. It's about freeing that side more completely from its dense connections to the bone, allowing it to passively elevate to match the other side more closely. Aggressive pulling creates an unnatural, surprised look. Releasing and resetting produces a result that looks like you, just restored.
Why brows can drop after eyelid surgery
This is something I discuss with every patient before surgery, because it catches people off guard when they aren't expecting it.
Both ptosis surgery and upper blepharoplasty can cause the brows to drop after the procedure. This is not the result of something done incorrectly during surgery. It's a normal physiological response — and it can't always be predicted ahead of time.
Here's the mechanism: when the eyelids can't open well due to ptosis, the brain unconsciously drives the frontalis muscle to work harder. The frontalis lifts the brow, which indirectly pulls the eyelid skin upward, giving the patient some improvement. It's an automatic workaround — patients don't even realize it's happening. When the ptosis is corrected surgically and the eyelid can open on its own, the brain no longer needs that extra frontalis drive. The muscle relaxes, and the brow settles to a lower position.
In both cases, the patient's brow position before surgery was artificially elevated by compensation. The post-surgical brow position is actually closer to the brow's natural resting state. But it can feel like a new problem, which is why the conversation beforehand matters so much.
Ingredient #7: Orbital shape changes
This is the ingredient that almost no one talks about, but it's one I evaluate in every consultation. Over time, the bony orbit and surrounding structures change. The eye socket transitions from a rounder, fuller contour to a more squared-off, hollowed shape. This happens because of bone remodeling, fat atrophy, and changes in the supporting ligaments.
These orbital shape changes affect how the eyelid drapes over the eye, how shadows fall across the upper lid, and the overall "framing" of the eye. They contribute to the sunken, aged look that patients describe but can't quite pinpoint.
While we can't reshape the bony orbit, understanding this ingredient helps me set realistic expectations and choose the right combination of treatments. Sometimes volume restoration (ingredient #5) can partially compensate for orbital shape changes by softening the hollowness.
Ingredient #8: Muscular function changes
The muscles around the eye don't stay static over time. Two muscles in particular are worth understanding:
The frontalis muscle (forehead) is the one that lifts the brow. As the eyelid or brow becomes heavier, the frontalis works harder to compensate, creating those deep horizontal forehead lines. In some patients, the frontalis gradually weakens with age, reducing its ability to compensate — which can make an already droopy eyelid look worse more quickly.
The orbicularis oculi is the muscle that closes the eyelid. Changes in its tone and function affect how the eyelid skin sits at rest, how the eyelid crease behaves, and even how the brow is positioned (the orbicularis has a brow-depressing effect).
Understanding these muscular dynamics is important because they interact with almost every other ingredient on this list. Botox, for example, affects the balance between the frontalis and orbicularis — which is why a poorly placed Botox injection near the brow can actually make eyelid heaviness worse by weakening the frontalis compensation.
The treatment map: matching solutions to ingredients
Here's where the ingredients approach translates into a surgical plan. Each ingredient has a specific treatment:
| Ingredient | Treatment |
|---|---|
| Eyelid ptosis | Conjunctivomüllerectomy (CME) or external levator surgery |
| Dermatochalasis (excess skin) | Upper blepharoplasty with conservative fat management |
| Low eyelid crease | Upper blepharoplasty with crease reformation |
| High eyelid crease | Ptosis repair (sets crease to anatomic height); crease lowering in select cases |
| Orbital fat excess or malposition | Conservative reduction; nasal-to-central fat transposition |
| Lateral eyelid fullness | Fat pad repositioning or lacrimal gland repair |
| Skin quality changes | Laser resurfacing, chemical peels, mesotherapy |
| Upper eyelid/brow volume loss | Fat grafting (brow region) |
| Brow ptosis | Endoscopic brow lift (release and redrape); direct brow for contour changes |
| Orbital shape changes | Volume restoration where appropriate; realistic expectations |
| Muscular function changes | Addressed indirectly through other treatments; guides Botox strategy |
The key insight is that many patients have two, three, or even four of these ingredients present simultaneously. A comprehensive evaluation identifies each one, and the treatment plan is built around addressing the combination — not defaulting to a single procedure.
Cellular age: why results vary from patient to patient
Everything I've described so far is also limited by something no surgeon can control: your cellular age.
I explain it to patients this way: eyelid surgery is like remodeling a home. If the home is relatively new, the remodel goes smoothly — the foundation is solid, the walls are plumb, and the finished product looks exactly like you planned. But the older the home, the more likely you are to encounter issues once you start working. The materials are less forgiving, there's more wear to account for, and the scope of what's needed may be larger than it first appeared.
The same is true for eyelid surgery. Younger tissue heals faster, holds sutures more securely, and responds more predictably. Older tissue — with years of collagen loss, reduced elasticity, and cumulative sun damage — is more variable. That doesn't mean surgery can't produce excellent results at any age. It means the plan needs to account for the starting condition of the tissues, and the expectations should match the reality of what those tissues can do.
You don't always need to fix everything
This might be the most important section in this entire post.
When I evaluate a patient and identify all the ingredients contributing to their appearance, I walk through every single one. I want the patient to understand what they have. Education is always the first step.
But understanding what's there and deciding what to treat are two different conversations.
The distinction matters most between medical and cosmetic concerns. If a condition is affecting your vision or eye health, the treatment discussion is more straightforward — we should address it. But for cosmetic concerns, the question isn't "what can we fix?" It's "what matters to you, and can we achieve a result you're happy with by addressing the things that bother you most?"
Here's a real example: I regularly see patients who have mild eyelid ptosis and moderate dermatochalasis. Their ptosis is real — it's measurable — but they actually like how open their eyes are, or they're simply used to it. What brought them in is the excess skin. In a case like this, I'll explain the ptosis, show them what it looks like, and discuss what ptosis surgery would involve. But if they're content with their eyelid height and just want the skin addressed, we may decide together that a blepharoplasty alone achieves a result they're genuinely happy with.
My job is to teach you what you have, give you the full picture, and then build a plan around what matters to you — within the boundaries of what's safe and what will produce a good outcome. I'm not here to sell procedures. I'm here to help you understand your options so we can make the best decision together.
Asymmetry: why one side looks different from the other
One of the most common concerns I hear is: "Why is one eye more droopy than the other?"
Asymmetry between the right and left side can be related to any of the ingredients listed above. But the most common cause is something most people don't consider — congenital asymmetry that is completely normal.
Everyone has differences between the right and left sides of their face. Not subtle differences — meaningful ones. I tell patients: the right and left sides of your face are sisters (or brothers), not twins.
These natural asymmetries typically come from differences in bone structure, differences in baseline muscle strength, and overall facial tissue size differences between the two sides.
Here's the part I want to be completely transparent about: it is essentially impossible to make both sides look the same. I can improve asymmetry — often significantly — but I cannot eliminate it. Several of the ingredients that create asymmetry are things we simply cannot manipulate: I can't reshape the orbital bone, equalize the baseline strength of muscles that have been different since birth, or redistribute the fundamental tissue volume differences between the two sides of the face. Surgery works within those fixed variables, not around them. Patients who understand this going in are almost always happier with their results, because they're measuring success against realistic improvement rather than impossible perfection.
Surgical sequencing: why the order of procedures matters
When multiple ingredients are present, I don't always address them all in one surgery. Sometimes I do — but sometimes there's a strategic reason to stage the procedures.
In an ideal world, my sequencing logic works like this: ptosis first, brow second, blepharoplasty third.
The reasoning: ptosis repair changes the eyelid height, which affects how much skin is visible and where the crease sits. Getting the lid opening right first gives me the clearest picture for everything that follows. A brow lift, if needed, sets the brow framework before I decide exactly how much skin to remove. And blepharoplasty comes last because the amount of skin I need to remove depends on what the eyelid and brow are doing after the other procedures.
In practice, we often combine these. Ptosis repair and blepharoplasty are commonly performed together since these two conditions frequently co-exist. There is one important exception to combining: when I correct ptosis using the external levator approach, I need the patient alert at some point during the procedure to open their eyes so I can judge eyelid height in real time. A conjunctivomüllerectomy doesn't require that cooperation.
In certain situations — particularly with Asian blepharoplasty or double eyelid surgery where ptosis is also present — I ideally stage the ptosis repair first (typically with a conjunctivomüllerectomy), let it heal for about six months, and then perform the double eyelid surgery. Working one variable at a time allows for greater precision, especially when eyelid crease position and height are critical to the aesthetic outcome.
Why getting the diagnosis right matters more than the surgery itself
Here's the core message of the ingredients approach: the surgery is only as good as the diagnosis.
The first step is always identifying every ingredient that's contributing to the appearance. The second step — equally important — is deciding together which ingredients to address. Not every ingredient needs to be corrected. The problems arise when ingredients go unidentified, not when they go intentionally untreated.
I see patients in my practice who've had upper blepharoplasty elsewhere and still feel like their eyes look heavy. In many of those cases, the surgery was technically well-done — the issue was that other ingredients weren't identified or addressed. This is not a criticism of other surgeons. These conditions genuinely overlap, and the evaluation requires specific training and experience to sort out. It's one of the reasons I believe the oculoplastic perspective brings value to eyelid surgery — our training is centered on the anatomy, function, and biomechanics of the eyelids and orbit, so diagnosing these overlapping conditions is the core of what we do every day.
When is upper blepharoplasty alone the right answer?
Despite everything I've said about multiple ingredients, there are plenty of patients where upper blepharoplasty alone is exactly the right surgery.
If your eyelid measurements show good muscle function, your eyelid margin sits at a normal height, your crease is in a good position, your brow is stable, and your volume is well-maintained — but you have clear excess skin that's folding over your crease — a straightforward upper blepharoplasty can produce a beautiful, long-lasting result. These patients typically notice a visible eyelid crease that was previously hidden, a more open and rested appearance without looking "done," easier application of eye makeup, reduced end-of-day eyelid fatigue, and improvement in the peripheral visual field when skin excess was significant.
The procedure itself is typically performed under local anesthesia, takes about 45 minutes to an hour, and involves a recovery of roughly two to three weeks before most patients feel comfortable in social settings. The incision is placed in the natural eyelid crease, so once healed, the scar is essentially hidden in the fold of the lid.
Recovery: what to realistically expect
I tell patients that what you do during the first week has the biggest impact on how quickly you recover. Icing, taking it easy, keeping the incision clean, and being gentle with the eyelids are the most impactful things you can do.
- First week: Swelling and bruising are expected and at their peak. Sutures are typically removed around this time.
- Two to three weeks: Most of the visible swelling has resolved, and most patients feel comfortable in social and professional settings — what I call "social recovery."
- Two to eight weeks: The incision goes through a normal phase where it becomes pinker and slightly more elevated. This is normal scar formation, not a problem.
- Four to six weeks: The new eyelid crease settles into position — a reasonable preview of the long-term look.
- Two months and beyond: Nearly all swelling has resolved and the scar matures, transitioning to a flatter, paler line over the following months.
The biggest variable in recovery isn't the surgery — it's the patient's own healing biology.
A note on Asian blepharoplasty
Everything in this post applies to the general principles of upper eyelid evaluation and surgery. However, Asian blepharoplasty (double eyelid surgery) is an entirely separate topic with its own philosophy, techniques, and adjunctive procedures. I have extensive experience in Asian eyelid surgery from my additional fellowship training at Samsung Medical Center in Seoul, and I plan to cover this topic in its own dedicated post.
The bottom line
If you're researching upper blepharoplasty, you're probably focused on the excess skin — and that may very well be the primary issue. But before committing to any procedure, make sure your surgeon has evaluated all the potential ingredients contributing to your appearance:
- Is excess skin the only factor, or is eyelid ptosis also present?
- Is your brow compensating for a weak eyelid muscle?
- Has volume loss changed the contour of your brow and orbit?
- Is the skin quality itself contributing to the aged appearance?
- Is your eyelid crease sitting lower than ideal?
- Is asymmetry between the two sides congenital or acquired?
The best outcomes in upper eyelid surgery come from two things: getting the diagnosis exactly right, and then building a plan around what actually matters to you. That's the conversation I have in every consultation — and it's the one I'd encourage you to have with whatever surgeon you choose.
Eric S. Ahn, MD is a board-certified ophthalmologist and fellowship-trained oculofacial plastic, cosmetic, and reconstructive surgeon in Torrance, California. He specializes in eyelid surgery, ptosis repair, Asian eyelid surgery, and facial rejuvenation. To schedule a consultation, call the office at (310) 791-2233.