Double Eyelid Surgery Before & After Case 3

This patient in his late teens presented with concerns that his eyes appeared small and sleepy. Patient brought in photographs of eyelids that he liked--they all had higher eyelid creases and double eyelids. 

During evaluation, Dr. Phan noted low and asymmetric eyelid creases, as well as bilateral upper eyelid ptosis, evident by the reduced distance between the eyelash line and center of the eye on both sides. This measurement, called marginal reflex distance 1 (MRD1), was 0.5 mm on the right and 1 mm on the left. They should be between 3 and 5 mm. Dr. Phan, therefore, recommended bilateral Asian blepharoplasty with pinch of skin removal and setting the creases at 5-mm and with taper contour, as well as external ptosis repair, for natural elevation of the eyelid creases and heights. 

At the same time, to balance the bone structures and soft tissues of the face, Dr. Phan placed RHA4 dermal filler to the nose and BOTOX® to the lower eyelids. The height of the nose now matched with the prominent cheek bones, and the thickened orbicularis oculi of the lower eyelids appeared thinner. 

Patient pictured here 1 month post bilateral external ptosis repair and Asian blepharoplasty with mild residual inflammation, as expected, while the eyes appeared more open, engaging and not overly done at all.