Upper Blepharoplasty Before & After Case 122

This patient in her 40s presented with concerns that her upper eyelids appeared heavy and saggy.

On evaluation, Dr. Phan noted excess skin of both upper eyelids, along with naturally thick skin. To address the dermatochalasis, Dr. Phan recommended bilateral sub-brow and crease blepharoplasty with fat removal.

The upper eyelid skin is thinnest near the lash line and gradually thickens toward the brow. For patients with naturally thicker upper eyelid skin, Dr. Phan often recommends a sub-brow blepharoplasty. In this approach, an incision is made just beneath the eyebrow rather than at the eyelid crease, as in traditional crease blepharoplasty. Up to 1 cm of excess skin may be removed from the sub-brow region, with additional skin excised through the crease incision when needed. To further reduce the thickness of heavy eyelid folds, orbital fat can also be conservatively removed at the same time.

Patient, pictured here 4 months after bilateral sub-brow and crease incision blepharoplasty with orbital fat removal, demonstrated less heavy, sagging eyelid folds and greater tarsal plate show. Her eyes appeared brighter and more engaging. For patients seeking even greater improvement in eye opening, ptosis repair may also be considered.