Blepharoplasties in Men?

Yes, men benefit from blepharoplasties--plastic surgery of the upper and lower eyelids.  In this fellow's case, he was concerned that excess upper eyelid skin impeded his vision, especially in the upper, outer portions of his field of vision.

Formal visual fields testing at his ophthalmologist's office confirmed that his sight was significantly hampered.  His insurance company agreed to pay for his upper blepharoplasties.

But what about those "bags" beneath his lower eyelids?  Since his upper eyelids were being rejuvenated, the patient and I agreed that simultaneous lower blepharoplasties would produce facial harmony.  (But there's no convincing an insurance company to pay for even rational aesthetic surgery.  This gentleman had to pay for his lower eyelid surgery out of his own pocket.)

The end result is excellent.

He sees better, and he looks better.  He still has a masculine appearance, and is certainly not "over done."  A happy, confident patient is always my goal!

Under Eye Bags Caused by Muscle Hypertrophy

Hi, This has been a problem since I was a little girl.  Now I'm 40 and want to improve the appearance of my under-eye bags, whether it is with surgery or fillers.

I look tired all the time and my bags just keep getting bigger as I age. I went to another consultation for blepharoplasty (eyelid surgery).

The doctor told me there's nothing that can be done, because it's all muscle and not fat. Could I have hypertrophy?  What can I do?  I can't stand to look at myself or have others look at me.  If there is surgery for this, what is it called?

-Shellee

 

Dear Shellee,

Find an experienced Botox injector.  Ask for 1 unit of Botox in the roll under each eyelid.  This might solve your problem without surgery.

(If your plastic surgeon is up on the latest treatments, 2.5 units of Dysport would also work.  Dysport is probably equivalent to Botox.)

Do be aware that this is a tricky use of Botox/Dysport.  There are a few potential (albeit unlikely) risks...

• Lowering the lower eyelid margin (so that you see white beneath your green irises)
• Loosening the tension on the fat beneath the eyes, such that bags really do become apparent (I agree with your current analysis.  You do not have fat bags, just excess muscle.)
• Causing your eyes to become dry and scratchy

I highly doubt that you will have problems, but other plastic surgeons might be hesitant to give my suggestion a try.  This is definitely a Botox/Dysport use for experienced injectors only.

If the Botox/Dysport is unsuccessful, the injector could try more.  Or, a little filler in the upper cheeks (at the infraorbital rims--the bony rim beneath the eyes) can smooth the area out.  My favorite is Sculptra.

(By the way, the world's 2nd most beautiful woman--Angelina Jolie--also has muscular rolls beneath her lower eyelids.  Shellee, you're in good company.)

(Who's the world's most beautiful lady?  My wife, of course!!)

Sincerely,

Mike Pickart