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Treatment for deeply set eyelids

Posted:10:16 a.m. Friday, June 27, 2014

By Anita Mandal, M.D.

Question: I’ve noticed that my eyes are aging and look deeply set. I saw a plastic surgeon about having an upper eyelid lift and was told that surgery would not help. Is there any other option, as my eyes make me look very tired?

Answer: It is a common misconception that deep set eyes can be improved with surgery. While some people are born with recessed eye sockets, for others, deeply set eyes often happen with age. In the case of the latter, the cause is often volume loss of the upper eyelid.

As the years pass, two separate processes can simultaneously occur in the upper eyelid. Orbital fat in our eye sockets can protrude or bulge into the upper eyelids. At the same time, the natural upper eyelid fullness of youth is diminished.
Recognizing the difference between protruding upper eyelid fat and loss of upper eyelid fat volume is key to selecting choice of treatment. Bulging excess upper lid fat is often corrected with a blepharoplasty or surgical upper eyelid lift. Upper lid volume loss can be successfully treated with injectable fillers, not surgery.

Injectable fillers like Restylane™ and Juvederm™ last a short time and can make the delicate upper eyelid area look puffy, especially since these fillers work by attracting your body water. A long lasting filler such as Bellafill® has a high safety profile and a more even consistency. Bellafill® can give smoother, more natural volume restoration to a deeply set upper eyelid. One must carefully review the inner, central and outer aspects of the upper lid and assess how much volume restoration and, thus, filler is required in the various subunits of the upper lid.

Careful consultation with a Facial Plastic Surgeon who is not only a skilled injector but also understands the anatomical basis for aging in the upper eyelid area is the first step in determining the best treatment choice for you.

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