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What good is a facelift if your eyes look old?

Posted: 6:00 a.m. Sunday, March 18, 2018

By Anita Mandal, M.D.
Question: I had a facelift 5 years ago and while my jaw and neckline look tighter, when I look in the mirror, I look just as old and tired as I did before. My plastic surgeon didn’t address my eyelids. I have heavy upper eyelids and deep hollows under my eyes. What can be done to make me look more refreshed and less tired?

Answer: As aging progresses, you’ll notice that you don’t just age in one area of your face, but you are likely aging in many different parts of the face. A skilled plastic surgeon recognizes this and makes recommendations that will give you an overall refreshed, natural and youthening effect. Focusing only on one area of the aging face can result in a situation like yours, where you’ve gone through an extensive procedure but don’t look significantly better.

I offer a “pan-facial” approach to facial rejuvenation. In a case such as yours, I would typically perform a surgical upper eyelid lift in patients with heavy skin and/or excess fat in the upper eyelids. It is important to check the position of the eyebrow. When a sagging brow may be contributing to the heavy appearance of the upper eyelids, I may advise Botox or in more significant cases, a surgical brow lift. In the presence of a droopy eyebrow, doing upper eyelid surgery alone may not be as effective.

As far as your lower eyelids go, if you primarily having hollowing of the lower eyelids without protruding fat or excess skin, then this is not a surgical problem. I typically treat lower eyelid hollows with injectable fillers which can work quite well. My filler options for this area include Restylane, Bellafill – The 5 Year Filler – or stem cell fillers, depending on the unique needs of the patient.

Patients who come in for a consultation are often focused on an isolated concern. However, any one particular facial concern may not be what is making one look aged. Not uncommonly, additional changes contribute to one’s overall aged appearance.

Careful consultation with a Board Certified Facial Plastic Surgeon who can offer a “pan-facial” rejuvenation approach to give you the most optimal results is the first step.


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