Answer:
That is a difficult question to answer without seeing you, but the answer is probably no. A droopy eyelid can be caused by a number of factors, but it can be summarized into three categories, brow ptosis, dermatochalasia, eyelid ptosis. Brow ptosis is when the forehead and brow drop causing the upper eyelid skin to fold and look more redundant and tired. In the case of asymmetry, sometimes the more droopy looking lid is the normal one and the person is really activating the forehead muscle and elevating the other side. This is the only situation that Botox may help. A browlift may also be needed. Upper eyelid dermatochalasia is when there is a redundancy of upper eyelid skin.  This is usually corrected with a blepharoplasty. At times a brow lift may also be indicated. Eyelid ptosis is when the actual eyelid margin is too low and covering the upper part of the iris (colored part of the eye) or pupil. This usually needs to be corrected surgically.

Posted by Dr. Buckingham

Answer:
Restylane can be used to improve the appearance of the lower eyelid in the right patient.  Nearly everyone has some degree of a tear trough or orbital groove at the junction of the lower eyelid and cheek and will require filling of this groove to optimize their result.  This can be done non-surgically with Restylane or surgically with a blepharoplasty or fat transfer.  In some patients they also have a significant bag in the lower eyelid that would benefit surgical reduction.  Ideal patients for Restylane are those that have an isolated orbital groove, patients with orbital fat bulging forward also can achieve some benefit from Restylane, but the result will not be as nice.  Restylane will last around one year when injected into the lower eyelid.

Posted by Dr. Buckingham

Yes we do perform asian or double eyelid surgery.  The procedure is usually performed in the office under local anesthesia with some oral medications to relax the patient.  Some patients prefer to have a deeper level of anesthesia at our surgery center, which can be arranged.  18 is certainly old enough to have the procedure.  There is a limit as to how young someone can be, but it is variable based upon individual maturity levels.  We would be happy to see you in consultation and discuss this further.

Ed Buckingham

Sorry for the delay in answering your question.  Server problems.  It may be possible to easily pinch some skin from under the eyelashes without creating visible scarring, but you have to be careful because you must have enough skin left under the eye so that it does not pull the lid down.  I would need to see you in consultation to assess whether you truly had excess skin or not.  If you only had fat removal my suspicion is that you may need your tear trough or orbital groove filled as well.  You may have had a fat repositioning procedure however and that may be fine.  Hope this helps and we would be happy to see you.

Ed Buckingham

Thanks for your question regarding blepharoplasty under local.  The piece of information I don’t have however is are you interested in doing you upper or lower eyelids?  I’ll just answer both.  An upper eyelid blepharoplasty can easily be done under local anesthesia and we almost always do it that way.  About half of patients also choose to take a little relaxation pill also.  It is the patients choice.  Lower eyelid blepharoplasty can be done under local, but we usually do not.  Because we usually use an internal incision for our lower eyelid procedures and because the lower eyelid almost always requires some kind of volume augmentation for the orbital rim/upper cheek, it is much better tolerated under IV sedation and local anesthesia.

Ed Buckingham