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Has anyone had filler in the upper eyelid region?

PostPosted: Sun Sep 18, 2011 7:24 pm
by Cayolinda
I was wondering if anyone has had filler placed for hollowing in the upper eyelids (the area right below the brow but above the eyelid)? I know many have had filler placed for lower lid hollowing (tear troughs), but I haven't heard anything about the upper lid area. If this can be done successfully, I feel I would benefit from filler in the area beneath my inner brow, but just wonder if anyone has had this done and what their outcome was. Anyone out there had this done?

Re: Has anyone had filler in the upper eyelid region?

PostPosted: Mon Sep 19, 2011 3:36 pm
by Randy44
Yes/ Juvederm, about 1.2 cc per upper eye lid (I have two). Lasts a long time, probably 4x what it would last in the N/L folds. It is good if you have hollows only. The problem I am experiencing is that I had some excess eyelid skin towards the outside of the eyes, inorder to fill that skin it took additional filler, and that added weight to the outer eyelids, and that has accelerated the eyelid droop which has gotten bad now, so I will probably have to have an upper bleph anyway, something I should have done before the filler, but I wanted to experiment with the filler first. Not a bad experience overall, just not a cure all. I expect that I will have the filler dissolved prior to the upper bleph, then reinjected at a lower volume after the upper bleph heals. The injects hurt, and I had headaches and vision problems for days after the injections.

Re: Has anyone had filler in the upper eyelid region?

PostPosted: Mon Sep 19, 2011 4:03 pm
by Cayolinda
hanks for the info Randy44. 1.2cc for each eye seems like a lot, is that because some of that was used for the outer eyes where you had the excess skin? I had a bleph a couple of years ago and my surgeon also placed fat via injection in my upper lid region. That really helped "lift" but enough wasn't placed right below my inner brow on my left eye, causing my brow to sag there; causes me to look rather angry or cynical when I'm not! My other eye looks good though so I don't look totally angry :) Did you have juve placed in this same area that I'm describing? Can you tell me if you used a facial plastic surgeon, or did you go to a derm or oculoplastic (eye) surgeon to do this. I'm nervous when it comes to the eye area to trust my eyes to just anyone. Thanks again for your reply!

Re: Has anyone had filler in the upper eyelid region?

PostPosted: Tue Sep 20, 2011 2:06 pm
by Randy44
My experience was that the inside (adjacent to the brow) of the upper lid could not be filled uniformly. My doctor was able to fill the outside and center of the upperlid, but when it got to filling the inside it just would not fill smoothly. He tried to force some in there, but it just created a discontiuous bump which looked awful, and I had to have it dissolved. So I still have hollows on the inside of my eyes. Finding someone to do it wasn't easy, so I had to work with the doctor (occuloplastic surgeon) on this, for I all know I was his first upper lid filler patient (he has done thousands of blephs). It seemed to be as much a learning experience for him as for me. But that was the best I could find in my area of the Country. Other than SoCal or NY, I expect that will be the norm.

I read a study on it, 1.2cc per upper eye is typical.

Another problem is the color change, it lightened the upper lids for me. One can use a bronzer there fairly easily, so it isn't a major problem. So a lot of potential restrictions that prevent one from getting perfect upper lids via filler.

Re: Has anyone had filler in the upper eyelid region?

PostPosted: Tue Sep 20, 2011 4:30 pm
by Cayolinda
Thank you for such a thorough explanation, it is so appreciated!! Your response has fully answered my question. I'm wondering if Ultherapy above the inner brow would help elevate my area of concern if filler cannot. Have you thought about that? Would you mind telling me where you are? I'm in south Florida, and I'm just wondering if you saw the same oculoplastic surgeon I'm considering? If he wasn't successful with you then I doubt he will be with me either. Although we have pretty good doctors down here, it seems the best are in CA and NY, especially when it comes to fillers. Thanks again Randy 44!

Re: Has anyone had filler in the upper eyelid region?

PostPosted: Tue Sep 20, 2011 8:42 pm
by Randy44
Assuming Ultheraphy works (I am skeptical), and assuming you can fit that device against the upper lids (I doubt it), and assuming it would not damage the eye (I wouldn't even consider it), I suppose it would be worth a try. :)

I don't live in FL, thus I am sure it is not the same Doc.

I currently have a moderate lid Ptosis problem that I will have corrected during my upper bleph operation, nothing extreme, just enough to expose enough extra upper lid hollow to make me look worried/tired. And it is expected that the upper bleph will slightly lower my brow (mine is naturally high), further reducing the gap above my lash line. You might consider same as a remedy.

Supposedly botox can be used at certain spots in the forehead to lower the brow, and thus would reduce that gap above the lash line, it just seems to unpredicatble to me, and I don't like numbing my muscles.

Re: Has anyone had filler in the upper eyelid region?

PostPosted: Wed Sep 21, 2011 6:18 am
by Cayolinda
I thought about Ultheraphy above the brow, not near the eyelid. It’s supposed to stimulate collagen and have a lifting effect so I thought if I lifted my inner brow, that would in turn give me more space between my brow and lid, which is what I need. I’ve heard great reviews on Real Self about Ulthera but I’m like you, skeptical and only in the thinking stage.

Randy44, I had moderate upper lid ptosis also. I went to several doctors about this and asked if it could be my brows causing this and not the lid itself. I was told it wasn’t my brows because like you, I have naturally high brows. So I proceeded with the bleph. In the process my doctor also filled my sub-brow with fat to further elevate my lids. That came out nicely (except for the inner part of my left eye). However, the ptosis was only slightly corrected. He even did a canthopexy and a temporal brow stitch to help with the sagging of my lids. I was then told (and I read) that having the bleph may have actually caused my brow to sag a bit, causing more ptosis! My doctor did a second temporal stitch, which helped a little more, but the bottom line is: I probably need a brow lift. A full fledged temporal brow lift, not just a stitch. I’m very disappointed because in the end, I think this should have been suggested to me in the first place. You are right, the upper bleph will slightly lower your brow as it did mine, and if this is what you want and need, it will work. Lowering my brow just made my ptosis worse.

I’ve never done botox. The idea of it scares me.

Re: Has anyone had filler in the upper eyelid region?

PostPosted: Mon Dec 31, 2012 11:04 am
by Tracy56
I had restylane done to my upper eyelid about 2 years ago. One eyelid looked more hollow because the brow was higher than the other. I asked the doctor to put a small amount in the area just below the brow to see how my skin would react and I was concerned about overfilling and lumpiness. He ignored everything I said and filled the inner corner, under the brow, and also across the lid. It left a ugly, lumpy mess on my eye that has yet to go away. The lid is droopy and the eye is much smaller over all than the other. I think at this point I am stuck with this result forever unless I have it dissolved. I have heard and seen very bad results with the dissolvers so I am not up for another bad result.

Re: Has anyone had filler in the upper eyelid region?

PostPosted: Mon Dec 31, 2012 12:54 pm
by Cayolinda
Tracy56 wrote:I have heard and seen very bad results with the dissolvers so I am not up for another bad result.


Tracy56, I have had bad results from restylane in my lower eyelid hollows and I was scared to have it dissolved too, but I decided it probably couldn't look worse than what I already had. It was a good decision and my only regret is that I didn't do it sooner. I had to dissolve on two different occasions (not for the same injection). Both times the doctors used very little product to dissolve, just a tad, which was good enough each time. I think if you're unhappy you should do the same, just be sure you choose a doctor that is experienced in fillers and in dissolving.

Re: Has anyone had filler in the upper eyelid region?

PostPosted: Wed Jan 02, 2013 2:47 pm
by Tracy56
Thanks for your advice, Cayolinda. I would love to have dissolved but I have heard that the dissolver can make eyes very dry. This eye is already extremely dry. I have plugs and use drops during the day and an ointment at night. So I'm not sure I want to take a chance and make it worse.
I will never understand why this doctor felt the need to fill up my lid with filler. I never asked him to put it in the inner corner. I didn't think it could be placed there to begin with.

Re: Has anyone had filler in the upper eyelid region?

PostPosted: Sun Feb 03, 2013 8:02 am
by annakief
I had it done with juvederm xc because my upper eyelid droops and I hated the result after, my eyes are swollen n eyelid feels heavy and it's affecting my vision. I had this done 3 weeks ago on my lower eyelid to n today I notice that my right lower eyelid is hollow! How could that be possible? I thought this last for a year! I paid 2000$ for 4 syringe, I may have as we'll a lipo done with fat injection to my face, I regret doing this. My face is never the same.

Re: Has anyone had filler in the upper eyelid region?

PostPosted: Tue Feb 26, 2013 2:44 pm
by GeorgeYangMD
Hi Cayolinda,

Although doctors and surgeons who inject fillers are a dime a dozen, it seems that injecting fillers for the upper eyelid hollowing is not very common. I first became interested in upper eyelid hollowing in 2006. Initially I was not using injectable fillers back then, and instead was using fat grafting, using Dr. ******'s Pearl Fat Grafting technique. This give very nice results, but once the fat is grafted, it cannot be easily removed. This technique requires an incision to graft the fat. Skin can be removed at the same time; however, it does not require skin removal to perform Pearl Fat grafting.

In 2008, I had a patient with severe upper eyelid hollowing and crepey upper eyelid skin. I thought she would be a good candidate for the Pearl Fat Grafting. However, she was afraid of getting the upper eyelid incision, because she tends to keloid. In general, the chance of keloiding from an upper eyelid incision is very rare, but I did not want to take that chance. I considered using Restylane to fill the area, but before I committed to the Restylane, I performed a Saline Simulation, or Water simulation, by injecting saline and numbing medicine to show her the effects of volumizing the brow skin. She really liked the simulation, so a couple weeks after the Water simulation, I performed my first upper eyelid filler using Restylane in 2008.

In general, the types of patients who tend to get this procedure are younger patients who appear to have a slight bit of upper eyelid skin excess, but simulatenously have an increase in upper eyelid platform showing as compared to photos of themselves when they were younger. They may also have an A-frame deformity or doll's eye deformity, where the upper eyelid skin appears be be vacuumed inside of the eyesocket. Although this vacuum effect prevents the upper eyelid from "hooding" it tends to make the eye look older.

Image
Before Photo: Age 35, After photo Age 38
Image Credit: GeorgeYangMD.com

Here is an example of a before (age 35) and after (age 38) photo of upper eyelid filler for upper eyelid hollowing.
Image
Although this woman's eyes are beautiful, she felt that her eyes looked older and sunked in. The increased eyelid showing looks nice, but we do not know how she used to look when she was younger.
Below is a close up photo of the same woman when she was 17 and modeling. The goal of the upper eyelid filling was to try to simulate her younger eyelid "configuration" as much as possible.
Image
I think the key photo which will help determine whether an injector is skilled at performing upper eyelid fillers is a view of the patient looking downwards. If the upper eyelid filler is injected properly, it should look very smooth when the patient is looking downwards. If it is lumpy, then the injector may be injecting it in the wrong place.
Image
Image Credit: GeorgeYangMD.com

I think the concept of adding volume around the frame of the eye is beginning to catch on. It first began many years ago with lower eyelid/tear trough filling. Now it is periorbital filling which blends the upper cheek with the lower eyelid area, to create a single convexity or a single curve below the eyelid blending into the cheek. The double convexity is when the lower eyelid bag, is separate from the beginning edge of the cheek.

Now there seems to be new articles discussing the upper eyelid hollowing even in plastic surgery journals. They discuss how a flatter and fuller brow has become more in style and the browlifted appearance with the angled arched brow. I think this look is "authentically" more like the way that these patients actually looked like when they were younger.

In summary, if there is too much eyelid showing, and the appearance of "excess upper eyelid skin", with a decrease of skin showing below the eyebrow, these patients are potentially good candidates for upper eyelid fillers alone. If there is hooding or hanging of the upper eyelid skin, adding upper eyelid fillers may make the hooding even worse. These patients still benefit from a conservative upper eyelid skin removal, but may also benefit from adding volume to the brow skin below the eyebrows. This can be done with either fat at the time of the surgery, or a couple of months later after the blepharoplasty to allow all of the swelling to dissipate.

Image
Image Credit: GeorgeYangMD.com

I hope these explanations help.

Best,

Dr. Yang
New York Facial Plastic Surgeon
My forum on MMH: http://www.AskDrYang.com

Re: Has anyone had filler in the upper eyelid region?

PostPosted: Wed Aug 07, 2013 2:39 am
by raysydney
The best dr is dr Gal Aharonov in Beverly Hills . I went to see him all the way from Sydney Australia in 2010 and he fixed my upper lids w restylane after another doctor Marcells in Sydney performed an ill advised blepharoplasty . Don't waste your time just go to dr Aharonov he is the best at injecting fillers in upper eyelids !

Re: Has anyone had filler in the upper eyelid region?

PostPosted: Fri Sep 01, 2017 2:04 am
by luv2shop4ever
Hi, I just had this done, it is truly the best thing, I went from looking gaunt to refreshed. Dr. Kalwerisky used Restylane. If your near Sacramento, he is in Davis.