Q: Dr. Eppley, I have had an upper blepharoplasty where a lot of skin was removed. This caused my eyebrows to lower ( about 5 or more mm). I want to restore my eyebrow position but I don’t want my eyes to appear any more wide open than they are and for too much of my upper eyelid to show. Is it possible to perform an upper eyelid skin graft to assist in my situation?
A: The first question is how long has it been since the initial blepharoplasty procedure? If it was 6 months or more afterward then it is reasonable to consider some management strategy.
If it is less than six months there is still some possibility of upper eyelid skin stretch that may lessen the overresection effect.
A skin graft can certainly be done to the upper for an over-resected blepharoplasty problem and it will take very well. It is the definitive answer to your present concerns. But there are some trade-offs. First a skin graft will often appear as a small patch because it will be virtually impossible to have a perfect skin color and thickness match. Secondly there has to be a donor site for the graft and it needs to skin that is very thin and with as little pigment as possible. This usually means it has to come from the back of the ear. In older patients it could come from the lower eyelids but this opportunity is very rare.
Dr. Barry Eppley