Q: Filler or Lower Blepharoplasty for Lower Lids? (photo)
I am 40 and have genetic under-eye hollowness. It has become markedly worse over the past few years. I really want to do something more on the permanent side, but am now thoroughly confused: An oculoplastic doctor has said that I am not a candidate for a lower bleph/that it wouldn’t make me look good. I have, however, seen that it gives amazing results on plenty of people with similar appearances. So – do I add or remove? Advice welcome! Thank you.

A: Fillers are great, but lower eyelid blepharoplasty has greater longevity.
Hi,
Although I am a huge advocate of the use of Radiesse to reestablish the roundness of the cheeks and the fullness between the upper cheek and the lower eyelid which will have the wonderful benefit of blunting the fat hernia, I believe your best choice would be a blepharoplasty. I do both procedures in all aged individuals. In your case, I would recommend a lower eyelid blepharoplasty. Your skin tone is excellent and your face appears very young. The Radiesse is great, especially as the face deflates and sags but your primary problem is the visibility of the fat hernia. The lower eyelid blepharoplasty is a terrific and effective procedure with great longevity. This will address the issue rather than mask it. The cost of the Radiesse over a short period of time will be greater than the blepharoplasty. The healing from the blepharoplasty will be quick- sutures are out in 3-4 days and echymossis resolves within 2 weeks ( considering you have no complications!). Good luck!
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