Q: I recently had successful ptosis repair. I was thinking of having a very minor skin excision to reshape the lid, and remove some skin on one side that has a little bit of extra. I don’t want much skin removed, I don’t want much increase in height. Maybe a mm or 2. Is this pretty achievable? Or does blepharoplasty require a larger excision?

Dr A’s Answer: Yes, you can certainly have an upper blepharoplasty after ptosis repair. Your concerns about an overdone upper eyelid are easily addressed. Mostly, an overdone upper eyelid is not the result of excess skin removal (that has a different set of problems) but rather removal of fat and muscle under the skin. Vibrant and young appearing upper eyelids are full and rounded, just not “flappy”. The key is to remove enough skin to get rid of the “flappyness” while maintaining the other tissues so that the eyelid crease is not excessively raised and the eye is not hollowed out.