It is possible to do a blepharoplasty (upper eyelid surgery) and at the same time add volume to the upper eyelids and brows. Natural aging consists of volume loss in the brow pad and upper eyelids. Sometimes there is also increased laxity or relatively too much skin which ideally would be trimmed away as well. Depending on the particular case, sometimes a blepharoplasty is needed, sometimes just filler, and sometimes a combination of the two.

In general I can give patients a very good idea of how much filler around the eyes they will need before starting. That is why a consultation is so important. I can give most patients a reasonable idea based on a good quality photograph. Determining how much volume will be needed also depends on your aesthetic goals for what you want your eyes to look like. Some patients desire a very full look while others would just like to fill in some of the hollowness around the eyes.

As a rough starting point, an average patient will need anywhere from 1/2 a cc to 1cc of filler in each upper eyelid. Same goes for the lower eyelid or under eye area. If there is a considerable degree of hollowness you might need as much as 2 cc in each upper eyelid or under eye. This will be discussed during your consultation.

To learn more about fillers around the eyes click here for the eyelid procedures page

Restylane in the upper eyelid stays longer than in pretty much any other place on the face. I routinely see patients back after longer than a year and the upper eyelid filler is still looking good with hardly any need for a touch up.

Because of the fact that filler lasts such a long time in the upper eyelids, combined with the precision and accuracy of the fillers, I believe it should be the treatment of choice in restoring upper eyelid volume over the use of fat. I think fat injections are more useful when it comes to total face rejuvination and are not worth the investment when only one small area such as the upper eyelids is to be treated. Fat injections are also not as predictable as the fillers thus necessitating possible touch ups and tweaks in the future.

Below is an example of a patient before and 3 YEARS AFTER Restylane injections into the upper eyelids to restore volume and correct an asymmetry caused by a previous eyelid lift by another surgeon.

Click here to view more before and after photos of upper eyelid fillers

By Gal Aharonov

The skin around the eye is very thin. Injecting fillers such as restylane and juvederm around the eye needs to be done by someone with plenty of experience. When done properly, injections of these "collagen" type products can be very beautiful and natural looking, but when done incorrectly can cause the issues you mentioned your friend having.

Your friend's lumps and issues can be reversed and fixed using a dissolving agent to melt away the filler. If she would like, she can have the procedure redone properly to have a more natural result without any of these issues.