Differentiating Type 1 from Type 2 Eyes When Considering Fat Transfer to the Upper Eyelid/Brow Complex

A colleague of mine really got it right when he created a new perspective on seeing youthful eyes.  He called them Type 1 and Type 2 eyes.  I cannot recall which one was which, which is not important.  Suffice it to say that one type of eye that we are born with is a very full upper eyelid that has almost no upper eyelid crease visible (and I am not talking about the Asian eyelid in this case).  The other type of eyelid is relative bony in appearance with a high crease, or sulcus, but still with adequate fat padding over the bony orbital rim.  If you look at models in magazines you will see these two types of eyelid configurations, sometimes the upper eyelid is very full and at other times it is full but still has a relatively skeletonized bony show of the upper eyelid.

Lindsay Lohan- Relatively Full Upper Eyelid

Cameron Diaz: Relatively Sculpted Eyes

The reason for making this distinction is to determine how to address the upper eyelid and brow when performing a fat transfer to rejuvenate it.  If an old photograph of an individual shows that he or she had a relatively high crease, then the objective of the surgeon would be to replace fat just over the bony eyebrow without trying to put too much fat to push the eyelid crease down.  For those who had a fuller appearing brow, the objective would be to add a bit more additional fat to lower the eyelid crease to where it was in youth.  These points may be more technically subtle but can be brought up during a consultation with me for possible facial fat transfer.

Samuel M. Lam, MD, FACS is a board certified plastic surgeon in Dallas, Texas. To learn more about Dr Lam’s fat grafting please call 972.312.8188 to schedule a consultation. If you would like to ask Dr Lam a question about lip surgery please visit our facial rejuvenation forum.