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Eyelids Hooding Too Soon, Need Advice on Which To Choose

asked 10 months ago by Carpadium in Portland, OR
Latest answer by Lisa L. Sowder, MD
Question viewed 587 times
Tags: comparison, hooding, options

See photos. I'm 32 and my skin is otherwise in great condition with no permanent wrinkles yet. I am wondering which would be right for me (and my budget). I've read there are many different methods, but based on these photos, looking for your advice. This is making me look older than I am I feel. Thermage Eyes ($1000 for eyes only) Pixel Perfect Fractional Rejuvination ($300 for eyes only) Blepharoplasty ($3000) Any Other Suggestions?

16 answers to Eyelids Hooding Too Soon, Need Advice on Which To Choose

Blepharoplasty the right operation?

Hold the phone. It looks to me like you have ptosis which requires repair and/or shortening of the muscles that raise your eyelids.. Get thee to an occuloplastic surgeon for evaluation! Lisa Lynn Sowder, M.D.

Lisa L. Sowder, MD
Seattle Plastic Surgeon

Ptosis or skin or volume, how can you tell?

None of us can determine what is your problem from a few static photos. Only a physical exam by a board certified plastic surgeon can determine if any of these things are contributing to your concerns. But for free, you can look in the mirror and determine if you have brow ptosis. 1- Look into the mirror and close your eyes. Keep them closed in a relaxed manner for about a minute (to let the forehead muscles relax). 2- Put a finger on your eyebrow and do not let it move. Then open... more

Robert M. Freund, MD
New York Plastic Surgeon

None of the above for your eyes!

You have a very small amount of lid ptosis which is likely hereditary. Fraxel or thermage will not benefit you at all. Blepharoplasty is not indicated and would only cause scarring. I would personally leave it alone until the skin excess because more problematic (10 years?) and a blepharoplasty would be indicated.

Jason D. Meier, MD
Jacksonville Facial Plastic Surgeon

You may have ptosis.

You may have ptosis, it appears so on your pictures. The last thing you need is a blepharoplasty. You need to see an opthalmologist. There is a simple operation to correct ptosis if that is indeed what you have.

Melanie L. Petro, MD
Alabama Facial Plastic Surgeon

Treatment for drooping upper eyelids or 'bedroom eyes"

"Bedroom eyes' is a common term for blepharoptosis or low position of the upper lid as it relates to the pupil. If it is not obstructing vision there is no absolute functional need to correct it and in many quarters it is considered to be aesthetically attractive. BUT ,if you want to address it a combined proceedure which corrects muscle laxity and upper lid skin redundancy is the best and most permenant solution. These proceedures are best done by board certified ... more

Barry H. Dolich, MD
Bronx Plastic Surgeon

Eyelid hooding

You already have several good suggestions. A few thoughts. This is not begin to qualify as "hooding". We reserve that for much more skin. Listen carefully to the doctor who suggested this might be "true ptosis". It could be just the way the photos are taken but the position of not just the extra skin but the eyelash margin is extremely low giving you a "sleepy" appearance. If that is the case nothing short of a very different operation to elevate the position of... more

Sherwood Baxt, MD
New Jersey Plastic Surgeon

Eyelid hooding treatments.

You definitely do NOT need a blepharoplasty. You may have slight ptosis which could be corrected but no browlift. Your eyes look great--leave them alone!

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon

Ptosis is the main problem

Based on the photos you have provided, eyelid ptosis [droopiness] is the main issue in your case followed by a minor excess skin component. Your brow position seems rather good. Now some have stated that your brow position maybe slightly elevated as your may be trying to compensate [subconsciously] for your droopy eyelids. Although this happens not infrequently, from your photos, I do not see any forehead wrinkles that are often the telltale sign of brow recruitment. So if I had to give... more

A.J. Amadi, MD
Seattle Oculoplastic Surgeon

Droopy lids

You need to consult a oculoplastic surgeon for a ptosis evaluation. Do not enter into laser treatments that probably not work.

David A. Bray, Sr., MD
Los Angeles Facial Plastic Surgeon

Blepharoplasty

No question about it. Blepharoplasty is a relatively simple operation to have. It will eliminate the excess skin for many years with little down time and a scar that will become almost invisible. The other techniques only give temporary results. Be sure to see a board certified plastic surgeon to have your evaluation.

E. Anthony Musarra II, MD
Atlanta Plastic Surgeon

Blepharoptosis - drooping upper eyelids

The most important photo you posted is the one on the far right because it is the only one with a straight forward gaze. Normally the edge of the upper eyelid should lie 2mm below the upper edge of the iris in this view. Yours is obviously lower so you have drooping upper eyelids (blepharoptosis). There is a small amount of excess upper eyelid skin but that is the least of your problems. The photo also shows overaction of the eyebrow lifting muscles to compensate for this blepharoptosis.... more

Aaron Stone, MD
Los Angeles Plastic Surgeon

Blepharoplasty is Most Efficacious, and Eventually Most Cost Effective

Based on the findings in the series of photos, an upper lid Blepharoplasty will best address the changes present, and provide the best value for your money. Thermage and fractionated lasers are not going to be tremendously helpful in your particular case. I understand the desire to be less invasive, but these treatments are (in my opinion) oversold for purposes of upper lid and brow changes. An alternative albeit more expensive (over time) solution is periodic use of Botox... more

Stephen Prendiville, MD
Fort Myers Facial Plastic Surgeon

www.drprendiville.com

Thermage and fractional skin resurfacing are not going to accomplish what you need.

Carpadium While these services may seem like a bargain what value will they be if they do not accomplish what you are looking to achieve. On the other hand they are unlikely to cause much harm. I can't say the same for upper eyelid surgery. I will assure you that if you have upper eyelid surgery, you are most likely going have the wrong surgery. What your photos show is upper eyelid ptosis with the upper eyelid hanging lower than they should on the eye.... more

Kenneth D. Steinsapir, MD
Los Angeles Oculoplastic Surgeon

Blepharoplasty

Hi, From your photos I would advise treatment with blepharoplasty. You could certainly try the other treatments, but blepharoplasty is the most likely to be effective.

Hugh McLean, MD
Mississauga Plastic Surgeon

Brow deflation

Although blepharoplasty can improve the appearance of the upper lids, your best option is filler injection into the upper eyelid/brow area. That is because the reason you have the wrinkles is because you have lost fat from the brow/upper lid region. That causes deflation and "collapse" of the soft tissue skin on top of it.

Mehryar (Ray) Taban, MD, FACS
Los Angeles Oculoplastic Surgeon

Eyelid Skin Hooding Can be Improved With and Without Surgery

You have several choices to improve your eyelid skin: Blepharoplasty: either using a laser or scalpel blade, the upper eyelid skin and fat can be contoured. One week of downtime. Thermage: can give you tightening of the upper eyelid skin. No down time. Mixto or Pixel laser (my preference is Mixto) can tighten the skin and can be used in combination with thermage. 3-5 days of down time. You need a complete evaluation by a cosmetic surgeon; preferably an... more