Lauren D. Mileo, MD

Based on your photos, I think that mainly your brow has descended into your eyelid area and is creating that hooded/droopy appearance which a brow lift would address. You might also have some excess eyelid skin that a blepharoplasty might address, but this requires measurements taken at an in person consultation. I would suggest getting evaluated by an oculoplastic surgeon who had optimal understanding of the eyelid/eyebrow anatomy, and will guide you to choosing the surgery that will give you the best results without wasting your money.

Some patient have more "scleral show" which is the white part between your eye and your lower eyelid. This is often due to anatomy and the relationship between your eye, eyelid, and eye socket. Sometimes the eye protrudes farther out of your eye socket due to systemic issues such as thyroid/autoimmune conditions. An orbital decompression is a surgery that enlarges your bony eye socket to create more space for your eye (and make it not protude as much). It is a very big surgery, and you need proper evaluation with bloodwork and imaging to determine if you are a candidate. You can also consider eyelid surgery (canthoplasty) to bring the lower eyelid higher up but that will change the overall shape of your eyes. For these surgical evaluations you should seek a consultation with an oculoplastic surgeon.

Can try another form of botox (xeomin, dysport, daxxify) to see if it will paralyze the muscles in the area more and soften the 11s. Otherwise will have to consider a procedure (forehead lift) if you want to more permanently treat the area.

It looks like your left upper eyelid hangs lower over your eye than your right. This is called "ptosis." Your case is mild and is like congenital (you were born with a weaker muscle on that left side) and is just getting worse overtime. There are surgical (ptosis repair) and nonsurgical (upneeq drop) options to fix mild ptosis. I would suggesting seeing an oculoplastic surgeon who will test and offer you either option to help lift the left eyelid to match the height of the right one.

If you have had two upper blepharoplasties and there is still some heaviness/hooding especially in the outer corners, then it is probably your eyebrow that is overhanging your eyelids. Your eyebrow also "droops" with time and gives the appearance that there is excess eyelid skin. However, your surgeon removed the maximum amount of eyelid skin without giving you issues of closing your eyes. So I would consider brow lifting procedures if you are still bothered by the appearance.