Is upper eyelid filler safe & effective? I'm 47 with hooded eyelids (Photo)

Question

Is upper eyelid filler safe and effective? I am 47 with hooded eyelids. I actually have always liked my hooded eyes but they don't age well. I've noticed that not many doctors around me offer this. So, I'm curious about the safety and success rate of this procedure. Thank you.

George Yang, MD · Answer

Hooded eyelids look good when there is enough brow fat pad hiding the rim of the eye socket bone. If you raise you eyebrows when looking in the mirror, you may notice that although your upper eyelid skin is hooding towards your eyelashes, when you raise your eyebrows, you see much more upper eyelid than you did when you were younger. 
The amount of upper eyelid skin (in actuality is it brow skin) is that same as when you were younger. The volume loss in relation to the amount of skin for hooded eyelids make the skin look loose. Notice that the loose skin disappears when you raise your eyebrows. So a browlift would give you the same look as raising your eyebrows, but without forehead wrinkles. If you like the look of the amount of eyelid you see when raising your eyebrows, then skin removal, skin tightening, or browlift will give you that look. 
Having said that, my interest in adding volume back around the brow area began in 2006, when observing patients after upper eyelid surgery. The goal of aged hooded eyelid surgery is to remove the loose skin, However, when looking at these patients younger photos, I did not see much eyelid “platform” the eyelid skin below the upper eyelid fold. All that I saw was a lot of “brow skin” or skin between the eyebrow hairs to the top of the eyelid fold. What I did notice was that the eyelid fold was “parallel” to the eyelash line curving softly in a parallel manner. At no point on young looking eyes is there a straight line area to the curve, which makes the amount of eyelid showing less than the inner corner of the eyelid which is usually more (AKA A-frame deformity). 
For upper eyelid filler, reviewing the patient’s younger photos is crucial to determining what exactly to next. Many times the hooded area is actually not the problem and the A-frame area is actually showing too much eyelid. By adding volume to the inner corner of the brow skin area will hide more eyelid and help to curve the eyelid fold more in the inner corner, thus making the eyelid fold parallel. The results are see as the volume is adding back and shown to the patient between incremental additions of volume. 
The results can last many years, the longest without a touch up is already up to eight years, but results may vary. It depends on if we are catching the volume loss early and immediately replacing it before it full hollows. By performing the upper eyelid filler, does not “stop aging” or stop the fat loss from continuing to happen. For these patients, then will need a touch up earlier. For other patients, who had eyelid surgery, or non-surgical skin tightening which “cooks off” more fat underneath the skin from the heat of the non-surgical procedure, then the results may last longer, since the fat was prematurely shrank on purpose. For my family members and my patients, I prefer than they keep as much natural fat as possible and I will try to maintain their “look” as is changes in the future. For this reason, I don’t recommend energy, heat, RF or laser to “tighten” the skin since I don’t see that as the actual problem to solve. 
In fact, if the original problem fat loss causing the hooding, then cooking the skin and fat more will shrink more fat and show even more eyelid than when they were younger. If you prefer your younger hooded eyelids, it will turn Blake Lively’s eyelids into Nancy Peloso eyelids as more skin and fat keeps getting reduced. 
I would rather maintain the look instead. During consultations, I show many more examples than are shown on the website. Most patients who have had upper eyelid filler done with me, don’t appear to have had anything done, and they don’t want people to know, hence I don’t push my patients hard to show their photos on social media like other practices. 
Best,
Dr. Yang
Best,
Dr. Yang

Whitney Florin, MD · Answer

You are absolutely correct in noticing that many providers do not offer this treatment. This is a highly advanced area to treat as injections around the eye (and truly anywhere in the face) carry the risk of injecting filler into a blood vessel which can cause occlusion and very rarely blindness. As always, it's best to see an experienced provider to see if you will be a good candidate for this procedure. Other options to improve hooding of the upper eyelid would be upper eyelid surgery (blepharoplasty), brow lift, or non surgical options such as energy devices/skin tightening to help lift the brows. Hope this helps!

Anil R. Shah, MD · Answer

Hello Fabulous877912! My name is Jessica, I am a physician assistant, and one of the providers at Shah Facial Plastics. I highly recommend scheduling an in-person consultation in order to better assess the areas of concern and discuss an appropriate treatment plan to help achieve your aesthetic goals. Our office phone number is: (312) 944-0117. I hope this helps and best of luck!

Michelle Zweifler, MD · Answer

In general, the best treatment for hooded eyelids is a blepharoplasty removing the excess upper eyelid skin.  Eyebrow sagging may also cause hooding of the upper eyelid; this can be address with brow lift, botox, and/or sofwave.  Fat can be placed to restore the fullness as well; filler is used much less commonly.

Nelson Lee Novick, MD · Answer

Hooding is the predominant feature seen in the photo. The Ten Minute Eyelift is a quick and simple and minimally invasive, nonsurgical approach for shrinking the excess floppy skin to better expose the true upper eyelid. Performed using only local anesthesia to numb the area, as the name suggests, it literally takes five minutes per side to perform. I literally just performed it on my wife a little over two weeks ago. The heat generated by light electrocautery causes immediate shrinkage of the excess skin and contraction. No need for invasive surgery and no risks as might be the case with fillers (which are seldom particularly effective anyway for this kind of issue). You would be wise to consult a board certified cosmetic dermatologist and best of luck.

Anna Chacon, MD, FAAD · Answer

Upper eyelid filler is a relatively new and novel treatment for hooded eyelids. The procedure involves injecting hyaluronic acid (HA) filler in the upper eyelid area to restore a more youthful appearance and decrease the appearance of sagging or drooping. The procedure is considered safe when performed by a skilled and experienced provider.There are some potential risks associated with filler injections, such as swelling, bruising, and infection, although these are rare. In rare cases, complications such as visual disturbances or vision loss have been reported.The success of the procedure can vary depending on the individual's anatomy, age, and skin type. Some patients report a noticeable improvement in the appearance of their hooded eyelids, while others may require additional treatments or surgical intervention.
It's important to consult with an experienced provider to discuss your treatment goals and potential risks before undergoing any cosmetic treatment. Your provider can also discuss alternative treatments, such as eyelid surgery, which may be more appropriate depending on your concerns and desired outcome.

Camille Cash, MD · Answer

From your photo you are a better candidate for either an upper blepharoplasty, a brow lift, or both.  The blepharoplasty would address the excess skin of the upper lid.  A brow lift would reposition the brow which in pulls some excess eyelid skin upward.  The result is a refreshed appearance to the eye.  I've included a video that I hope you find helpful.

J. Renee Booth, MD · Answer

Significant caution is used with filler near the eyes because the blood vessels have connections with the main artery to the eye. This means there is a risk of partial or total vision loss. This is the main reason to avoid filler around the eye. Another reason is that filler would be more likely to increase volume and plump the area, which will be unlikely to achieve your desired outcome. The best way to deal with extra skin depends on the cause. If it is due to laxity of the brow, then a brow lift will help. If it is dues to laxity of the upper eyelid skin, then a blepharoplasty or laser would help. Another less invasive option to try would be platelet rich plasma, although it is important to remember that there will be less improvement with non-invasive options in this situation.

Leonard Grossman, MD · Answer

Fillers do not belong in the eyelid itself. Some fillers can for used in the eyebrow re-creating the fullness of the younger face. I personally prefer to use patient own fat as it takes root in the area and produces natural and practically permanent results, My recommendation is to find a Plastic Surgeon who specializes in fat grafting. I hope this helps and good luck from New York City Plastic surgery

Is upper eyelid filler safe & effective? I'm 47 with hooded eyelids (Photo)

Answers (9)

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