40 year old with droopy eyelid(s), what are my options? (photo)

Question

Eyelids have always been slightly hooded, with left side more pronounced. Have gotten worse in recent years.

James Shire, MD · Answer

It is difficult to determine from your photo, but you appear to have brow ptosis (sagging) greater on the left side than the right. You may also have some excess upper eyelid skin in addition. You should be evaluated by an experienced facial plastic or oculoplastic surgeon to be evaluated and discuss your treatment options.

Kenneth D. Steinsapir, MD · Answer

I suspect you can have a personalized blepharoplasty possibly including a ptosis correction and do very well.  Look for a surgeon who takes an individual approach and does not do cookie cutter surgery.   The potential surgeon needs to spend time examining you.  If the consultation takes 5 minutes, you are in the wrong office.

John J. Martin, Jr., MD · Answer

Not a great photo, but looks like you have extra skin which could be removed with an upper eyelid blepharoplasty.  You also have a lower brow on the left which makes this side appear worse. So would need to lift at least the left brow as well.

Walton Montegut, MD · Answer

This is a good question.  When eyelids have extra skin, the procedure that is needed is a Eyelid Lift, or a Blepharoplasty.  This is a surgical procedure that is relatively simple to remove the skin and fat from the upper eyelid.  I like to refer to it as easy as going to the dentist.  It is performed under local anesthesia and the down time is minimal.  It refreshes your face and takes away that tired eye look.  After training with Dr. Henry Baylis (the founder of the Jules Stein Institute), I perform revision eyelid surgery.  It is important that eyelid surgery be performed correctly the 1st time.  This area of the body does not do well with revisionary surgery.  Therefore, do it right the 1st time.  Also, if your lids are droopy, you may need a muscle repair which is considered Ptosis repair surgery.  This is a repair of the actual muscle.  I hope this helps.  Proceed carefully and make sure the right procedure is performed.  Thank you.

Lawrence Scott Ennis, MD, FACS · Answer

Let's start with the upper lids, what happened as we get older is the brow descends. This often gives us the illusion that there is extra skin in the upper lid. Most often I recommend an endoscopic brow lift to raise the lateral portion of the brow and correct this hooding before we do anything to the upper lids. This is done through for small incisions back in the hairline using high definition cameras. 
 
 In the lower lids, there are three fat pads under the arm and a curtain of muscle that holds the fat back. As we get older if that gets heavier in the muscle get tired creating "bags" under your eyes. The second issue is the cheek pad descends leaving a hollowness under your eyes and making the nasolabial fold's deeper. 
 
 This is corrected by making a small incision under the, taking out the fat, and elevating the cheek pad. 
  
Dr Scott Ennis - Plastic Surgeon – Destin, Fl

William Portuese, MD · Answer

The photograph demonstrates significant asymmetry of both the eyebrows and the eyelids. A brow lift procedure can address making the eyebrows more symmetrical by raising the  lower eyebrow to meet the opposite side. Alternatively, an upper blepharoplasty procedure can accomplish removal of an asymmetric amount of skin, muscle and fat to make the eyelids look more symmetrical. For more information and many before-and-after examples of both procedures, please see the link and the video below

Damon B. Chandler, MD · Answer

I see patients similar in appearance to your photo almost daily in my practice. Of course an in-person consultation will be most critical, but your photo seems to show excess tissues of both upper eyelids and a higher brow on the left side of the photo which makes the upper eyelids appear differently.  A brow lift could be considered, as others here have suggested. From your photo alone, I might consider a cosmetic upper eyelid blepharoplasty along with precise Botox -- as long as you have reasonable expectations, I think you'd get a lovely result.  Make sure to seek out a board-certified, fellowship trained Oculofacial Plastic Surgeon or Facial Plastic surgeon with particular expertise in cosmetic eyelid surgery -- I think you require a specialist with a keen eye for detail.  Best of luck!

Matheson A. Harris, MD · Answer

It looks like you have some asymmetry of the brows and a slight amount of extra upper eyelid skin.  You should be evaluated for either a combination blepharoplasty and brow lift, or just a brow lift alone. At your age, this may be all you need to lift the skin off your eyes and improve the symmetry.

Sara A. Kaltreider, MD (retired) · Answer

Any treatment that you consider should include elevation of the eyebrows. Without an examination, it is difficult to determine whether or not you would require blepharoplasty or ptosis repair along with brow lift. Be sure to seek consultation from an expert in eyelid and brow surgery to achieve your best results. Best wishes.

40 year old with droopy eyelid(s), what are my options? (photo)

Answers (9)

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