Three years ago I had successful upper eyelid surgery. Now my upper lids are droopy again. What options do I have?

Doctor Answers 5


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Dear Michelle alaoule,  I see you are from Colorado Springs and just wanted to tell you what a lovely area that is. My daughter has moved to the area last year and my wife has made several trips to the amazing "Garden of the Gods" "Pikes Peak" and the Historical Broadmoor Hotel and we are looking forward to a visit in August to see what else the Springs has to offer. With that said, typically if you have had the upper eyelid skin laxity reduced with a previous blepharoplasty then it may be that your brows have fallen and in these cases then an endoscopic browlift can be performed to put the brows back to their natural pre-aging position. In my practice in many cases I often prefer to perform the browlift first and then if there is skin laxity remove the excess skin with blepharoplasty either at that time or if needed further down the road. It is important to lift the facial tissues away from their attachments and shift the entire facial unit of skin, muscle and soft tissue back to their natural pre-aging position to allow a very natural and youthful appearance. I have included a video above and a link below to view similar cases. Best regards, Michael V. Elam,M.D.

Orange County Facial Plastic Surgeon
5.0 out of 5 stars 218 reviews

Three years ago I had successful upper eyelid surgery. Now my upper lids are droopy again. What options do I have?

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Hello Michelle alaouie,

Without photos it is hard to say.  If your eyelid skin has started to develop some slack, then a touch up procedure would likely help.  If your brows have started to fall and are creating the appearance of the droopy eyelid, then a brow lift would be the treatment.  I'd recommend you discuss your concerns with your origainl surgeon to determien what is the best option for you.  

I hope this helps and good luck.  

William Marshall Guy, MD
The Woodlands Facial Plastic Surgeon
5.0 out of 5 stars 31 reviews

Options to re-treat upper eyelids

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Photos or an exam of you would be helpful to give you the best advice, but in general, surgery can be re-done on the upper eyelids if any drooping returns.  

Michael I. Echavez, MD
San Francisco Facial Plastic Surgeon
4.5 out of 5 stars 18 reviews

There is just no substitute for a personal consultation.

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Even a photograph of your eye area is very helpful here for the real self community to provide more concrete suggestions for your eyelids.  Revisional eyelid surgery can be highly successful.  What you may need is highly dependent on what your anatomic issues are.  Do you have forehead ptosis? do you have upper eyelid ptosis?  Do you have loose eyelid platform skin?  All of these issues and more need to be assessed to design an appropriate surgery for you.   Rather than removing things, sometimes what is needed is eyelid structure.

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Return of upper eyelid excess

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Dear Michelle,
When patients have heavy upper eyelids they frequently elevate their brows with out even realizing it because if feels better, they may be able to see better, and it actually looks better. Typically people are completely unaware they are doing this and it is important when evaluating a patient for upper lid blepharoplasty to have them completely relax their forehead because their brows will likely drop or descend to the more resting or natural position after their surgery. Sometimes the resting position is aesthetically too low and they also have brow ptosis that can also be treated to improve the look of the upper lids with a brow lift. If people have both brow ptosis and upper lid skin and fat excess, the order of correction is important. The brows should be elevated first, and then less upper lid skin is typically removed because some of the excess skin has been recruited when the brows are lifted. The fear is removing too much tissue and creating or exacerbating dry eye symptoms, which is particularly common in Colorado because of the lack of humidity.
It could be that what your are noticing is that your brows have naturally descended a bit after your upper bleph, or maybe you just have a recurrence of excess skin and/ or fat if your first surgery was conservative (not a bad thing). Just respect that your eyelids have a very important job to perform, and we don't want to compromise that for an improved cosmetic look. Chronically blood shot and irritated eyes aren't so pretty either.
Best of luck,

Stacey Folk, MD
Denver Plastic Surgeon
4.8 out of 5 stars 25 reviews

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