How Effective Are Non-surgical Options Compared to Eyelid Surgery?

Are some conditions resolved with non-surgical alternatives to blepharoplasty? How often do patients end up needing surgery in the long run anyway?

Doctor Answers 8

Eyelid Surgery Vs Non Surgical Options

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Although blepharoplasty (eyelid) surgery is the only treatment that is long lasting there are a few things you can do that are of temporary help. Make sure you have an exam to make sure that you do not have weak eye muscles, ptosis, as your cause by an exam by a board certified specialist.

Lower lids: Ceramide creams for the lower lids which in minutes as they dry the clear membrane tightens the lower lid skin minimizing bags and wrinkles. This lasts from 4-8 hrs and can be reapplied as needed. Radiofrequency, laser and peels tighten the skin with minimal downtime. Fillers for fat transfer #lipoinjection, to the lower lid to fill in the cheek-lid depression that casts shadows also helps many.

For the upper lids, Botox in the crows feet area just below the brow will gently lift the lateral brow and lift a bit of the hooding on the side of your eye. This lasts about 3-4 months. Make sure you go to an expert injector associated with a Plastic Surgeon, Facial Plastic Surgeon, Dermatologist, or Ophthalmologist skilled in injections.


Nonsurgical treatment of eyelids

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I use the Pixel laser (Erbium YAG) if there are fine lines in the lower lids but if there is extra skin, a blepharoplasty (eyelid surgery) should be performed. For dark circles, either restylane or fat injections help.

The choice of Blepharoplasty Surgery vs non surgical eyelid treatment depends on what your eyelids look like.

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Blepharoplasty with surgery or laser works best if there is significant extra skin or herniated fat pads.  If the eyelids a slightly loose or wrinkled, it is possible to get a great results with ablative or sometimes nonablative laser treatments. 

Mark Taylor, MD
Salt Lake City Dermatologic Surgeon
4.2 out of 5 stars 18 reviews

Non-surgical options can be effective

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Non-surgical alternatives for blepharoplasty include Botox/Dysport injections to raise the eyebrow which can result in a more open eye apperance,  fillers (Restylane or Juvederm) to carefully smooth out the under eye area and chemical peels or laser to smooth fine lines and imnprove pigment.  All of these effects are temporary and therefore proceeding with a surgical treatment can be considered for a more long-lasting result. 

Consult with a plastic surgeon to discuss your options 

David J. Levens, MD
Coral Springs Plastic Surgeon
5.0 out of 5 stars 79 reviews


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This question seems to ask when can injectables improve the appearance of the eyes and when is surgery necessary to achieve the desired improvement.  For the upper eyelids the answer to this question depends on the extent of any excess redundant upper eyelid skin.  The appearance of the upper eyelids can sometimes be improved with the use of neuromodulators.  However, if there is excessive upper eyelid skin surgical removal of the excess redundant skin is necessary.

Paul Carniol, MD
Summit Facial Plastic Surgeon
5.0 out of 5 stars 8 reviews

We can't answer this question definitively yet.

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It is very clear that the noninvasive treatment are very good.  For some people it means help for many years avoiding the need to have eyelid surgery.  There are other for whom the noninvasive methods simple do no adequately address there anatomic issues.  They need surgery.  I personally believe that there are individuals for whom minimally invasive methods will work for them until they reach a point where they are no longer interested in cosmetic procedures.  What I can't tell you is how many will ultimately transition from being success with non invasive methods to needing surgery and when this will happen for a given person.

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

Nonsurgical alternatives to blepharoplasty

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A general question can only be answered in general terms. If you do not need a blepharoplasty, then the non-surgical treatments such as Botox, can be effective. If you have ptosis or sagging in the upper eyelids and brows, then surgery may be required to elevate the brows and/or excise excessive upper lid skin. Similarly, if you have lost volume in the lower eyelid area, then Restylane can achieve an improvement but if the condition is such that this is insufficient, then a lower lid blephasroplasty would be required.

Non-surgical Alternatives to Blepharoplasty

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The brief answer is that although there are non-surgical treatments for specific aesthetic concerns around the eyes, there is no substitute for skin removal in the upper eyelids when it is indicated, or fat removal/cheek repositioning in the lower eyelids.  Botox/ Dysport/ Xeomin are very effective in addressing crow's feet, Sculptra and fillers are very effective at adding volume to the cheeks, but do not address the concerns shared by most upper/lower eyelid Blepharoplasty candidates

Stephen Prendiville, MD
Fort Myers Facial Plastic Surgeon
4.9 out of 5 stars 104 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.