Eyelids Hooding Too Soon, Need Advice on Which To Choose

See photos. I'm 32 and my skin is otherwise in great condition with no permanent wrinkles yet. I am wondering which would be right for me (and my budget). I've read there are many different methods, but based on these photos, looking for your advice. This is making me look older than I am I feel. Thermage Eyes ($1000 for eyes only) Pixel Perfect Fractional Rejuvination ($300 for eyes only) Blepharoplasty ($3000) Any Other Suggestions?

Doctor Answers 16

Droopy lids

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You need to consult a oculoplastic surgeon for a ptosis evaluation. Do not enter into laser treatments that probably not work.

Los Angeles Facial Plastic Surgeon

Blepharoplasty the right operation?

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Hold the phone.  It looks to me like you have ptosis which requires repair and/or shortening of the muscles that raise your eyelids..  Get thee to an occuloplastic surgeon for evaluation!

Lisa Lynn Sowder, M.D.

Lisa Lynn Sowder, MD
Seattle Plastic Surgeon
5.0 out of 5 stars 77 reviews

Ptosis or skin or volume, how can you tell?

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None of us can determine what is your problem from a few static photos. Only a physical exam by a board certified plastic surgeon can determine if any of these things are contributing to your concerns. But for free, you can look in the mirror and determine if you have brow ptosis.

1- Look into the mirror and close your eyes. Keep them closed in a relaxed manner for about a minute (to let the forehead muscles relax).

2- Put a finger on your eyebrow and do not let it move. Then open your eyes. If the eyebrow tries to move upward or moves upward after you take your finger off of it, then you have some brow ptosis.

If you think you have lost eyebrow volume, then ptosis may occur and the test above may be appropriate. Another way to evaluate brow volume loss is to compare current eyes with old photos.

Finally, if it is just a little excess skin, be wary of too much surgery. You have a predisposition for looking too hollow. Only have skin excision - not skin and muscle.

I hope this does not confuse - Good Luck!

Robert M. Freund, MD
New York Plastic Surgeon
4.8 out of 5 stars 34 reviews

None of the above for your eyes!

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You have a very small amount of lid ptosis which is likely hereditary.  Fraxel or thermage will not benefit you at all. Blepharoplasty is not indicated and would only cause scarring.  I would personally leave it alone until the skin excess because more problematic (10 years?) and a blepharoplasty would be indicated. 

Jason D. Meier, MD
Jacksonville Facial Plastic Surgeon
5.0 out of 5 stars 11 reviews

You may have ptosis.

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You may have ptosis, it appears so on your pictures.  The last thing you need is a blepharoplasty.  You need to see an opthalmologist.  There is a simple operation to correct ptosis if that is indeed what you have.  

Melanie L. Petro, MD
Birmingham Facial Plastic Surgeon
4.7 out of 5 stars 31 reviews

Treatment for drooping upper eyelids or 'bedroom eyes"

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"Bedroom eyes' is a common term for blepharoptosis or low position of the upper lid as it relates to the pupil. If it is not obstructing vision there is no absolute functional need to correct it and in many quarters it is considered to be aesthetically attractive.

BUT ,if you want to address it a combined proceedure which corrects muscle laxity and upper lid skin redundancy is the best and most permenant solution. These proceedures are best done by board certified  surgeons be they plastic or occuloplastic.

Barry H. Dolich, MD (Retired)
Bronx Plastic Surgeon

Eyelid hooding

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You already have several good suggestions. A few thoughts. This is not begin to qualify as "hooding". We reserve that for much more skin. Listen carefully to the doctor who suggested this might be "true ptosis". It could be just the way the photos are taken but the position of not just the extra skin but the eyelash margin is extremely low giving you a "sleepy" appearance. If that is the case nothing short of a very different operation to elevate the position of the lid will be of any value. If it is just the small amount of skin that I see in the picture.... a skin only upper lid blepharoplasty  is quick and efficient and will last you the better part of your life. Hope this helps

Sherwood Baxt MD

Sherwood Baxt, MD
Paramus Plastic Surgeon

Eyelid hooding treatments.

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You definitely do NOT need a blepharoplasty. You may have slight ptosis which could be corrected but no browlift. Your eyes look great--leave them alone!

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 38 reviews

Ptosis is the main problem

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Based on the photos you have provided, eyelid ptosis [droopiness] is the main issue in your case followed by a minor excess skin component. Your brow position seems rather good. Now some have stated that your brow position maybe slightly elevated as your may be trying to compensate [subconsciously] for your droopy eyelids. Although this happens not infrequently, from your photos, I do not see any forehead wrinkles that are often the telltale sign of brow recruitment.

So if I had to give a value for what surgical procedure would help you the most, I would say ptosis repair as the most "bang for your buck], probably 80%, followed by blepharoplasty [removal of skin] at about 20%. Brow lift would not be in my consideration for you at this time.

Best of luck

seattleface com

A.J. Amadi, MD
Seattle Oculoplastic Surgeon
5.0 out of 5 stars 42 reviews


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No question about it.  Blepharoplasty is a relatively simple operation to have. It will eliminate the excess skin for many years with little down time and a scar that will become almost invisible.  The other techniques only give temporary results. Be sure to see a board certified plastic surgeon to have your evaluation.

E. Anthony Musarra II, MD
Atlanta Plastic Surgeon

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.