Filler or Botox For Puffy, Droopy Eyelids?

Will fillers or botox help with my issue? I'm 44 years old and besides having a natural, puffy, natural eyelid as part of my anatomy the lids are starting to droop. Thank you. Lourdes

Doctor Answers 11

Botox or fillers for puffy and droopy eyelids

No doctor can advise you well over the internet. You will have to be seen in consultation to evaluate your particular circumstances.  Some puffy lower eyelids are worsened by Botox in the lower eyelids by decreasing the muscle's pump action  and fillers such as Juvederm and Restylane can absorb water making the puffiness worse. Other patients can have improvement with contour when fillers are injected in the tear trough to smooth out the "double bubble" of the lower eyelid muscle and the fat herniation.

Upper eyelid sagging might be lifted slightly by injecting Botox in the glabella between the eyebrows and the outer eyebrows (the tail of the eyebrows) and off-label use of Restylane in the outer and mideyebrows can help support this structure and help lift the upper eyelid sagging. Finally, Ultherapy ultrasound of the forehead can help lift the forehead eyebrow complex and sometimes Thermage can tighten the upper eyelid.

For some patients, blepharoplasty is an ideal treatment for the sagging and can eliminate much more sagging skin than that which can be tightened or lifted with noninvasive means. The cost of all the treatments must be considered too.

The information provided in Dr. Shelton's answer is for educational purposes only and is not intended to constitute medical advice.  The information provided should not be relied upon as a substitute for consultations with a qualified health professional who may be familiar with your individual medical needs. If you are experiencing a medical emergency proceed to your nearest emergency room.



Manhattan Dermatologic Surgeon
4.9 out of 5 stars 38 reviews

Filler or Botox For Puffy Eyelids

What we would recommend for someone who wants to try a less invasive treatment is Botox. Botox can help lift the eyebrows and the forehead and create a more open-eyed look. If it is the eyelids and not a matter of a drooping forehead, we would recommend an upper blepharoplasty for a more permanent result. A blepharoplasty is done to remove excess amounts of skin and/or fat, therefore dramatically reducing any drooping associated with it.



Edward E. Dickerson, IV, MD
Fayetteville Facial Plastic Surgeon
4.7 out of 5 stars 120 reviews

Botox Brow Lift for Puffy, Droopy Eyelids

A Botox brow lift may be the first step for you in determining how much skin is drooping over your eyes. If the Botox allows the brows to come up and your eyes look less hooded, that's great. If after the Botox brow lift, you feel there's too much skin over your eyes, than an upper eyelid blepharoplasty may be the right choice for you. Make sure that you seek a specialized and qualified doctor for upper eyelid surgery.

Amiya Prasad, MD
New York Oculoplastic Surgeon
4.3 out of 5 stars 72 reviews

Treatments for puffy, droopy eyelids

Photos would really be necessary to provide you with the best advice.  From what you describe, filers would not be of much help.  An upper blepharoplasty is usually the best treatment option for puffy upper eyelids.  Surgery would also help to address ptosis, or drooping of the eyelid. Thank you, and I hope this helps answer your question.

Paul S. Nassif, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 47 reviews

Post photos

There are many different underlying reasons for what patients call "puffy" or "droopy" eyelids, such as excess skin, eyelid swelling, eyelid fat, or a droopy eyelid. Each condition has a different treatment. Posting a photo will help us tell you what might be best for you.

A.J. Amadi, MD
Seattle Oculoplastic Surgeon
5.0 out of 5 stars 41 reviews

Droopy eyelids correction with no surgery

Droopy eyelids cannot I repeat cannot be corrected by fillers or botox. Botox will raise the brow slightly but after youv'e wasted $2000 and dot see results you should get a blepharoplasty. A very easy fast healing operation which takes a little longer than your repeat botx treatments

Richard Ellenbogen, MD
Los Angeles Plastic Surgeon
4.7 out of 5 stars 30 reviews

Botox Benefits

When properly diagnosed, neuomodulators (Botox/Dysport) and facial fillers (Restylane/Juvederm) can have a profound effect on orbital and eyelid anatomy.  Great care should be used with these substances and only by experienced Cosmetic Practitioners.


Robert A. Shumway, MD, FACS

Robert Shumway, MD
San Diego Facial Plastic Surgeon
5.0 out of 5 stars 12 reviews

Yes Botox will help with this issue

While Neurotoxin's are not surgery Botox can help lift the brow and possibly make the droopy lids  better. Most patients your age start with neurotoxin's due to the fact there is little or no downtime with this treatment.  If you are against having eyelid surgery right now it may be a good alternative for you. Here at my practice we  provide information during the consultation and cover all the options, short term and long term remedies. We make a treatment plan for the present with goals for the future. Without seeing photos it is difficult to give you the correct answer, my recommendation is to have a consultation with a board certified plastic surgeon and see what options are best for you. Good luck! 

Z. Paul Lorenc, MD
Manhattan Plastic Surgeon
4.6 out of 5 stars 34 reviews

Options for Puffy, Droopy Eyelids

Droopy eyelids may be a side effect of a "droopy" forehead. For droopy eyelids only, Botox or Dysport can be helpful to temporarily (4-6 months) open up the eyes. For more long lasting improvement, a blepharoplasty may be beneficial. If a droopy forehead is the reason your eyelids are dropping, then a forehead lift, endoscopic or open, with or without an eye-lift (blepharoplasty) will be in order.


Consult with a facial plastic surgeon or experienced oculoplastic surgeon for an examination and discussion of your options.

Anifat Balogun, MD
Seattle Otolaryngologist

Botox or Surgery

Without pictures, it is impossible to give you specific advice.  However, if you have ptotic (droopy) skin, then you likely need a blepharoplasty (eyelid lift).  If you only have crow's feet (wrinkles to the outside of your eye/eyelids) then Botox Cosmetic can be very helpful.


Good Luck.

David Shafer, MD
New York Plastic Surgeon
4.9 out of 5 stars 77 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.