What can I do to minimize the appearance of drooping eyes caused by aging? (photos)

Question

I have noticed my eyes are getting droopier by age. I had a small forehead lift 6 years ago but time goes on. Suggestions?

Jason Emer, MD · Answer

As we age, our eyelids naturally sag and droop. A combination approach would be best to see visible improvement. In terms of non-surgical treatment options, I would recommend a Chemical Brow Lift (using Botox, Dysport, Xeomin, or Jeuveau) and filler injections to rejuvenate the temples, eyebrow, eyelid, eye troughs, upper eye hollows, and forehead. I typically combine this with Ultherapy and thread lifting to lift the brow; RF and skin tightening laser treatments to stimulate collagen production and rejuvenate the skin; and laser or superficial RF devices for improvements in texture, color, and any crepey skin around the eyes as needed. In some cases, surgery is the best solution to achieve the desired results. See an expert for a formal consultation. Best, Dr. Emer.​

Albert Ko, MD · Answer

Hi there! Thanks for your question. I think you would be a great canidate for a blepharoplasty procedure, to remove the excess skin on your upper eyelids that are causing them to be heavy.I would reccomend a consultation with a board certified plastic surgeon. Hope that helps!

Marc Polacco, MD · Answer

Thank you for your question. The best treatment would likely entail a combination of a brow lift with a blepharoplasty (eyelid surgery). If you like where your brows are currently situated after your prior lift however, a blepharoplasty alone would likely be the better option. I hope that helps, and all the best to you.
-Dr. P

Libby Copeland-Halperin, MD · Answer

Thank you for your question and for sharing your photos. You appear to have some excess skin and fat in your upper eyelids that are contributing to the drooping you commented on. This could be addressed with an upper blepharoplasty/eyelid surgery. In this procedure, a small incision is made in the upper eyelid and hidden in a natural skin fold and the excess skin and fat are removed). From your photos, you also appear to have some sagging/drooping of your eyebrows and may also benefit from a brow lift. This can often be performed through small incisions hidden in your hair line and can be performed at the same time as upper eyelid surgery as an outpatient procedure under IV sedation. I recommend you meet with a fully-trained plastic surgeon to discuss your goals. Good luck!

Johnson C. Lee, MD · Answer

Thank you for your photo. If you already had a successful brow lift and your eyebrows are in a stable position, then blepharoplasty helps directly remove extra skin in the upper eyelids. This will turn the clock back on your eyes for a more more smooth and youthful look with less crepey skin and less hooding. Upper skin blepharoplasties can be done easily as an office procedure under local anesthesia. The incision is hidden in your natural crease so there is no sign that you have had surgery other than your improvement. Non-surgical options include lifting your eyebrows slightly with botox or an energy device such as Ultherapy however the benefit is minimal and temporary. It is best to have an in-office examination to evaluate your periorbital anatomy and function and determine the best and safest treatment plan for your eyes. Hope this helps!!

Johnson C. Lee, MD
Board-Certified Plastic Surgeon

Johnson C. Lee, MD
Board-Certified Plastic Surgeon​

Derek Fletcher, MD · Answer

Your photos suggest you would benefit from both nonsurgical and surgical facial rejuvenation strategies. Toxin (Botox or Daxxify, a new long-acting Botox alternative) will help with glabellar lines (11's) and crows feet smile lines. Both will elevate your lateral brow and give you more arch, which might be enough to achieve your brow goals. Skin care with Retin A and hydroquinone will improve skin tone, texture, and pigment. I would strongly consider skin resurfacing with a chemical peel or laser as well. Deep chemical peels may partially correct your extra upper eyelid skin enough to delay surgery several years. Both lasers and chemical peels can tighten the lower lids enough to avoid external incisions on the lower lids. It is important that to understand that surgery can remove extra skin, change shape of the brows and eye fissure, and add facial volume. But it does not address the years of sun damage many patients have from living an active lifestyle outdoors.
Surgically, you may be a candidate for brow lift, upper eyelid blepharoplasty, and scarless lower lid blepharoplasty with facial micro fat grafting. Which brow lift technique is best suited for your needs is determined by your goals and a detailed, in person exam. Bring photos of yourself from before your first brow lift, the operative report, and photos of yourself from right after your brow lift to help your surgeon understand where you started, what was done, and how effective your first brow lift was.

William Portuese, MD · Answer

An upper blepharoplasty procedure can accomplish removal of the extra hooded skin and a small amount of fat from the upper eyelids to rejuvenate them. This procedure can be performed under local anesthesia as an outpatient procedure.

What can I do to minimize the appearance of drooping eyes caused by aging? (photos)

Answers (7)

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