I Can't Get a Bleph for my Droopy Upper Eyelids Due to Dry Eyes. What Would Be the Next Best Option?

I'm 46 and have moderate to severe droopy upper lids. Since surgery is ruled out, what is the next best procedure to use? I realize the best result would be with surgery, but at this point ANY result, no matter how small, would be an improvement.

Doctor Answers 12

Cosmetic Eyelid Surgery For Patients with Dry Eyes

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Cosmetic eyelid surgery can enhance appearance dramatically, but care must be taken for patients with dry eyes.   If you have been diagnosed with a significant case of dry eyes, it is important to evaluate how dry the eyes are and to treat them preoperatively.   The use of medications or tearduct plugs can restore some of the moisture to the eyes and make your surgery safe and rewarding.    I would recommend an evaluation by an opthamologist who specializes in the treatment of dry eyes and have your plastic surgeon collaborate with that doctor to optimize your eyes before the procedure.   If your eyes are severely dry, surgery may not be wise, but this is really a minority of patients.  

Los Angeles Plastic Surgeon
4.8 out of 5 stars 34 reviews

Blepharoplasty Options

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Thank you for your question. I recommend you see an Oculoplastic and Board Certified Plastic Surgeon for another evaluation of your candidacy, then discuss other alternatives.  This may include a mini brow lift, or other procedure. I hope this helps.

Blepharoplasty and Dry Eyes

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Upper lid blepharoplasty can be performed in patients with dry eyes.  The degree of dry eye needs to be evaluated and a more conservative surgical approach can be used safely in many cases.


Jill Hessler, MD
Palo Alto Facial Plastic Surgeon
4.9 out of 5 stars 32 reviews

Upper Blepharoplasty with Dry Eyes

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Upper blepharoplasty surgery can be done for patients with dry eyes, but it requires someone who is aware of the precautions and the techniques to prevent the dryness from worsening.  Please consult with a board certified specialist who can best assist you in achieving the results you seek.

Kimberly Lee, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 13 reviews

I Can't Get a Bleph for my Droopy Upper Eyelids Due to Dry Eyes. What Would Be the Next Best Option?

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It is important for you to be examined by an Oculoplastic surgeon, a physician who is trained both in Ophthalmology and Plastic Surgery, to see if you are a surgical candidate, and if so, what the best option for you would be.  Good luck.

Sam Goldberger, MD
Beverly Hills Oculoplastic Surgeon

I Can't Get a Bleph for my Droopy Upper Eyelids Due to Dry Eyes. What Would Be the Next Best Option?

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Hard to tell without photos, but at your age, most patients I see requesting upper blepharoplasty benefit more from a brow lift to correct their problem. Patients with dry eye syndrome frequently undergo successful blepharoplasty. See someone who is familiar with the surgery in that patient population and get more information.

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 29 reviews

Heavy upper eyelids

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There are three factors that contribute to heavy upper eyelids. 1) upper eyelid ptosis which is true drop in the upper eyelid height;  2) upper eyelid dermatochalasis, from excess loose skin;  3) droopy brows, which cause crowding of the upper eyelid area.  If you have signficant dry eyes, correcting the first problem (ptosis) may not be possible but the other two problems can be improved without affect on dry eyes, if done conservatively (that would be upper blepharoplasty and brow lift).  See an oculoplastic surgeon for evaluation.

Mehryar (Ray) Taban, MD, FACS
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 91 reviews

Eyelid surgery with patient with dry eye condition

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Often it is possible to perform eyelid surgery on a patient with significant dry eye complaints.

In fact, the surgery can often address some of the contributing factors for the dry eye condition.  This will involve an assessment of the lower eyelid position as well as the upper eyelid lifting muscles, brow position and eye drainage status.

Often, the appearance of the eyes and the tendency of the patient to have dry eyes is improved in the same setting.  

By approaching the entire eyelid and brow area, it is frequently possible to help patients who were told there was no hope for them.

Brent Moelleken, MD
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 195 reviews

Alternatives to a Blepharoplasty for Droopy Eyelids (due to dry eyes)

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I am assuming you have seen a cosmetic plastic surgeon and the option of an upper blepharoplasty has been ruled out due to 'dry eyes'. That said, have you had a consultation for a brow lift, and/or the use of Botox and dermal filler to give you a brow lift, and therefore opening up the eye? These techniques need to be maintained (Botox every 3-4 months, and the dermal filler every 9 months). The result may be minimal but as you say, 'no matter how small, it would be an improvement'.

I wish you a positive result.

Cory Goldberg, MD
Toronto Plastic Surgeon
4.9 out of 5 stars 48 reviews

Browlift may be a good option

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Given your history of dry eyes, a brow lift may help improve the tissue redundancy of the upper lid. Also, non-surgical Botox or Ultherapy may be good options. It is difficult to provide specific or relevant recommendations without an examination or at least good clinical pictures.

Edwin Ishoo, MD
Cambridge Facial 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.