I Have Droopy Eyelids, What Can I Do? I Do Not Want to Have a Surgery Yet. Laser Will Work? (photo)

I am 42 years old and Southamerican woman. Thank you for your reply. Kindly, M

Doctor Answers 12

Droopy eyelids can be lifted with Botox, Ultherapy, Pelleve and Thermage

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In the photograph you are contracting your frown muscles. In doing so, you are bringing your inner eyebrows towards each other and lower. This pushes down on the upper eyelids.  If the position of your eyebrows is about the same at rest, then possibly Botox injected into the glabella between the eyebrows and the outer corner of the eyebrows at the descending portion of the eyelid muscle (orbicularis oculi) can help relax the muscles which pull down on this area. This allows the lifting muscle of the forehead to raise up the eyebrows, and with them the upper eyelids. Certainly, it does not raise them as much as a brow lift.

Laser resurfacing with the CO2 laser provides the greatest tightening but would not be enough to warrant its risks or down time possibly. Ultherapy, ultrasound energy, can help lift the forehead, as can Pelleve radiofrequency and other devices such as Thermage, although I find Ultherapy much more effective than the Fractional CO2 laser and Theramage. There are risks which you need to discuss with your physician and you need to have an in-person consultation to examine you with different facial expressions.

A blepharoplasty, surgical excision of the upper eyelid skin, won't address the eyebrow position, and if the blepharoplasty is done, you may never be a candidate for a brow lift as it might pull up on your already tightened upper eyelids making the eyes open slightly when sleeping and they would suffer medical consequences from drying out.

Some doctors use the hyaluronic acid fillers as an off-label indication to inject underneath the eyebrows and even forehead to help protrude the soft tissue outwardly slightly if there has been atrophy, and this can help lift the eyebrows in height slightly. Please also discuss the risks of such a procedure with the doctor who might pose this as a possible treatment.

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

Manhattan Dermatologic Surgeon
4.9 out of 5 stars 38 reviews

Thermage is perfect for this.

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If you have the time, I would recommend that you visit the site listed below. Also, please visit the Thermage website.

Further questions that you have on the details of the procedure can be obtained by a Thermage expert, who is a board certified dermatologist working at AlphaDerm.com

Thank you.

Christine Glavey, MD (retired)
Alpharetta Dermatologic Surgeon

Botox for Brow lifting

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Your main problem is droopy eyebrows, not eyelids.  Botulinum toxin (Botox) injection can help elevate the brows and maybe useful for you.  See an oculoplastic or facial plastic surgeon.

Ultherapy and NuFace Trinity for droppy eyelids

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Surgery to remove the excess skin on your upper eyelids (blepharoplasty) is my first recommendation.  It is a fairly simple surgery with minimal downtime and it will you give you a nice refreshing, younger look to your eyes. While my intial recommendation is surgery,  I do want to respond to your request for non-surgical options.  We have found two treatments to be beneficial for individuals just like you, who are not quite ready to undergo surgery.  Ultherapy is a new type of non-surgical, non-invasive procedure for the face that uses ultrasound and the body’s own natural healing process to lift, tone, and tighten loose skin.  Another option is Nuface Trinity: It’s completely non-invasive, FDA-cleared device, and all treatments can be done from the comfort of your home.

See links below for more information. 

I hope you find this information helpful.



Upper eyelids

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From the photo it seems that you might benefit from an upper eyelid blepharoplasty.  This is an operation that can be done with local anesthesia in the office.  Some skin and muscle are removed from the upper eyelid.  I do not think you need a brow lift from I can see in the photo.

Surgery for droopy eyelids

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People who have permanent ptosis, where the eyelid hangs over or droops, need to have surgery. Ultimately, as we age, the muscles in this area weaken and can affect sight even. So if you are in your younger years, it'd be better to undergo surgery, as eventually you're going to need to do it anyway. Fillers, lasers, etc. aren't an option for this area, and surgery (which really is a rather simple procedure) is your best choice.

Eyelid sugery and alternatives

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Eyelid surgery, or blepharoplasty, is a beautiful procedure that yields excellent results and should be custom tailored in every aspect to your individual goals, needs, and anatomy. 

From your perspective as a patient, this surgery is very stealth with relatively simple recovery. From the standpoint of your surgeon this is a very intricate, detailed and fun surgery to perform where assessment and planning are everything!

Blepharoplasty has come a long way and become much more modern in recent years, focusing more on long-term results than just on taking away as much skin and fat as possible. This modern approach yields a much more natural look with much more satisfying long-term results. 

Blepharoplasty will address sagging skin, displaced, bulging fat and excess muscle. Occasionally areas around the eyes, like the eyebrows and sometimes even cheeks, need to be addressed to give a harmonious and comprehensive result.

There are non-surgical alternatives to blepharoplasty, including laser resurfacing, Botox, fillers, brow lifting and others, but which of those are applicable to you will be dependent, and a discussion with your surgeon can help delineate those options.

To ensure you are receiving the highest level of care, seek out a modernly trained, new-school dermatologic surgeon, oculoplastic surgeon, facial plastic surgeon or plastic surgeon who is board certified and fellowship trained in one of these "core four" cosmetic specialties. Membership in organizations like the American Academy of Facial Plastic and Reconstructive Surgery help to identify a highly trained surgeon.

Cameron Chesnut #realself500 Physician

Consider Botox and Ultherapy for browlift

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Upper eyelid blepharoplasty would be a fairly quick and effective procedure for improving the excess upper lid skin and create a more defined eyelid crease. However, you can achieve a nice nonsurgical brow lift with Botox and/or Ultherapy. Consult with an appropriate specialist who offers these procedures.

Thermage for droopy eyelids

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Surgery would definitely give you the best result but if you are not yet ready for surgery, you could consider Thermage for eyelids.  It can cause some tightening and lifting of your eyelids and you would still be able to have surgery later when you are ready.  Fractional CO2 resurfacing laser may tighten some skin, especially under your eyes, but you would need to protect your skin from the sun.  You could consider both of these non-surgical treatments.

Martie Gidon, MD, FRCPC
Toronto Dermatologist

Droopy Eyelids, what can I do?

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Unfortunately there are no quick fixes for this type of issue, Botox will only make it worse. Surgical excision is your best option, good luck.

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.