Puffy hooded upper eyelids. Is there anything I can do to treat this without surgery? Like diet or topical solutions? (photo)

Thank you for sharing your question. Unfortunately, only surgery will improve your problem. Make a consultation for evaluation with an Oculoplastic Surgeon. Good luck,

Based on the photo you've sent, very few nonsurgical options will provide as significant or long-lasting a result as undergoing upper blepharoplasty (eyelid lift).  When there is excessive heaviness of the lid, combined with skin excess that is causing hooding, blepharoplasty surgery will address both concerns, and provide the best, longest-lasting results. Be sure to consult with a certified plastic surgeon, and he/she will help guide your decision-making. Best wishes.

If you're against surgery at all costs, laser will tighten the skin for some time and is easy to do and recover from.  Otherwise manually elevate your brow and if its not giving you the deer in the headlight look and you like how your lids are better creased and your eyes more alert looking, then you could benefit from a browlift.

Surgery will be needed but what surgery?  Merely removing skin and fat may not work out to your advantage.  A careful analysis utilizing life size photographs and comparison to photographs from you youth will be helpful. A visit with your primary care to rule out underlying thyroid or metabolic issues is a good start.  You have considerable asymmetry and a lot of what you are seeing is the result of fat atrophy. Board certified plastic and facial plastic surgeons would equally be able to assess this for you.  Choose based on the results he or she can show you with similar cases to your own. 

Hi
It looks like you have extra skin and fat. I'm not sure diet or topicals will be enough for what you might want. You could try a diuretic (water pill/HCTZ) to see if it helps. Topicals won't do enough. And cut back on salt intake. i always recommend my patients try to keep their sodium under 1,500 mg/day.
Ultimately, you will likely want an upper blepharoplasty--you'd look really good with that!

Aside from limiting salt and alcohol intake there is nothing that will adequately reduce your eyelid skin like a well performed blepharoplasty. Seek the advice of an ABPS surgeon

Limiting salt and alcohol intake is always helpful.  Sometimes a little rest helps.  If the bags or puffiness isn't too prominent often a combination of tear trough and mid face fillers as well as either micro-needling or laser resurfacing would help.Get a consultation with a facial plastic surgeon first.  If you're in Los Altos, CA/Menlo Park, CA areas I think Drs. Lieberman and Parihk are good to see.  Jill Hessler MD is also a good surgeon in your area.I'm in San Jose.Chase Lay MD

Unfortunately there are no non-surgical procedures that can adequately improve the fullness of the upper lids in a patient with your individual anatomy. Based on your photo but without an examination, you appear to be an excellent candidate to cosmetically improve the appearance of your eyelids with an artistically performed conservative upper lid blepharoplasty.

Following the advice of anyone who would presume to tell you exactly what to do based on a limited 2 dimensional photo without taking a full medical history, examining you, feeling and assessing your tissue tone, discussing your desired outcome and fully informing you about the pros and cons of each option would not be in your best interest. Find a plastic surgeon that you are comfortable with and one that you trust and listen to his or her advice. The surgeon should be certified by the American Board of Plastic Surgery and ideally a member of the American Society for Aesthetic Plastic Surgery (ASAPS). You should discuss your concerns with that surgeon in person.

Robert Singer, MD FACS

La Jolla, California

The puffiness is caused by herniated fat in the upper lids, while the excess skin is creating the hooded look.  A surgical upper blepharoplasty is required to address both of these issues.  An upper blepharoplasty procedure can be performed under either local or general anesthesia depending upon the patient's desires.  For many examples, please see the link and the video below

Unfortunately, given your photo and history, there is no treatment short of a blepharoplasty that will achieve your goals.  An upper eyelid blepharoplasty, in which the excess skin, muscle and fat pads are addressed, is really the only reasonable option.  Seek out a board certified plastic surgeon, who has extensive blepharoplasty experience.  Best wishes, Dr. Lepore.