What procedure is needed for upper eyelids sagging downward? (Photo)

Question

The outer corners of my upper eyelids are sagging downward and it’s making me look tired/dull. I want to open up my eyes, look more refreshed, and possibly have a more upward tilt. I’m wondering what the best approach is to correct this issue in the simplest way. I’m not sure I want a brow lift . I’m wondering if a bleph/canthoplasty is the right move.

Jason Emer, MD · Answer

Hello and thank you for your question. A formal evaluation would be needed to determine the best treatment. There are both surgical and non-surgical options to correct this, depending on the situation.

For less significant upper eyelid skin excess or more mild improvement, there are nonsurgical treatments: Radiofrequency (Thermage or Venus Legacy/Viva), injectable fillers, and a Botox brow lift can help contour the eyebrows and lift the eyelid skin.

Surgery (browlift and/or upper blepharoplasty) is a great option for more significant improvement- for example if the hooded eyelids have more excess skin present.

Dr. Donald Groves is an expert facial plastic surgeon that I work with, who specializes in these types of procedures. It is important that if you are considering surgery that you go to someone who is well trained and very experienced with these delicate operations to get the best results. I suggest getting a consultation with an experienced cosmetic dermatologist and facial sculpting expert, or an aesthetic facial plastic surgeon like Dr. Groves; we are both located right here in Los Angeles.

Best, 
Dr. Emer

Andrew Miller, MD · Answer

It is certainly possible to perform a limited upper eyelid surgery. It is important that you are confident that the surgeon will not be too aggressive with the upper eyelid skin excision, though, because it could limit the ability to do other procedures that may be needed in the future. See a facial specialist for consultation.

Michelle Zweifler, MD · Answer

Upper blepharoplasty removes the extra upper eyelid skin to help refresh the eyes.  The canthopexy or canthoplasty will tighten the the lower eyelid with restoring a more upward tilt to the out eyes.  The canthopexy is often performed from the upper eyelid incision.

Carmina Cardenas, MD · Answer

I agree with you about not needing a Brow lift. Your brows are perfect. 
Your upper eyelid is perfect in the inner and mid portion, it is just the lateral part of the eyelid. The external canthus is perfect in position, so no need of canthopexy. 
I consider just a lateral upper blefaroplasty will be enough. An outpatient procedure, only skin, respect the muscle. 
Dr. Cardenas.

Zoran Potparic, MD · Answer

This procedure would address the issue of position and shape of lateral eye commissure and lower eyelid. In person consultation with a board certified plastic or Oculoplastic surgeon is recommended. Good luck.

What procedure is needed for upper eyelids sagging downward? (Photo)

Answers (7)

Answer: Little excess

Answer: Little excess

Answer: Lateral canthopexy

Answer: Lateral canthopexy

Recommended reading

Everything you need to know about Eyelid Surgery

Our mission is to create a world where every investment in modern beauty is Worth It.

What procedure is needed for upper eyelids sagging downward? (Photo)

Answers (7)

Answer: Little excess

Answer: Little excess

Answer: Lateral canthopexy

Answer: Lateral canthopexy

Browse related questions

Recommended reading

Everything you need to know about Eyelid Surgery

Our mission is to create a world where every investment in modern beauty is Worth It.