I've developed sudden upper eyelid hoods. What can be conservatively done? If bleph needed how long do the results last?

Question

Upper eyelids suddenly got puffy/hooded, esp. my right one-obliterates eyelid & looks like I was punched in the face. Is this ptosis or just aging? If it's ptosis, is it reversible? What non-invasive options can be tried? I suffer bouts of dry eye from ocular rosacea, will surgical lift be a problem for me? I also have circles/bags under eyes. How long will results of an upper eyelid lift last? Do upper lid results outlast lower lid results? How long do injections (botox?) last on upper lid?

Kenneth D. Steinsapir, MD · Answer

The subbrow fold is a very important feature of your face.  It is important that this structure is still present after eyelid surgery.  Unfortunately some surgeons thing that it is their job to remove all of this tissue.  Loss of this structure will convert your upper eyelid from an outty fold to an inny fold. If that happens you will be very unhappy with the result. What you need instead is just a small amount of visible eyelid platform to show.  This is best accomplished with an micro-anchor blepharoplasty.  There is no substitute for a person to person consultation to assess your eyelid tissue and define a surgical plan.

Adam Tattelbaum, MD · Answer

Thanks for your questions. I will try to address them one at a time. Is this ptosis or just aging--- your photos are not good enough for me to determine if any ptosis is involved, but it looks more like natural aging. Ptosis can be treated by tightening  the muscle to the upper eyelid in most cased if that is contributing.What non-invasive options can be tried?--- sometimes botox under the outer brow can cause elevation of the tail of the brow. I call this a chemical brow lift, but it may not do enough with your degree of laxity. For the average patient botox lasts 4-6 months, but there are exceptions.I suffer bouts of dry eye from ocular rosacea, will surgical lift be a problem for me?-- dry eye can be a contraindication to eyelid surgery.  The risk or worsening is lower in upper lids but still requires a thorough discussion with your PS and a conservative approach if you elect to proceed. It may not be worth addressing the lower lids where the risk of dry eye can be greater.How long will results of an upper eyelid lift last? Do upper lid results outlast lower lid results?.. The answer to this largely depends on your genetics. It is safest to say neither will last forever. Sometimes patients will repeat these surgeries when they notice relaxation again.Summarizing: You will really need to see a Board certified PS to evaluate both your lids and brow position (yes this mist be considered too). You will need to rule out ptosis, and make a plan taking into account your medical history, goals, expectations and degree of risk.Hope this has helped.

John J. Martin, Jr., MD · Answer

You have some heavy skin of the upper lids.  This can be removed with an upper lid blepharoplasty.  It doesn't look like you have ptosis in these photos, but they aren't great.  At an in person evaluation the brow can  also be evaluated.  Often doing a temporal brow lift at the same time will help to open up the outer corner of the eyes.

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question.  The
best advice you can receive is from an in-person consultation.  With that
being said, based on your photographs, you are a good candidate for upper eyelid blepharoplasty.  You do not appear to have ptosis.  You may also consider lower eyelid surgery.  Make sure you specifically look
at before and after pictures of real patients who have had this surgery
performed by your surgeon and evaluate their results.   The most
important aspect is to find a surgeon you are comfortable with. I recommend
that you seek consultation with a qualified board-certified plastic surgeon who
can evaluate you in person.
Best wishes and good luck.
Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Michelle Copeland, MD, DMD · Answer

Eyelid surgery has become one of my most popular procedures. If
excess upper eyelid skin is hooding the eye and needs to be eliminated, an
incision is made in the crease at the top of the lid and excess fat and skin
are removed. The incisions are closed and sutured on the underside of the skin.
If undereye puffiness and dark circles need to be eliminated, an incision is
made along the lower lashes that will be almost invisible when it heals. Next,
the fat below is either removed or redistributed and the saggy and crepey
excess skin is then pulled up and cut off. The incisions are closed with tiny
sutures, which are removed in four to six days. The incisions are along your
eyelash line, making it a virtually scarless procedure.

Steven Wallach, MD · Answer

Photos often do not show everything and an exam in person is key.  It might be that an upper lid blepharoplasty would be beneficial.  Good luck.

Mark Taylor, MD · Answer

I prefer using an UltraPulse CO2 laser to remove the excess skin and fat from the upper eyelids.  The chance of bruising and bleeding is less than with scalpel surgery and patients can often return to light duty work in 2 to 4 days.  The suture is removed in one week  It is rare that a person would ever need to do this twice, so it is considered a permanent fix for most people.

William Portuese, MD · Answer

From the limited photographs, it appears that there's excess skin/hooding of the upper eyelids, for which a  blepharoplasty  can accomplish improvement. For more information about upper blepharoplasty and many examples, please see the link and the video below

Tae Ho Kim, MD · Answer

The best and only option is upper eyelid blepharoplasty.  This can be performed under local anesthesia and is tolerated very well.  Actually, I prefer to have the patient awake so that I can see how the correction is going during the procedure.  Recovery is about a week.  It should not impact the eye itself, but you may want to ask your ophthalmologist prior to undergoing the procedure.  The results will last 7 to 10 years if not longer.  Each person ages differently.  Botox will not help you.  The best thing to do is to have a consultation with a board certified plastic surgeon or oculoplastic surgeon for an honest opinion.  Good luck!

William B. Rosenblatt, MD · Answer

I looks like you are a good candidate for a blepharoplasty. See a board certified plastic surgeon who will examine you and go over all of your questions. Usually the results from a blepharoplasty last many many years.

I've developed sudden upper eyelid hoods. What can be conservatively done? If bleph needed how long do the results last?

Answers (13)

More Eyelid Surgery Questions

WE SEND PRETTY
EMAILS

Answers (13)

More Eyelid Surgery Questions

1.5 years after blepharoplasty & canthoplasty. When will the scars resolve?

As I'm getting older, it seems one of my eyelids is either getting bigger or the other is getting smaller (Photo)

Blepharoplasty or filler for hollow under eye? (photos)

It's been about three years since I had upper eyelid surgery but my scars are still visible. What can I do to rid of it?

Eyebag surgery at age 32 now 78 - they are back, can I have this surgery again?

WE SEND PRETTY EMAILS

WE SEND PRETTY
EMAILS