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

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.

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.

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.