Droopy eyelids ptosis. New photos, second question (Photo)

Hello Doctors. I had posted earlier but was unable to edit or add photos so I wanted to post a few others and your opinions. Female age 46 and seems as though these hoods popped up fast. Right eye appears worse and looks at it's worst in the mornings. Worried why one eye would be worse. Caffeine cream seems to help a tad. What kind of procedure and what would the success rate be? Thank you very much in advance. I appreciate your input.
This is a follow-up to an earlier question. Click here to read it.

Doctor Answers 4

Upper blepharoplasty

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A conservative/augmenting upper blepharoplasty will be the best option to rejuvenate the aging changes in the upper eyelid. This can be followed by hyaluronic acid injections  within the eyebrow-eyelid fat pads to reverse the hollowness and improve the 3D contours. 

London Oculoplastic Surgeon

Upper eyelid surgery candidate

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 The photographs demonstrate asymmetrical hooding on the upper lids,  and there is no ptosis present. The asymmetry is due to the orbital anatomy including skin, muscle and fat. An asymmetrical eyelid procedure  can remove excess skin and fat more so on one side to balance out with the opposite side. Both sides are required. For many examples and more information, please see the link and the video below

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 157 reviews

Eyelid Blepharoplasty

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Dear GoodGal,
Thank you for your question and photos!  We always recommend a consultation with exam with a Board Certified Plastic or Cosmetic Surgeon in your area.  

From viewing your photos, you do look like you would be a great candidate for eyelid blepharoplasty. A surgical procedure where a small wedge of skin is removed from the upper eyelid creating a more uniform and tighter more youthful eyelid.  Sutures are placed hidden in the natural upper crease line and typically removed in 5 to 7 days.  

From your photos it looks like one eyebrow may be lower than the other creating one eye to appear more hooded than the other.  This is easily fixed by removing more skin from the hooded upper eye.  

Best of luck!

Robert Shumway, MD
San Diego Facial Plastic Surgeon
5.0 out of 5 stars 12 reviews


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This is not ptosis - the lid height is normal.   You have some extra skin on the upper lids, called dermatochalasis.  You have less fat in the upper left eyelid, so that the sulcus is deeper and the skin will not appear as droopy.  You could do a blepharoplasty to remove the extra skin.

John J. Martin, Jr., MD
Coral Gables Oculoplastic Surgeon
5.0 out of 5 stars 31 reviews

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.