Hooded Eyes at 30! Lasers, Botox, Lift, or...? (photos)

Question

My eyes have been Hooded all my life, but my vision is starting to 'see' my lashes and headaches are happening. When I raise up my brow, my eyes are very awake looking without any hood. I would love any ideas of what the solution is as it seems like at such a young age this is being problematic. I just don't know the best path to research. Thank you!

Kenneth D. Steinsapir, MD · Answer

A detailed consultation determines precisely what is going on, what resources you have, and to determine what you like and don't like about your eyes.  It is essential to understand that while your upper eyelid hoods are a problem for you, they are also a very important feature of your face.  The key is to determine a solution that does not remove every bit of the upper eyelid fold which would effectively skeletonize the upper eyelid.  This type of balanced result may be achieved with just structured microblepharoplasty or it might require eyelid surgery with a judiciously performed browlift.  Overlifting the eyebrow would be an aesthetic mistake because it skeletonizes the eyes and creates the surprised look.Botox is great but I do not think it will provide enough treatment effect to accomplish the aesthetic improvement you need.  There is no harm in trying it.  Just be aware that many of these services actually cause the eyebrow to fall rather than lift the eyebrows.

Jason Emer, MD · Answer

For significant improvement, hooded eyelids require surgery if there is enough skin. For 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. I recommend getting a formal evaluation with an experienced cosmetic dermatologist. Best, Dr. Emer.

Kian Karimi, MD, FACS · Answer

Thank you for sharing your question. This is a very common for people of all ages. For my younger patients, I recommend trying a small amount of Botox to elevate the brows. When properly placed by an experienced injector, there is little risk of further brow droop and you will get a nice, temporary brow lift. I find this to be a great way to determine if you like the aesthetic of a lifted brow. If yes, then it might be worthwhile to have a consultation for a surgical brow lift, which offers a more permanent result. I recommend scheduling a consultation with a board-certified plastic surgeon who does injectables in order to get more information about both procedures.

A.J. Amadi, MD · Answer

You have a classic low eyebrow position that tends to crowd the eyes, but still is an attractive shape. If you are looking for a more "open look", you truly have 2 options that can work well, and it depends on your aesthetic taste which one you choose.1. Brow lift-  This is a technique whereby the forehead and brow are elevated to open the eyes and relieve the heaviness of the upper eyelids. Depending on the hairline and the length of the forehead, an endoscopic or hairline approach can be used. This will give you are more arched/raised eyebrow position and its important for your surgeon to demonstrate how high you would be comfortable with your position, as too high an eyebrow leaves you looking surprised. See below link of examples of brow lifts. 2. Upper blepharoplasty is the straightforward choice which keeps your natural low brow position intact, and simply removes a bit of skin from the upper eyelids. Its important that this happen in a conservative fashion so that if you decide to have  a brow lift in the future, you still have enough skin to be able to undergo surgery and still have adequate skin to close your eyes. Pick a surgeon that is equally skilled and comfortable with both techniques and you can decide together which would be a good fit for you.

Arnold Almonte, DO · Answer

Thank you for your question. You demonstrated the look you want perfectly by raising your eyebrows. The question is how to best achieve this. Temporary solutions include Botox and fillers. I have found placing a little filler under the eyebrow can elevate the brow just enough to provide the look you want. A lateral brow lift is a longer lasting solution, but it's a surgery. So you have your options in front of you. Seek an experienced plastic surgeon. I wish you the best!

William Portuese, MD · Answer

The photographs demonstrate asymmetrical and low eyebrows, which makes the eyelids look asymmetrical and hooded. To raise the eyebrows and make them more symmetrical would require a brow lift. To remove the excess hooded skin on the upper eyelids would require  a conservative upper eyelid skin blepharoplasty. For many examples of both procedures more information, please see the link and the video below

Joel B. Singer, MD · Answer

Given your young age, I would probably recommend Botox injections for the next few years. Try botox and see if this creates the type of results you are seeking. If you feel like you need a more dramatic and long-term solution, then you may consider a blepharoplasty or similar eyelid surgery but I would recommend waiting for a few more years as you are fairly young.

Ed Breazeale, Jr., MD · Answer

Great Question! There are a few different things you can do! Botox being the fastest, easiest, and cheapest. You can always do a chemical brow lift with Botox and it will only be 5-8 units each eye. This will help you not look as hooded. Botox will only last 3-4 months so you will have to keep it up. Or you can have a lateral brow lift done, which would be surgery. At your age I would suggest trying Botox first- see how you like it and if it lifts you as much as you want to be lifted- if not you can have surgery. Good luck!

Michael Elam, MD (retired) · Answer

Dear hoodedeyewonder, Personally in women who look similar to your age I would perform and endoscopic browlift to address lifting the brows to their pre-aging position. This opens the patients eyes so that they do not feel like they look tired or angry anymore and they regain a more youthful appearance. It is very important to place the brows back to their normal position to open up the eyes before you consider having eyelid skin removed with a blepharoplasty. When necessary due to excess upper lid skin laxity these procedures are done in conjunction with one another. I would definitely not advise an upper lid blepharoplasty alone without addressing the brows as this will have an unnatural looking final result and will pull the brow down further. I personally perform an endoscopic browlift by undermining down below the malar region and lifting the skin muscle and tissue as one unit back to its pre-aging position. No skin is removed, the endoscopic incisions are hidden in the hairline and patients look ten years younger with no tell tale signs of surgery. Due to the high level of patient satisfaction my entire staff has had this procedure performed including my wife and I believe you would be an excellent candidate as well. Seek consultation with some experts in the field who provide natural looking before and after results to ensure the surgeon does not over elevate the brows or remove to much upper lid skin in blepharoplasty. See the link below for examples and the video above. Best regards, Michael V. Elam, M.D.

Ronald V. DeMars, MD (Retired) · Answer

Thanks for the question and good photos. You appear to have already made your diagnosis - ie low brows vs excess upper lid skin.The treatment is repositioning the brows at a more feminine level either temporarily through the use of Botox or more permanently with a brow (forehead) lift.

Hooded Eyes at 30! Lasers, Botox, Lift, or...? (photos)

Answers (10)

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