What to Do About Puffy, Droopy Lids? (photo)

I was born with naturally puffy lids that have always bothered me, and now that i'm in my mid 40's (45) the puffy area has drooped and makes me look tired. From looking at my photos what can I do to resolve this issue that is driving me crazy?!!! Please advice!

Doctor Answers 16

You are candidate for upper eyelid blepharoplasty. It is important to choose a surgeon through their before and after work

I wrote a book called “The Fine Art of Looking Younger” where I described that facial aging has two processes: one is volume loss which is loss of bone, muscle and fat; the other is skin elasticity causing descent. People often complain about puffy upper eyelids, because this area becomes deflated when fat is lost and the skin elasticity changes.

My colleagues tried many years to restore the volume in the area, which in principle sounds logical. However, if you place fat it in the eyelids where there is loss of volume, unfortunately, the skin elasticity tends to not hold it very well and you may deal with a lot of swelling and potential irregularities.

I recommend an upper eyelid blepharoplasty which is the strategic or artistic removal of extra skin. This procedure also creates the shape of the eyelid crease that is consistent with your natural ethnic appearance. This will create a platform so that your eyes look more open.

I also suggest that you do some research and interview some cosmetic surgeons who have a lot of experience with cosmetic eyelid surgery, and take a look at before and after photos to get a sense of the unique style each surgeon brings. In addition, you have to be comfortable with the type of sedation or anesthesia that will be used on you.  I hope that was helpful, and thank you for your question.

New York Oculoplastic Surgeon
4.3 out of 5 stars 72 reviews

What to Do About Puffy, Droopy Lids?

         Your brow position is OK, and upper blepharoplasties will help with the contour and the appearance. Find a plastic surgeon with ELITE credentials who performs hundreds of eyelid surgeries each year.  Then look at the plastic surgeon's website before and after photo galleries to get a sense of who can deliver the results.  Kenneth Hughes, MD Los Angeles, CA

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 496 reviews

What to Do About Puffy, Droopy Lids?

You may be a good candidate for an upper eyelid blepharoplasty.  Please see an eyelid specialist to make sure that you truly are a good candidate for this procedure.

Sam Goldberger, MD
Beverly Hills Oculoplastic Surgeon
4.7 out of 5 stars 16 reviews


Please see my response to your other post on this topic:

You need to be examined in person by a board certified plastic surgeon to formulate a specific plan. You would likely benefit from a blepharoplasty and fat removal. If your lacrimal gland is causing the bulge laterally, it can be 'tucked' in during a blepharoplasty. Best,

Asif Pirani, MD, FRCS(C)
Toronto Plastic Surgeon
5.0 out of 5 stars 35 reviews

Treatmnet for Puffy, Droopy Lids

The eyes are the windows to the soul. All too often, however, they seem to reveal exhaustion. The very delicate skin around the eyes tends to get crepey and puffy due to fatigue and stress. 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.
An effective non-surgical option that might benefit you is Thermage, which can tighten the skin around the eyes. The new and improved Thermage is a virtually painless, non-invasive (no incision!) treatment that can tighten skin and stimulate your body to make healthier collagen—the building block that provides structure to your skin. Fast and easy, Thermage requires no downtime from normal activities.

Michelle Copeland, MD, DMD
New York Plastic Surgeon
4.6 out of 5 stars 10 reviews

Puffy eyelids

Your brow elevation looks good, your upper lids lack definition. Creating a skin fold and reducing the volume of the upper lids-together should give you a nice result from a upper lid blepharoplasty.

Terry A. Cromwell, MD (retired)
Lafayette Plastic Surgeon
5.0 out of 5 stars 2 reviews

What to Do About Puffy, Droopy Lids?

The posted photos appears as you are an excellent candidate for upper lid blepharoplasties. Seek in person evaluations PLEASE! 

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.6 out of 5 stars 174 reviews

What to Do About Puffy, Droopy Lids?

I notice that your eyebrow sits high. This may be due to the compensatory action of the forehead muscle to lift the eyelid by lifting the eyebrow. In any case, you have excess skin and fat in the upper eyelid that needs to be addressed. If the upper eyelid droop is present it can be fixed at the same time as a Blepharoplasty. You need to see a PS who can help you

Naveen Somia, MBBS, PhD, FRACS
Sydney Plastic Surgeon
5.0 out of 5 stars 74 reviews

Treatment of Puffy, Droopy Lids

As we age we develop extra eyelid skin either because our brows drop or upper eyelid skin excess.  On your photo your brows appear to be at a good position but an examination with a plastic surgeon would allow you to know for certain.  In that situation a blepharoplasty can be a great option for you.  A small amount of eyelid skin, muscle and possibly fat can be removed from the upper eyelid to create better definition and brighten the eyes.  If this is done alone I generally perform this with local anesthesia and minimal sedation.  Patients are very comfortable during the procedure and generally recover more quickly with this approach.   

Jill Hessler, MD
Palo Alto Facial Plastic Surgeon
5.0 out of 5 stars 27 reviews

Correction of Puffy, Droopy Eyelids

It is impossible to give specific advice without an exam. You do appear to have some droop, but this may be due to the weight of the upper lid skin. If so, then the blepharoplasty itself will correct the droop also. If not, then the ptosis will also have to be corrected. Where your upper skin fold is located is also impossible to determine from the photos. If you have an occidental fold that is at the top of the underlying tarsus (the thick tissue under the skin), then a simple eyelid lift is all you will need to correct the puffiness. If you lack this fold, as a large number of asians and some others do, then you may also need attachment of the muscle to the top of the tarsus.

Robert T. Buchanan, MD
Highlands Plastic Surgeon
5.0 out of 5 stars 6 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.