My eyes are drooping and have become not only hooded, but also unsymmetrical. Do I need a brow lift or eyelid surgery? (photos)

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.

It appears that you have asymmetric ptosis (droopy eyelids) and dermatochalasis (excess skin). A blepharoplasty and ptosis repair can equalize the appearance. A good physical examination by an Oculoplastic surgeon is important.

I do not believe you need brow lift but perhaps conservative upper blepharoplasty but also need to get evaluated for possible mild ptosis. See an oculoplastics specialist.

Based on the photos you submitted I'd suggest the blepharoplasty. Your brow is nicely arched and lies above the supraorbital rim.

Based on these photos, you seem to have condition called eyelid ptosis, saggy eyelids. In person consultation with a board certified plastic or oculoplastic surgeon, is recommended. Good luck.

Hello. You have a ptosis problem in your eyelids. This is not a simple upper eyelid problem, this is more detailed, please do some research. The surgery will give you a very fresh and vibrant look. You also need a lateral canthoplasty called fox-eye or cat-eye. I’m the only triple board-certified facial plastic surgeon all around Europe. I’m just focused on this issue. I am a doctor who goes to almost every country in the world and explains my techniques to important doctors with the seminar invitations I receive, so I am definitely the only doctor who can perform your operation very comfortably and successfully. You can get more detailed information about me, ask all questions about your case and sending your photos to my assistants at the number on my profile (+90 539 204 40 90). You can also book an online consultation and discuss your problems with me. With all respect.

Hi there! The eyebrows and eyelids, as you may know, are closely related. You appear young based on your photos so I would be hesitant to be too aggressive such as with a brow lift. Scarring and need for revision after aging further are reasons to potentially wait. Blepharoplasty does remove skin and can help tremendously, though it is a surgery. Have you considered neuromodulators such as Botox and Dysport? These are my mainstays when beginning to address these issues as they are safe, easy to perform, and show quick results. Staying safe and conservative before proceeding with surgery is always a good idea.

Fullness of the upper lids can be cosmetically improved with a number of surgical options depending on individual anatomy and desired outcome: an artistically performed conservative upper blepharoplasty, a repositioning of the brow if it is low, or a combination of both.

Following the advice of anyone who would presume to tell you what to do based on limited photos and more importantly without taking a full medical history, examining you, feeling and assessing your tissue tone, discussing your desired outcome and fully informing you about the pros and cons of each option would not be in your best interest. Find a plastic surgeon that you are comfortable with and one that you trust and listen to his or her advice. The surgeon should be certified by the American Board of Plastic Surgery and ideally a member of the American Society for Aesthetic Plastic Surgery (ASAPS). You should discuss your concerns with that surgeon in person.

Robert Singer, MD FACS

La Jolla, California