How can I improve the appearance of my droopy eyes? Could 10 years of using Latisse be making my eye area look worse? (photos)

Question

39/F. For a decade, I've used Botox to lift my outer brows and my neutral expression became always raising my brows. I've also used Latisse on my eyelashes, brows, and scalp for a decade. My eyelids feel heavy/droopy, my brows are low, and I look so tired/angry. I've read that Latisse can age the eye area and I'm concerned about ptosis. How can I improve the look of my eyelids and brow? I prefer the longest-lasting option. (I've had hairline lowering surgery.) PICS: Neutral/Smiling

Kenneth D. Steinsapir, MD · Answer

Latisse contains a prostaglandin (bimatoprost). Since 2004, it is clear that bimatoprost and other lash stimulating prostaglandins damage eyelid and eyebrow fat. Yes, it grows eyelashes and eyebrow hair (the jury is out on scalp hair). However, it kills eyelid and eyebrow fat. If you study the Latisse website models 2/3 of them in the 4 month before and after pictures show loss of upper eyelid volume. Allergan avoided "discovering" this effect in their initial clinical studies because they intentionally excluded frontal photographs with the eyes open. They essentially only studied the so-called superior lash view. That is the image looking down on the eyelashes. It is said that the changes are reversible. However it is not clear that the changes are in fact reversible. Tragically many woman dismiss these changes as "normal" aging and never suspect that the product that is giving them thicker, darker, longer eyelashes is prematurely aging them. As a caution, yes, there are over the counter products that do grow eyelashes and eyebrow hair. These also contain prostaglandins and are harmful to the eyelids structure. I do think that you could benefit from eyelid surgery. However, I recommend that you see someone who actually understands the effect of Latisse on the eyelids because these eyelids are stiffer than normal eyelids due to chronic fibrosis also caused by these products. Because there can be a degree of recovery after stopping prostaglandin based lash growth products, I recommend letting the eyelid recover for 6 months before committing yourself to eyelid surgery.

Jonathan Kulbersh, MD · Answer

Thank you for your question. Unfortunately, long-term use of Latisse can lead to some eye drooping over time. It would be best for you to stop using the topical medication to prevent further damage. The good news is there are different treatment options to address the drooping and refresh the eye area. One option is some well-placed Botox injections to lift the outer corners of the brow. This procedure can be performed in just a few minutes and does not require any downtime afterward. Surgical treatment options might include an upper blepharoplasty to address the drooping eyelids, or possibly a brow lift to correct a fallen brow line. I recommend scheduling a consultation with an experienced, board-certified facial plastic surgeon who can assess you in person and create a customized treatment plan that meets your needs and goals best.

Nelson Lee Novick, MD · Answer

From the photos, there appears to be significant depression of the lateral brows. A few microdroplets of Botox can be placed in the lateral brow to help elevate the outer one-third of the eyebrows and restore the more feminine, more youthful upward and outward flare of the eyebrows. Following this, a filler may be placed in the same region to resupply the lost volume in that region, which is the primary reason for the sagging brow. Make sure that you consult with a board certified aesthetic physician and ask to see his/her personal before and after photos prior to agreeing to proceed. Best of luck.

Toby Mayer, MD · Answer

Irregular Trichophytic Forehead Lift for sagging brows. Your brows need to elevated as you can do with your finger-not a blepharoplasty in my opinion. Your previous scar can be removed and properly closed.

Michael I. Echavez, MD · Answer

I would say the simplest option to treat your upper eyelids would be with an upper blepharoplasty to address the excess skin.  It is possible that you could be a candidate for a brow lift as well, but an examination of you would be helpful to determine that.

How can I improve the appearance of my droopy eyes? Could 10 years of using Latisse be making my eye area look worse? (photos)

Answers (6)

Answer: Irregular Trichophytic Forehead Lift for sagging brows.

Answer: Irregular Trichophytic Forehead Lift for sagging brows.

Answer: Treatment of droopy eyelids

Answer: Treatment of droopy eyelids

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Everything you need to know about Eyelid Surgery

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How can I improve the appearance of my droopy eyes? Could 10 years of using Latisse be making my eye area look worse? (photos)

Answers (6)

Answer: Irregular Trichophytic Forehead Lift for sagging brows.

Answer: Irregular Trichophytic Forehead Lift for sagging brows.

Answer: Treatment of droopy eyelids

Answer: Treatment of droopy eyelids

Browse related questions

Recommended reading

Everything you need to know about Eyelid Surgery

Our mission is to create a world where every investment in modern beauty is Worth It.