Want to treat hooded eyes & improve tilt - do I need to go down surgery route? (Photos)

Thank you for your question and providing photos.
There are several options, surgical and nonsurgical, available to address hooded/droopy eyelids depending on the degree of the ptosis.
The surgical option to consider is blepharoplasty, which involves the removal of excess skin and fat from the eyelids, resulting in a more rejuvenated appearance. It's important to note that this procedure is more invasive and generally requires a period of downtime for proper recovery. However, based on the information you provided and reviewing your photos, it appears that there’s a distance greater than 3mm between your eyelash line and eye crease which means your indication for surgery is minimal.
Alternatives to surgery are injectable procedures which can provide temporary improvements. One example is the use of Botox or similar injectables to relax the muscles around the eyes and lift the eyebrows, thereby reducing the appearance of droopiness. Another option is the utilisation of dermal fillers to add volume and lift to areas around the eyes. These non-surgical options may be more suitable for you until a more substantial indication for surgery is present.
It is essential to consult with a qualified plastic surgeon who can assess your specific situation and provide personalised recommendation. The surgeon will be able to evaluate the severity of your concerns and discuss the advantages and disadvantages of both the surgical and non-surgical approach. They can also provide you with a better understanding of the potential risks and expected outcomes associated with these treatments.
Wish you all the best. Allen Rezai M.D.

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.

Thank you for your question regarding a procedure for your "hooded" eyes. In similar situations that I have handled, an upper blepharoplasty procedure would correct and rid of the excess skin (and excess fat if any is present) on your upper eyelids. To be sure, see two or more experienced, board-certified plastic surgeons in your area for a complete evaluation to make sure you are a good candidate and that it is safe for you to have an upper blepharoplasty. I hope this helps