Eyelid Skin Excision or Lateral Brow Lift? No Hooding Problem Except in Very Outward Margin of Each Eyelid.

Lateral eyelid laxity with hooding most prominent at very end of eyelid with almost vertical fold in area just beyond eye folding onto eyelid corner. Previous eyelift from 20+yrs ago continues to give sufficient lid show esp in medial area. Brows seem to be no lower than decades ago. Issue probably result of volume loss in temple, side sleeping and SLIGHT brow descent in outward 20%. What is the most conservative option likely to provide noticeable and long term improvement?

Doctor Answers 9

How to correct slight drooping of outside part of eyebrow without surgery

Without performing an examination it is impossible to make a definite recommendation.  However, slight descent of the lateral brows can often be addressed using noninvasive techniques.  Injection of filler into the fat pad under the brow (a structure that deflates over time) and/or into the temples can both lift the brow and provide a more youthful fullness.  Botulinum toxins such as Botox, Dysport, and Xeomin can also be used to obtain elevation of the lateral brow in some cases.   Finally, noninvasive skin tightening such as Ultherapy can be used.  Ultherapy is the only noninvasive treatment that has a specific FDA indication for noninvasive brow lifting.

Nashville Oculoplastic Surgeon
4.8 out of 5 stars 41 reviews

Eyelid Skin Excision or Lateral Brow Lift? No Hooding Problem Except in Very Outward Margin of Each Eyelid.

 By your description and prior history of upper eyelid surgery (blepharoplasty), it's more likely that the lateral hooding is due to a low brow position.  This would iindicate some form of Browlift as the solution.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.6 out of 5 stars 25 reviews

A photograph would be very helpful.


There are many ways to tailor surgery to the individual anatomical circumstance.  Without a photograph it is impossible to provide anything but the most general statement that there are many available options.


Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Eyelid Skin Excision or Lateral Brow Lift? No Hooding Problem Except in Very Outward Margin of Each Eyelid.

         The brow lift may be reasonable, but an exam would be critical.




Kenneth Hughes, MD Los Angeles, CA

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

Blepharoplasty versus browlift

 Without pictures it's impossible to give an opinion. Surgeons look at the distance between the eyebrows (both medial and lateral) to make a judgment call as to whether or not a brow lift would be needed. When low eyebrows are present a brow-lift is considered. Excess upper eyelid skin, even with lateral hooding is usually an indication to perform an upper blepharoplasty, when the brows are in good a good position. The primary goal of the upper blepharoplasty is to remove excess skin and fat from the upper eyelid. For examples of what can be accomplished with a blepharoplasty please see the link below.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 145 reviews

Eyelid skin excision or lateral brow lift?

Actually a physical exam is best but a photo would help. You seem to understand the situation quite well. In the case of prior eyelid skin resection I am usually reluctant to take further skin and most likely an  endoscopic outer third brow lift (temporal lift) would be the best option here. The wasting in the temporal areas can be corrected with or without the lift but would not contribute to any elevation of the outer third of the brow.  Also if you underwent an eyelid procedure 20 years ago you likely had fat resection so you may also need volume replacement in the upper eyelid as well which can help fill out the skin envelope without further skin resection.

Grady B. Core, MD
Birmingham Plastic Surgeon
4.6 out of 5 stars 12 reviews

Lateral brow lifting and filling

A photo is necessary to evaluate but you are probably correct in your assessment of fat loss in the lateral brow and temple area with lateral brow descent, and may benefit from lateral brow lifting and filling.

Mehryar (Ray) Taban, MD, FACS
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 73 reviews

Hollowness of the temporal fossa causing lateral brow hooding

It is not unusual for a person to develop temporal wasting.  this is the area lateral to the orbital rim.  This temporal fossa contains the Temporalis muscle.  Many women develop a 1 -2 % volume decrease in this area per year.  If you have an indentation above your ear this could be your problem.   Volume filling of this area is useful this can include the use of fat or an injectable agent such as Sculptra. 

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 19 reviews

Eyelid Skin Excision or Lateral Brow Lift?

Answering a question about a specific facial appearance is, of course, impossible without knowing the look of the face. Please resubmit with photos.

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 27 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.