Droopy Eyelids - Alternatives to Eyelift Surgery?

I know an eyelift would work for my sagging eye lids....but what about non surgical ways to improve eye lids?

Doctor Answers 138

A quick alternative to Eyelift Surgery for upper eye lid hooding: The Ten Minute Eyelift

Hooding of the upper lids is a fairly common problem with aging. Shrinkage and the downward displacement of the supporting fat pads under the eyebrows, coupled with an overall loss in both the amounts and quality of collagen and elastic fibers are contributing factors.

While blepharoplasty remains the gold standard for treating this problem, many people wish to avoid the expense, risks and downtime of traditional eyelift surgery. For these people, the Ten Minute Eyelift, a minimally invasive technique, offers a viable and quick alternative.

The procedure is simple. The redundant portion of the underside of the hooded area of each upper lid, which is hidden from view, is first marked and then injected with a tiny amount of a local anesthetic.

Next, a heated probe is run along the marked areas until visible shrinkage and retratction of the hooding is observed and the underlying true upper eyelid exposed sufficiently. Once done, the resulting line-like wound is covered with an ointment and is left to heal spontaneously.

Each eyelid takes about five minutes to treat in this fashion, hence the name the Ten Minute Eyelift. Most people return to their daily routines immediately afterward, although some prefer to do so the following day.

Slight swelling, tenderness, and a tiny amount of drainage and scabbing along the treatment line are common and are simply treated by cleaning and the application of a bit of Vaseline or antibiotic ointment. Wounds are generally completely healed in seven to ten days.

A fine, linear scar eventually results, which remains hidden under the remainder of the now shortened and less droopy upper lid.

Overall, patients have been quite gratified by the results and by the ease, rapidity, relative inexpensiveness and lack of need for traditional eyelift surgery.

New York Dermatologic Surgeon
4.9 out of 5 stars 31 reviews

Top 5 Options for Non-surgical Eyelid Rejuvenation

There are several non-surgical options to rejuvenate a "droopy" upper eyelid, based on the following issues:

1. If the eye is closing (PTOSIS) from a weakened muscle in the lid: A prescription eye drop called IOPODINE may be instilled into the eye and within a minute, the eyelid often opens. This is a temporary solution that lasts for about 8 hours and needs to be repeated daily (if you want to maintain the look)

2. If the extra skin from the upper eyelid is the issue: Botox may be placed around the eyes in the muscle (that causes the eyelids to close), allowing the counter acting muscles (that open the eyes) to become more forceful, thereby giving a "lift".

3. If the underlying issue of the "droopy" eyelid is extra fat and redundant skin (DERMATOCHALASIS): Multiple types of lasers may be used to make the skin and underlying tissue tighter, as well as to reduce wrinkles / crow's feet.

4. If the eyebrow is low and is causing an extra skin on the upper eyelid: A filler can be injected directly above the brow to elevate it. Botox can also be injected directly into the brow to yield a nice elevation.

5. If the lower eyelids are "puffy": Placement of a filler in the cheeks to elevate them to the level of the "bags" will mask the puffiness.

I hope you find this information helpful.

James R. Gordon, MD, FACS, FAAO
New York Oculoplastic Surgeon
5.0 out of 5 stars 144 reviews

Nonsurgical approaches to droopy eyelids

Droopy eyelids can be improved non surgically with the use of neuromodulators like botox or Dysport which can raise your eyebrows lifting some of the droopy lids as well. Results typically last from 3 to 6 months. Other alternatives include fillers like restylane or juvederm strategically placed to elevate the corners of the brows pulling the lids with them. Finally, you can do an endoscopic browlift that helps to raise the brows which can create some mild elevation of the lid skin as well. I hope this information helps.

Scott Trimas, MD
Jacksonville Facial Plastic Surgeon
5.0 out of 5 stars 20 reviews

The best non-surgical way to reduce the appearance of...

The best non-surgical way to reduce the appearance of sagging eyelids is to avoid salty food, drink loads of water and get lots of sleep. This is especially useful to reduce the sagging of the lower lids.

Botox can raise the upper eyelids. Any other form of rejuvenation would require surgery.

Henri P. Gaboriau, MD, FACS
Seattle Facial Plastic Surgeon
5.0 out of 5 stars 7 reviews

Alternatives to eyelid surgery

In my plastic surgery practice, we also have a medical spa that offers treatments from Botox to lasers, to skin care, etc.  If there is a way to provide an improvement without surgery, that is our preference. However,there is no option for redundant skin other than surgery. There are no photos so I'm  not sure what you mean by drooping lids.  It would provably be worth your while to look at the websites of plastic surgeons and look at their before and after photos. When you see images you like, take more time and research the background and training of the plastic surgeon.

Michael Law, MD
Raleigh-Durham Plastic Surgeon
4.8 out of 5 stars 120 reviews

Treatment options for sagging lids

Sagging eyelids are usually associated with advancing age, but the truth is, many different underlying conditions may affect the appearance of the eyes. As Dr. Gaborieau has mentioned, getting plenty of sleep, adequate hydration, and avoidance of salt may help some of the common causes of sagging eyelids. Other important ones are allergies, and chronic edema or swelling that is non-allergic in nature.

In the case of the upper eyelids, BOTOX injections placed correctly can result in a slight elevation of the brow, and consequently raise the skin of the upper eyelid to "open up" the upper eyelid area. These results are not consistent, and may vary between patients. Certain amounts of droop in the brow, or excessive skin in the upper lids, may have to be corrected surgically.

In the lower lids, several other factors come into play. Some of the first signs of aging are seen in the lower eyelid area resulting from a decrease of fat under the skin of the lower eyelid. This exposes not only the bone of the eyesocket, creating a "tear trough deformity", but in some cases may expose the normal fat of the lower eyelid, resulting in the appearance of lower lid "bags".

It is essential for the treating physician to recognize this condition prior to recommending removal of fat. Such surgical treatment can lead to hollowing and a gaunt appearance postoperatively.

While surgery and fat removal certainly have a place in lower eyelid bag treatment, younger patients with loss of fat in the lower lids benefit most from addition of volume in this area. Volume can be added with fat grafting, or simpler procedures such as Restylane injections. This is a treatment we call "Thirties Eyelift" in my practice. Restylane injections can be done with mild discomfort in the office, and some of my patients have had their results last up to one year with a small touch up.

Behrooz Torkian, MD
Beverly Hills Facial Plastic Surgeon
4.3 out of 5 stars 17 reviews

Alternatives to eyelid surgery

Yes, there are many different options to improve the eyelid area without surgery. You can use Botox to lift the brow and create a smoother appearance. You can also use Ultherapy skin tightening and DOT laser resurfacing to improve sagging skin. We also recommend that our patients use Elastiderm Eye Cream from the Obagi Nu-Derm line to tighten eyelid skin. 

Juan A. Brou, MD
Oklahoma City Plastic Surgeon
4.7 out of 5 stars 36 reviews

Non surgical eyelid lift options

There are many non surgical options for improving the appearance of sagging eyelids, although a consultation to properly diagnose the reasons for the sagging is important. Here are a couple of ideas:
  • Botox can very subtly lift the eyebrows, getting some of that lose skin further away from the eyelid crease
  • a skin care regime that includes products that stimulates collagen, and include products that appear to "tighten"
  • lower eyelids can be treated with a deep Erbium laser treamtent to completely resurface and tighten the skin
  • superficial laser treatments of the lower lids, such as a micro laser peel, can improve the texture and tone

The gold standard for removing excess skin and fat from the upper eyelids is an upper eyelid blepharoplasty. In the hands of a specialist, this is a procedure with high satisfaction rates, with most people take 1 - 2 weeks off social activities.

Thomas Buonassisi, MD
Vancouver Facial Plastic Surgeon
4.9 out of 5 stars 108 reviews

Alternatives to Surgical Blepharoplasty

Any responsible decision about alternatives to Blepharoplasty require a consultation and evaluation with a well experienced and qualified Board Certified surgeon.

Alternative considerations might include:

  1. Adequate sleep
  2. good nutrition
  3. skin care
  4. BOTOX
  5. Injectable fillers
  6. chemical peel
  7. laser resurfacing

If you have truly droopy upper eyelids, surgical Blepharoplasty and/or brow lift are probably best considerations.

Paul C. Zwiebel, MD
Denver Plastic Surgeon
4.7 out of 5 stars 41 reviews

Nonsurgical eyelifts

When significantly more eyelid skin is there than needs to be (sagginess), surgery is the best option to remove this.

For patients who do not want surgery, it is possible to resurface the eyelid skin with a laser. This will produce some tightening. Ironically, it tends to produce much more swelling than a blepharoplasty would.

Botox to the corners of the eye allows the eyebrow to rise somewhat, giving the eyes a more rested appearance. This effect of the Botox tends to wear off fairly quickly, usually before the Botox does.

Regular use of retinoid creams such as Retin A can tighten eyelid skin a bit.

Avoidance of salty foods and alcohol, and use of cold compresses can temporarily make the eyes look better.

Not great options, but they do not involve cutting surgery.

Brent Moelleken, MD
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 178 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.