Droopy Eyelids - Alternatives to Eyelift Surgery?

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.

There are a few reasons that leads to eye lid hooding or excess skin;
Here are 5 possibilities and treatment options:
1. Eyelid modification with filler, Botox laser, or mini-procedure for excess skin of Upper eyelid
2. Eye drops which is a temporary solution for ptosis or saggiing of the eyelid itself
3. upper eyelid muscle surgery for sagging of upper eyelid skin
4. Laser procedures (multiple options are available) for excess upper eyelid skin and fat
5. Botox or Dysport injection for lifting of the eyebrow which helps lift the skin of upper eyelid
6. Filler injection of the upper eyelid / brow junction in cases where the deflation of the tissues has led to drooping eyelid
7. Placement of the filler injection in the lower lid and cheek junction can correct the appearance of circle or trouph appearance in that region
Hope this was helpful.
Best,
Dr Sajjadian

Sometimes wrinkles of the lower eyelids can be addressed with laser treatments or a chemical peel, and bags can be improved with injectable fillers or fat grafting. However, the upper eyelids need surgery for a meaningful improvement.

For the upper lids surgery really is your best option. The recovery can be quick and results are great!

In my hands, the nonsurgical options of the upper lid are essentially limited to fractional ablative CO2 laser and autofat tansfer. The fat transfer can help with brow elevation. This then gives the lid a more open appearance. With fat transfer there is still some downtime as there is typically some swelling post op.



The laser works by tightening the skin. This is modest though. It likely will tighten by a milimeter or so as compared to a blepharoplasty which we can remove 7-15mm of skin. 



It all depends on what you are looking for. There are options out there. Some people do chemical peels in this area. I a not a fan but there are surgeons who get great results.



Hope this helps.



Best of luck,



DrC

Many patients come to the office hoping to improve the
appearance of their droopy eyelids. The
most common treatment is upper eyelid surgery.
This removes the excess skin from the upper eyelids and thus improves
the overall appearance of the eyes.

An alternative to surgery is Botox. Botox can be used to elevate the brows, which
will open up the eyes and approve the appearance of your droopy eyelids. This is not a replacement for surgery but is
a great option for patients that are not ready for surgery.

It is important to see a board certified plastic surgeon to
discuss your Botox options. Your surgeon will be able to discuss the advantages
of eyelid surgery versus Botox for treatment of your options. Your surgeon will be able to individualize your
treatment based your desires and anatomy.


Please discuss your treatment with a board certified plastic
surgeon.

This is an excellent question! There will almost always be a non-surgical option to address issues with the eyelids and the face, though the biggest difference is how effective it is compared to surgery. This will vary widely based on the cause of your issues. If the droopiness is from excess skin, then there are several different types of laser treatments that can tighten this area and even some medical grade skin care products. If the issue is more from "bags" of fluid, then changes in the diet (low sodium, low sugar, etc.) can help minimize how much fluid the body holds on to. If the droopiness is more of a "hollowness" then sometimes this can be addressed with filler, creating a more smooth transition from eyelid to cheek. If the issue is from prolapsed fat or stretched out eye muscles (festoons), then surgery would likely be a more effective option than some of the non surgical adjuncts.
Hope this helps!Kyle Kimura, MDFacial Plastic and Reconstructive Surgery

Hello,

Alternatives to surgical eyelid tucks include BOTOX, fillers and lasers. These modalities can help soften the wrinkles around the eyes, improve skin tone and lift the eyebrows.( and also the lids)
They can be quite effective in cases of early hooding and drooping as well as hollowing in the tear troughs. As with all minimally invasive treatments, these modalities have their limitations and a surgical eyelid tuck may be the best and most effective treatment in more severe cases of drooping and bags.

Warm regards,

Dr Pedy Ganchi
Village Plastic Surgery

If you have excessive upper or lower eyelid skin, or protrusion of the lower eyelid fat pads, surgery may be the best option. HOWEVER, there are many non-surgical eye rejuvenation options. 1. Botox. Placed in the right spots, botox can lift the eyebrows and upper eyelids. It can also smooth lines around and under the eyes. 2. Filler. Filler can be used under the eyes to rejuvenate. It can also be placed under the outer aspect of the eyebrow to give lift to the lid. 3. Laser resurfacing. The CO2 laser (Lumenis Total FX) works well to help lift and smooth eyelid skin. 4. Non-surgical lifting devices like Ultherapy can be used to lift the eyebrows and thus the lid. I recommend "multi-modality" treatment for eye rejuvenation. That involved a combination of options. For example, combining the use of surgical rejuvenation with CO2 laser resurfacing. Follow this regular botox treatments for improved longevity. 

To give the eyebrows a nice lift, we use injectable fillers to improve the eyebrow, upper eye, forehead and temple. A filler is placed on the bone and in the fat pads of these areas to contour and lift without it looking overdone. We use cannulas to limit pain and swelling. I suggest getting a formal consultation with a facial sculpting expert. 

There are a number of options if you are not ready for surgical blepharoplasty. A small amount of Botox just below the outer part of the eyebrow will raise the outer eyebrow 1-2mm, but will need to be repeated every 3 months for continued effect. For a longer-lasting result skin-tightening lasers such as Thermage and Ultraformer III will lift the sagging upper eyelid skin.

There are many nonsurgical ways to improve the appearance of your eyelids. 
Here is a quick reference sheet:
BotoxTo smooth the crows feet, smile lines, and wrinkles around the eyesCan be very carefully injected to raise the eyelids non surgically (to be done only by an expert; off-label use)To stabilize and/or elevate the lateral browsChemical Peel/LasersTo smooth the crows feet, smile lines, and wrinkles around the eyesFillersTo fill the lower eyelid hollows and/or camouflage the bags. Can change the shadowing of the lower eyelid dark circles
Hope this helps!