My eyelid is drooping due to significant fat loss from radiofrequency treatment. How can I fix this?

Question

I am turning 40. I had radiofrequency, ultherapy, and eye thermagy. After the treatments, my upper eyelid became hollow and seems to be sagging due to fat loss. My upper eyelids are sagging and covering eyes. I look so old and smaller eyes. Especially eye areas. I don"t want to have unnatural blephaloplasty. Is there any way my upper eyelids can be fixed besides blephaloplasty? Should I do fat transfer or filler or laser resurfacing like fraxel, c02 eye lift? Please let me know. Thank you.

Brian S. Biesman, MD · Answer

I am sorry to hear about your experiences.  Without more information it is difficult to provide an answer to your questions.  I did develop and perform all the initial testing on the Thermage eyelid treatment tips and we did not experience any cases of fat loss as a result of these treatments.  I would recommend evaluation by an eyelid specialist who has extensive experience in the use of Thermage, Ultherapy, as well as  nonsurgical and surgical solutions to eyelid rejuvenation.

Ron Shelton, MD · Answer

I'm not sure which radiofrequency you had on the upper eyelids other than then the Thermage. I have not seen fat removal as a result of radiofrequency on the eyelids. Ultherapy is not done on upper eyelids.If the upper eyelids are sagging, it may be from a forehead that has sagged or the eyebrows, or both.  Other patients have eyelids that lower as a result of the muscle and tendon of the upper eyelid and that requires different surgery than mere skin removal.  Standard blepharoplasty surgical removal of sagging upper eyelid skin results in natural looking and younger eyelids. It is the most effective way of addressing this concern. But if my patients absolutely don't want surgery, there are a few things that can be done to help lift the upper eyelids slightly.  ThermiSmooth or ThermiTight radiofrequency or Ultherapy ultrasound tightening of the forehead, along with off-label use of hyaluronic acid filler under the outer eyebrow and Fraxel Repair resurfacing of the preseptal upper eyelid skin, and Botox treatment of the glabellar forehead and outer eyebrows can all help lift the upper eyelid, but not to the same extent as a blepharoplasty.

Julia Ann Sullivan Miller, MD · Answer

It would be helpful to look at photos to see exactly how your eye is drooping following your procedure.  If your eyelid is actually ptotic, meaning that the eyelash line is lower in one eye compared to the other, you might require surgery to lift the lower lid.  However, if its a matter of excess skin causing your eyes to appear droopy, you have a few options.  The best and most permanent option would be an upper lid blepharoplasty.  In the hands of a capable plastic surgeon the results are very natural and youthful in appearance.  You can also have a Fraxel laser done to the upper lid to help tighten the skin and minimize the droopy appearance.  Finally, if you had your procedure recently, you should give yourself some time to heal before you rush into another procedure.  It is always best to discuss your concerns and your options with your physician.

Hratch Karamanoukian, MD, FACS · Answer

Ultherapy is FDA approved for nonsurgical eyebrow lift. It is not used and not safe for used on the upper eyelids. Read the Ultherapy book on the elink below.

My eyelid is drooping due to significant fat loss from radiofrequency treatment. How can I fix this?

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