Eyelid Surgery: Cost, Photos, Rewiews, Q&A

Droopy eyelids treatment options

There are not many alternatives besides surgery for someone with true droopy eyelids. One must distinguish whether it is a true ptosis (droopy eyelid) or if it is dermatochalasis (excess skin hanging over the eyelid).

The best way to repair either problem would be with surgery. There are a few different ways to repair a ptosis depending on its severity so it is important that one receives a complete eyelid exam before undergoing surgery.

Some patients have both a ptosis (droopy lid) and dermatochalasis (excess skin) and need a combination of procedures to receive the best results. (David Freilich, MD , Englewood Oculoplastic Surgeon)

Non-surgical treatment for sagging eyes

My favorite way to help patients who have droopy eyes is to use a neuromodulator. Botox and Dysport can be used in a way to give the patient a chemical brow lift.

The effect is usually good for approximately 3 to 4 months. The use of Botox and Dysport in this method is not FDA approved but has been used safely for well over 10 years. Of course you should ask your doctor about this if you are interested. ( Carlos Wolf, MD , San Francisco Facial Plastic Surgeon)

Non-surgical treatment for drooping eyelids

Drooping upper eyelids are best treated with surgery (or blepharoplasty). A temporary alternative that may achieve a degree of eyelift is to inject the lateral orbicularis oculi muscle.

This muscle is a strong depressor of the eyebrows, and selected weakening of this muscle can raise the eyebrows and hence give an appearance of an eyelift. One must understand the results are not as dramatic as surgery, and only lasts a few months. ( Corey S. Maas, MD , Annapolis Facial Plastic Surgeon)

Botox, Dysport, Thermage as treatment for drooping eyelids

Always consider the brow when evaluating droopy upper eyelids. Neuromodulators such as Dysport and Botox can give a temporary chemical browlift to give you an idea of the effect of a browlift. Also for those not considering surgery, Thermage can often give a subtle brow and upper eyelid elevation without the costs or downtime. ( Lee Kleiman, MD)

Drooping eyelids

If the eyelids are drooping, then surgery is really the only answer. If it is the upper lids, you may actually need not only a skin excision but also a browlift. ( Steven Wallach, MD , Manhattan Plastic Surgeon)

Eyelid surgery alternatives

When considering rejuvanation of the orbital region one has to take in consideration:

1. the position of the brow
2. The position of the lids
3. the laxity of the lids
4. The amount of excess skin and the quality of the skin
5. any herniated fat (BAGS)
6. The tear trough.

Then we can recommend the treatment and their alternatives from fillers and Botox to fat transfer and then surgery. ( Samir Shureih, MD , Baltimore Plastic Surgeon)

Alternative to surgery for droopy eyelids

The upper eyelid blepharoplsty is the best way to treat this problem. Laser results are unpredictable and in my opinion, Laser surgery for the eyelids is a poor alternative. If there is minimal skin excess and the patient could benefit from a brow lift.

This operation can also improve the upper eyelid appearance. Botox when used judiciously can create a brow lift and improve the appearance of the upper eyelids, especially the lateral hooding.

The sagging of the upper lid is sometimes the result of loss of volume to the upper lid.

Establishement of adequate volume in the upper lid by micro-fat grafting or Restylane injection could benefit the appearance of the upper lid. ( Farhad Rafizadeh, MD , Morristown Plastic Surgeon)

Not many alternatives

If the problem is redundant skin and wrinkling, a laser resurfacing might be of help. It does not deal with fat herniation or redundant muscle. In my estimation, it is a harder recovery than surgical correction. As with any problem, the treatment has to fit the issues involved. Short cuts usually lead to dissatisfaction. ( Vincent N. Zubowicz, MD , Atlanta Plastic Surgeon)

Non-surgical eyelift does not work for significant hooding of eyelids

If you have lax upper eyelid skin or hooding of the upper eyelids, blepharoplasty surgery done by an expert surgeon will give you an excellent result that you will be happy with. I have seen results of Termage and laser resurfacing and they are not effective in my opinion. The exception is that a CO2 laser resurfacing can help tighten residual skin that is left after a blepharoplasty has achieved inadequate skin removal.

The non-surgcial techniques tighten the upper eyelid skin only minimally if they are used safely-they may help minimal skin excess-but minimal skin excess is not an indication for blepharoplasty. Lasers are useful for wrinkle removal and minimal skin tightening on the lower eyelids. ( Brooke R. Seckel, MD, FACS , Boston Plastic Surgeon)

BOTOX®/Dysport®, Eyebrow Lift Surgery or Injectable tissue fillers create eye lift

When you refer to eyelift surgery, perhaps you really mean eyebrow lift surgery. While surgery is often the best lasting approach to droopy eyelids, temporary resolution of this problem can quickly and easily be accomplished using injectable materials.

BOTOX®/Dysport® can be used to elevate the eyebrows by de-functioning the eyebrow depressors, so that the unopposed muscles in the forehead will raise the position of the eyebrows and, secondarily, will also improve the droopiness of the eyelids.

Injectable tissue fillers, such as Restylane®, Juvederm®, or Radiesse®, may also be used to elevate the eyebrow position by creating more fullness in this area. ( Michael R. Macdonald, MD , Bay Area Facial Plastic Surgeon)

Eyelid lifts, botox, brow lifts

Prior to any treatments or surgeries to the eye area, brow position, eyelid skin and fat excess, lid movement, and vision should all be evaluated. Droop upper lids can be caused by many different issues. Low brows can cause it, and in that case a browlift is best. Sompe patients choose Botox treatments to elevate their brows.

On some occasions, this non-surgical approach may temporarily creat some eyelid lifting, however, this is very temporary, and problems with asymmetry can occur. Eyelids can also droop over the colored portion of the eye itself. This is caled ptosis and requires a different type of surgery than a simple eyelid lift. A board certified plastic surgeon can help you decide on the best option for you after and exam and consultation. ( Patti A. Flint, MD , Scottsdale Plastic Surgeon)

Alternatives to surgery for drooping eyelids

Drooping eyelids can be more than excess skin. Without an exam it is hard to offer sound advice. In general I could not recommend any non-surgical alternative that I have any faith in. Wishing you all the best. Tal Raine MD ( Talmage J. Raine, MD, FACS , Champaign Plastic Surgeon)

Medical alternatives to droopy eyelids

Surgery is the definitive treatment. On the internet, there are sold eyelid crutches which lift baggy skin out of the visual axis. I have had one patient use it. I thought it looked terrible on them and quite strange but they were not a surgical candidate at all and were happy with the glasses. I wouldn’t recommend it to a family member as a first choice but that option is there. ( Chris Thiagarajah, MD , Denver Oculoplastic Surgeon)

Botox injections into your brow may eliminate the need for surgery.

In the majority of cases there is no substitute for a surgical excision of the excess upper lid skin called upper lid blephroplasty. In some select cases the upper lid skin redundancy can be taken up as part of an operation designed to restore the arch to the eyebrow called a brow lift.

This surgery pulls up the brow and simultaneously takes up the slack in the corresponding upper eyelid. You can try this yourself by pulling up your brow and observing the effect is has on your loose upper lid skin. Botox preparations can, if injected into the brow following a certain pattern, simulate to a minor degree the effects of a surgical brow lift. In doing so they can influence the upper lid skin in a manner similar to surgery.

Generally, only the most minor of upper lid skin redundancy is improved with such injections. Also, be aware that the effects of botox dissipate in 3 to 6 months and will have to be repeated indefinitely to maintain the desired result.

Ask your surgeon if your situation may be amenable to Botox injections as an alternative to surgery. Of course, there is no harm in simply trying botox first and if it happens to satisfy your needs then you have avoided going under the knife. (David A. Ross, MD , Chicago Plastic Surgeon)

Alternatives to eyelid surgery. The non surgical blepharoplasty

There really is no substitute for eyelid surgery. There are poor substitutes. There is a crease on the upper eyelid at the level of the tarsal plate of the upper eyelid. A long time ago before surgeons perfected the modern blepharoplasty, strips of double sided stickey tape (about 1/8 inch wide) were applied just above the fold and the patient would appy the strip with the eyes closed and once in place they would open their eyes. This maneuver woud create the surgical result wished for. This technique works for about 4 to 6 hours. ( Gary H. Manchester, MD (retired) , San Diego Plastic Surgeon)

Non surgical eye lid rejuvenation- an alternative to surgery

There are some patients who are not ready to go under the knife to rejuvenate their eyelids. Here are some options.

Excess eye lid skin: Rather than surgically removing this excess, the skin be smoothed out with Fraxel laser therapy or alternatively using Thermage radio wave technology. Droopy eye brows often contribute to the heaviness of the upper eye lids. The brows can be lifted by relaxing muscles that pull the brows downward with Botox injections as well as increase brow support using fillers i.e. Restylane, Juvederm, Radiesse or Sculptra.

Lower eye lid puffiness: This is caused by a combination of excess lower eye lid fat and a loss of facial volume just below the eye lid which accentuated the lower lid fat excess.

Optimally, the fat is removed surgically and volume restored just below the eye lid with fat injections, Sculptra or other fillers. A dramatic improvement in the puffiness can be accomplished by simply camouflaging the lower lid with fillers and removing any of the fat. Results can be quite dramatic.

Crows feet: wrinkles around the eye lid both at rest and with smiling can be addressed non surgically by relaxing the underlying eye lid muscle which creates these lines by Botox injections. For lines that are present at rest and etched in, Fraxel laser resurfacing along with Botox injections goes a long way to smooth out the eye lid skin.

In summary: Most patients benefit from a combination of the above techniques. ( Ran Y. Rubinstein, MD , Manhattan Facial Plastic Surgeon)

It depends on the nature of the droop

True excess upper eyelid skin (dermatochalasis) will not improve without surgery. In certain circumstances where the muscle responsible for lifting the upper eyelid is stretched or torn, a condition known as ptosis occurs.

This is equivalent of a low window shade on the pupil. Again, this condition will not improve without surgery.

Lastly, in certain conditions a low brow can cause a tired appearance. Botox can help to chemically lift the tail of the brow on temporary basis ( Stephen Prendiville, MD , Fort Myers Facial Plastic Surgeon)

Sagging Upper Eyelids

The brow and upper eyelid skin are intimately involved. In some patients elevation or pseudoelevation of the brow will help rejuvenate the upper eyelid complex. In other patients, particularly males be cautious about over ambitious elevation of the brow. Botox is probably the best way to nonsurgically address sagging eyelids.

What happens is that part of the orbicularis oculi muscle serves to lower the eyebrow. By temporarily weakening this muscle, the eyebrow will no longer have a lift to it, hence the eyebrow will lift. It is important when utilizing this technique that it is balanced with the frontalis muscle ( a muscle which elevates the brow) to avoid the Joker or Sinister look to the brow which is quite common after botox therapy.

Facial fillers can also help lift the brow which may soften the upper eyelids. Facial fat (which is a surgical procedure technically) is more commonly used for this application. Most facial creams are not effective on the upper eyelid skin.

An experienced injector will help create a youthful and balanced approach to your eyes and discuss alternatives to upper eyelid sagging. ( Anil R. Shah, MD , Chicago Facial Plastic Surgeon)