How to Fix Droopy Eyelids: Surgical and Non-Surgical Solutions

Droopy eyelids are more than a cosmetic concern. When upper eyelid skin sags significantly, it can obstruct peripheral vision, make you look perpetually tired, and add years to your appearance. Whether your droopy eyelids are caused by aging, genetics, or an underlying medical condition, a range of effective treatments exist to restore a brighter, more alert, youthful eye area.

It is important to understand that "droopy eyelids" can refer to two different conditions. Dermatochalasis is excess skin on the upper eyelid that hangs over the lash line, commonly caused by aging and gravity. Ptosis is a drooping of the eyelid itself due to weakness or damage to the levator muscle that lifts the lid. These conditions require different treatments, and many patients have both. This guide covers all options for fixing droopy eyelids so you can find the right solution.

Understanding the Causes of Droopy Eyelids

Age-related drooping is the most common cause. As you age, the skin of the upper eyelid loses elasticity and begins to fold over itself, creating hooding that can range from mild to severe. Simultaneously, the fat pads around the eyes may shift or atrophy, and the levator muscle that opens the eyelid can stretch and weaken, causing true ptosis where the lid margin itself droops lower than normal.

Genetics also play a significant role. Some people inherit naturally heavy, hooded eyelids even in their 20s and 30s. This is a structural characteristic rather than an age-related change. Other causes include contact lens wear over many years (which can stretch the levator tendon), previous eye surgery, neurological conditions, and trauma. A thorough evaluation by an oculoplastic surgeon or a board-certified plastic surgeon experienced in eyelid surgery is essential for determining the cause and recommending the appropriate treatment.

Surgical Options for Droopy Eyelids

• Upper Blepharoplasty (Eyelid Surgery): The most common and effective treatment for excess upper eyelid skin. The surgeon removes a precisely measured strip of skin (and sometimes underlying fat) through an incision hidden in the natural eyelid crease. The procedure takes 45-90 minutes under local anesthesia. Results are permanent and the scar is virtually invisible once healed. Average cost: $2,000-$5,000 per eye.
• Ptosis Repair Surgery: If the levator muscle is the problem, ptosis repair tightens or reattaches this muscle to raise the eyelid margin to its normal position. This is a functional surgery that may be covered by insurance when the drooping lid impairs vision. It is often combined with blepharoplasty for comprehensive improvement.
• Brow Lift (Forehead Lift): Sometimes what appears to be droopy eyelids is actually a drooping brow that pushes skin down onto the upper eyelid. A brow lift elevates the entire brow position, opening up the eye area. It can be performed endoscopically through small incisions behind the hairline. Average cost: $5,000-$10,000.
• Combined Blepharoplasty and Brow Lift: Many patients benefit from both procedures performed simultaneously. The brow lift addresses brow position while blepharoplasty refines the eyelid itself. This combination delivers the most comprehensive rejuvenation of the upper face.

Non-Surgical Options for Droopy Eyelids

• Botox Brow Lift: Strategic Botox injections into the muscles that pull the eyebrow down can create a subtle brow lift of 1-3mm. This opens up the eye area and can reduce mild hooding. Results last 3-4 months and cost $200-$500 per session. Best for patients with mild drooping who want a non-surgical improvement.
• Upneeq (Oxymetazoline) Eye Drops: FDA-approved prescription eye drops that temporarily lift the upper eyelid by stimulating the Mueller's muscle. Each dose raises the lid by 1-2mm and lasts 6-8 hours. Useful for mild ptosis as a daily management option. Not a permanent solution but provides an immediate improvement.
• Radiofrequency or Ultrasound Skin Tightening: Devices like Thermage or Ultherapy can modestly tighten upper eyelid skin by stimulating collagen production. Results are subtle and work best for very mild laxity. Not effective for moderate to severe drooping. Average cost: $1,000-$3,000.
• Plasma Fibroblast Treatment: Uses a device that creates tiny plasma arcs on the skin surface to cause controlled tissue contraction. Can tighten mild upper eyelid laxity. Multiple sessions needed. Results are less predictable than surgery and carry risks of scarring and hyperpigmentation. Average cost: $500-$1,500 per session.

How to Determine the Right Treatment for You

1. Perform a self-assessment: Look in the mirror with relaxed facial muscles. If your eyelid skin folds over the lash line, you likely have dermatochalasis. If one or both eyelid margins sit lower than normal (partially covering the pupil), you may have ptosis. Many patients have both.
2. Check if it affects your vision: If droopy eyelids obstruct your peripheral or upper visual field, the condition is functional and surgery may be covered by insurance. Your ophthalmologist can perform a visual field test to document the impairment.
3. Assess severity honestly: Mild hooding responds well to Botox brow lifts or Upneeq drops. Moderate to severe drooping requires surgery for a meaningful, lasting correction. Non-surgical treatments cannot replicate the results of a well-performed blepharoplasty.
4. Consider your brow position: Stand in front of a mirror and manually lift your eyebrows. If this resolves most of the eyelid heaviness, a brow lift may be more important than eyelid surgery. If the eyelid still looks heavy with the brow elevated, blepharoplasty is needed.

Frequently Asked Questions

Is eyelid surgery painful?

Upper blepharoplasty is performed under local anesthesia with sedation, so you feel no pain during the procedure. Post-operative discomfort is minimal, typically described as a mild tightness or soreness. Most patients manage well with over-the-counter pain relievers and cold compresses for the first 2-3 days.

How long does it take to recover from eyelid surgery?

Most patients return to normal activities within 7-10 days. Sutures are removed at 5-7 days. Bruising and swelling are most noticeable for the first week and largely resolve by day 10-14. Most people feel comfortable going out in public with light makeup at the 10-day mark. Final results are visible at 3-6 months.

Can Botox fix droopy eyelids?

Botox can provide a subtle improvement by lifting the brow 1-3mm through strategic injection of the brow depressor muscles. However, it cannot remove excess skin or repair a weakened levator muscle. Botox is best suited for mild drooping and as a temporary solution for patients not ready for surgery.

What is the difference between hooded eyelids and ptosis?

Hooded eyelids (dermatochalasis) involve excess skin folding over the eyelid crease and sometimes over the lashes. The eyelid itself opens normally. Ptosis is a condition where the eyelid margin droops lower than normal due to muscle weakness, partially covering the pupil. Hooded eyelids are treated with blepharoplasty; ptosis requires levator muscle repair.

At what age should you consider eyelid surgery?

There is no specific age requirement. Most patients seeking eyelid surgery are between 35 and 70 years old, but patients with genetically heavy or hooded eyelids may benefit from surgery in their late 20s or 30s. The right time is when the drooping bothers you aesthetically or begins to affect your vision.

Preview Your Results Today

Use our AI-powered plastic surgery simulator to visualize how different procedures will look on you before making any decisions.