Loose eyelid skin can lead to droopy eyelids. Some patients have variable amounts of excess upper eyelid skin plus droopy brows that contribute to this condition. Excess and loose lower eyelid skin is seen in almost all patients who have excess eyelid upper eyelid skin. Treating both the upper and lower eyelids will give the best results. Depending on the amount of excess skin and laxity, together with factors such as the state of your surrounding skin, either laser resurfacing or eyelid surgery can make an extreme difference.
- Droopy eyelids can range from mild to severe. In severe cases vision can be blocked
- Excess skin on upper lids can be due to excess upper eyelid skin, an abnormal position of the margin or brown ptosis
- Addressing the cause of the problem will give the best results
- Excess skin and laxity can be due to a combination of genes, age, sun and smoking
- Most people with excess upper eyelid skin will also exhibit excess or loose lower lid skin
- Treating both upper and lower lids will give the best results
- Treatment can either be surgical or via laser resurfacing
- The best method will depend on factors such as the degree of skin laxity, your health, and most importantly the state of the surrounding skin
- Surgery can be combined with mini-s-face lifts as well as laser resurfacing
Droopy eyelids are inevitable, however some people age prematurely. This can be due to genetics, however lifestyle factors such as UV exposure, especially if you live in a high index city like Brisbane or the Gold Coast, coupled with smoking can accelerate skin laxity.
Genetics play a significant role in the formation of eyelid skin laxity, as I regularity perform procedures in males and females in their 30s.
There are 3 different conditions that can cause loose, lax and droopy eyelids. Some patients may only have one factor, some all 3 contributing to this condition.
- Excess laxity – this is termed dermatochalasis, and can present as upper or lower lid laxity. Most people who exhibit upper lid laxity over the age of 40 will also have lower lid laxity. This can result in patients looking tired, and wrinkled, especially under the eyes.
- Eyelid margin repositioning – this is known as ptosis. Ptosis most commonly presents in adult life, but can be present at birth. Abnormal eyelid margins can give a heavy and tired look.
- Brow positioning. Eyebrows that move downwards with time an gravity can also contribute to droopy eyelids, and a ‘tired’ look. This is called brow ptosis.
Patients in the 40s upwards will have varying degrees of all 3. Balancing laxity, eyelid margins and the position of the brow will give optimal results.
Surgery or laser resurfacing will address skin laxity. If you exhibit mild to moderate skin laxity of both upper and lower eyelids, laser resurfacing will address this problem.
For patients that exhibit marked or severe laxity, surgical excision of excess skin gives the best results- this is called surgical blepharoplasty.
An examination will give me a guide as to the best treatment for you. Some patients may only require laser resurfacing whilst others surgical. In cases where by upper and lower eyelid laxity is associated with poor skin texture and tone, I may recommend surgery, followed by resurfacing.
It is extremely important to take note of the surrounding skin before advising on what is the best treatment. For example, if laser resurfacing for eyelids is planned, then feathering to the surrounding skin is essential to prevent any sharp ‘cut offs’.
Treatments are well tolerated and pain is minimal. We use a mix of local anaesthetic cream plus injections to the treated areas. If a case extends beyond 20 minutes, I may add light sedation to help decrease both pain and anxiety of the procedure. Pain is not an issue as this is addressed well before surgery.
It depends on what is performed.
Eyelid surgery heals the fastest- downtime is usually less than one week. Sutures are out within 5 days, and swelling last for a day or two post surgery.
Laser resurfacing has a downtime of 5-10 days. The more laxity you exhibit, the longer the downtime as more energy levels are needed to stimulate collagen.
Surgery is different from laser resurfacing. After surgery, you can expect swelling for up to 2 days. You will have sutures that come out at day 5. We then tape the area for another week with strips. Mild swelling may persist for a week or two, but the results will be instantly noticeable. The scar line will fade within 8-10 weeks, depending on the location of surgery (upper or lower lids).
Laser resurfacing is associated with weeping and swelling for up to 3 days. You will be required to clean the area twice a day, and use a special healing balm for up to 10 days. The healing time of laser is variable, as this depends on the laxity of your eyelid skin. I usually perform a mix of both erbium and CO2 laser resurfacing for optimal skin tightening and wrinkle removal.
Surgical blepharoplasty last longer than laser belpharoplasty. Expect 6-15 years following surgical, and 4- 12 years following laser eye lid surgery. Genetics play the most important role in longevity of the procedure.
Yes. I will go thru the process and plan once an examination is made. I take photographs and come up with a detailed treatment plan. This will be explained to you during the consult. You will also receive a phone call from my assistant surgical or laser nurse one week prior to surgery to reinforce what was discussed during the initial consult. We will take you thru the treatment as well as the expected healing processes as well as the downtime during this call.
Yes. If you exhibit altered skin texture and poor skin tone, laser resurfacing of your face can be combined with resurfacing of your eyelids. In fact 90% of my eyelid resurfacing is combined with face resurfacing, as most patients will also have associated facial skin laxity.
I also combine upper eyelid surgical excision of lax skin WITH laser resurfacing of the face. In many cases patients exhibit marked upper eyelid laxity with only moderate lower lids laxity- this combination of surgery and laser gives optimal results.
Cost will depend on whether surgery or laser is performed. As a guide-
- Laser resurfacing to upper and lower lids with cheek blend $3800-$4200
- Surgical upper lid blepharoplasty $3,900
- Surgical lower lid blepharoplasty $2,900
- Upper and lower lid blepharoplasty $5,300
No. This treatment is considered cosmetic in nature and not covered under Medicare/ Private Health. The exception is if eyelid skin laxity is so severe that it covers the field of vision and obstructs or impairs sight. This is exceptional rather than the rule.
By Dr Davin Lim
Laser and Aesthetic Dermatologist
Treating eyelids and the surrounding areas is my subspeciality. Have a look at the before and after photos and you can see why. I believe that the ‘eyes are the window to the soul.’ Eyes are the very first thing people look at when they meet and greet you. Saggy and droopy lids can convey tiredness and sadness as well as age.
My treatments are aimed at opening up the eyes, tightening excess skin, however I look beyond that. Have a look at my photos- I treat the underlying problem with surgical or laser blepharoplasty, but also treat the surrounding skin to provide a natural balanced look. Eye rejuvenation goes beyond removing or tightening loose eyelid skin- I take it one step further and blend in the surrounding skin. I lessen crows feet (without the need for Botox), I also address loss volume around the orbit- fillers in certain areas will highlight the eyes.
Last but not the least, I have a professional brow specialist that works with me- this is icing on the cake, having your brows waxed and shaped professionally can give lifting and complete the process of eye rejuvenation.
Eye rejuvenation is one of my favourite procedures as the outcome truly is ‘eye opening’.