Years ago, those with hooded eyelids who were looking to lift them had few options beyond surgery. But technology has come a long way in the last several years, and now there are several non-invasive options: Botox, eyebrow thread lifts, and plasma fibroblast treatments among them.
From an aging perspective, hooded eyelids are when the skin above the eye sags and hangs over the eye. The excess skin occurs between the brow and the upper lash line. They're caused by a variety of factors, including age and genetics. Lindsey Zubritsky, MD explains that as we age, we lose bone, facial volume, collagen, elastin, and fat. So over time, the structure of the face changes. And, due to gravity, all of our skin eventually begins to sag.
While these are some of the most common reasons for hooded eyelids, many people are born with a naturally hooded eyelid due to their facial structure and the skin dropping down and folding over the crease of their lid. "The majority of my patients are older women between the ages of 40 and 70, but many men and even young adults are coming into the office seeking treatment" for hooded eyelids says Zubritsky.
With the help of Zubritsky and Azadeh Shirazi, MD, we explored some of the options for those looking to lift their lids.
Zubritsky says that Botox is an easy, relatively low-risk procedure with minimal downtime used to lift hooded eyelids and droopy brows; this is often referred to as a "Botox brow lift."
This procedure is best used in mild cases of hooded eyelids or for younger patients. Botox for hooded eyes works by relaxing the muscles around the eyes and between the brows, which then lifts the eyebrow to a higher position. Shirazi says that when Botox is strategically placed, it can lift and open up the eyes quite significantly, resulting in a brighter look to the eyes.
Price: Botox's cost depends on the number of units used by your provider, but in 2019, the national average was around $379.
Temple and Brow Filler
Shirazi explains that the loss of structure around the eyes can cause the eyebrows to droop. Adding a dermal filler to the area can provide a lift to the eyebrows and decrease the look of hooded eyelids.
Price: The cost of dermal fillers depends on the brand used (Juvederm Ultra, Ultra Plus, Voluma, Restylane Lyft, Restylane, Belotero, Sculptra, etc.), ranging from $625 to $850 in 2019.
Resurfacing lasers can tighten the skin while promoting collagen production. This helps the area heal in a smoother, more even appearance while ablating loose skin around the eyes for a non-surgical eyelift, according to Shirazi.
Price: Ablative laser resurfacing will cost a pretty penny—in 2019, the procedure came in around $2,200.
Eyebrow Thread Lift
An eyebrow thread lift is a minimally invasive procedure. Dissolvable threads are strategically placed in the appropriate layer of skin with a needle (no incision needed) and lifted upward; they essentially act as an anchor. The excess threads are then cut off. This creates an instant lift to the eyebrow area and adds support for the upper eyelid. In addition, it helps the region to produce new collagen over time. It's a pretty quick procedure performed under local anesthetic—it can even be done on your lunch break. Keep in mind that it does come with a little bit of bruising, soreness, or swelling for a few days post-treatment.
Price: The cost of an eyebrow thread lift can range from $1,500 to $6,000. Results lasts between one to three years, depending on quickly your body dissolves the threads.
Plasma Fibroblast Skin Tightening
Plasma fibroblast skin tightening treatments work by creating hundreds of tiny holes or controlled micro-injuries on the upper eyelid with a high-frequency electric current. Instantly, the little holes shrink up, resulting in a retraction of the skin and a tightening and lifting effect. This may sound a bit frightening, but it's considered to be a low-risk procedure. Since the eyelid area is thin and delicate, a bit of swelling may occur with this procedure.
It usually takes two to three weeks for the tiny holes to heal, and you will see the final result within six to eight weeks, depending on your skin's healing time. Results can last up to three years.
Price: Plasma fibroblast skin tightening treatment costs vary, but are typically in the upper hundreds of dollars.
Microcurrent devices are popular because they are relatively easy to use, can be performed at home, and are not as expensive as in-office procedures. Microcurrent devices like NuFAce Trinity with the ELE attachment (a smaller attachment for the eye and lip areas) work by stimulating muscles, resulting in a temporality lifted effect to the skin.
Price: Microcurrent devices will, on average, range from $200 to $400 and should last thousands of uses.
Eyelid surgery, known as upper lid blepharoplasty, is recommended for people with moderate to severe eyelid sagging. Out of all the treatments for hooded and sagging eyes it will be the most invasive and expensive, and come with the most downtime. However, the results often last around a decade, which is significantly longer than most other treatment options.
Price: Blepharoplasty will be the most expensive treatment option, with costs ranging from $2,000 to $5,000.
The treatment you ultimately end up choosing—if you choose any at all—is a personal decision, based on factors including your desired results, downtime, and budget. It's a good idea to speak with a board-certified dermatologist about your options to obtain your goals.