Drooping eyelids. What works and what doesn’t.10/01/24
Firstly, I am Dr Maeve Kenningham and I have worked in the NHS since 1996 in General Practice and Specialty doctor in Dermatology. I have had additional training roles for the Royal College of GPs and the Dermatology Department at Cardiff University. I have been practising in aesthetic medicine since 2012 and have won awards and kudos for my contributions to aesthetic medicine in the UK.
Let me give you some honest, straight forward, no snake oil advice on a common aesthetic issue that patients ask for my help on, drooping eyelids.
This is a common complaint in those who are ageing and even in the younger person because of their anatomy and possibly some extrinsic factors that is making the elastin (the spring back of the skin) brittle. Those extrinisic factors are : sun damage, smoking, drinking more than 14 units a week, a diet that is sugar laden. There are the intrinsic factors too such as good old fashioned ageing and the menopause. Drooping eyelid skin can make you create forehead lines and for some creates tension headaches and sores at the corners of the eyelids as the skin rubs.
Let’s kick off with what in my experience doesn’t work that well:
I don’t offer plasma around the eyes anymore, I’ve been disappointed with the results. Most people need repeated sessions and there is at least 1 week of downtime with each treatment. There is also a risk of hyperpigmentation and scarring.
Thread lifts don’t help this area either, for a variety of reasons.
What works to help with drooping eyelids. What are the disadvantages and how long would you expect the results to last.
I’ve put them in no particular order as combinations often work the best.
What can work well:
1. Botox (botulinum toxin is a prescription medicine) when performed strategically can lift brows very nicely and tastefully which in turn improves the heavy lid. The down side is that it is short lived (about 3-4months), so maintenance is every 3-4 months. Maximum results are seen 2 weeks after the injection. Click here for my blog and video about Botox Botox blog
2. Polynucleotide injectables tighten the skin to a good extent, the downside is possible bruising and you may need 2-4 sessions, it depends. Maximum results are seen 6-12 weeks later. This lasts until you start ageing around the eyes again, anytime between 9-12 months. Thereafter, maintenance is 1 session every 6-9 months, but it depends on your rate of ageing. Click here for more details on PNs Blog on Polynucleotides
3. Radio frequency micro-needling also tightens the skin and there’s only 4- 12 hours of redness/ swelling but you may need 2-4 sessions. Maximum results are seen 6-12 months later. This lasts until you start ageing around the eyes again, anytime between 9-12 months. Thereafter maintenance is 1 session every 6-9 months, but again, it depends on your rate of ageing.
4. Fillers in the temple, forehead +/- upper lids (also known as the “A frame”). Often, when we age there is skeletonisation of the face. This sunken appearance is a bit like a deflation of a balloon and as such, the once taught and suspended skin drops and leads to tissue descent. This can be seen in the upper face as concavity of the forehead and temple, hollowness of upper eyes and then descent of the eyebrows and so resulting in descent of the eyelids. Fillers in strategic areas can give a lovely tasteful “ageing well” result. Don’t be put off by the awful results we all see out there! Dermal fillers are just tools, it’s the skill of the tradesman/woman you need to be picky about. Imagine that a needle and a syringe of filler is the same as a paintbrush and paint. You can give these to a toddler and the same tools to a professional artist and you will get 2 very different paintings (results)! So, choose your injector wisely.
The downside of filler injections are possible bruising and risks of vascular events, however a doctor who uses ultrasound will reduce certain risks. You may need 2 sessions but sometimes 3, it depends. These results often last for well over a year sometimes 2. Thereafter, maintenance is approximately 12-18 months for most. Click for the link to my website page detailing Dermal fillers Dermal fillers Pros and Cons
5. The gold standard, if you have a significant issue, is still blepharoplasty (surgery) with all its associated down sides. This lasts until you start ageing around the eyes again, in my patients who have had eye surgery, most want tightening of the eye tissue again around 12-18 months later and I use combinations of all 1-4 above to maintain their results. I am not a surgeon so I do not perform surgical blepharoplasties. For more info on surgical blepharoplasty and qualified surgeons local to you can be found here: https://baaps.org.uk/patients/procedures/9/eyelid_surgery_blepharoplasty
If you’d like an appointment with me, and you live less than 2 hours away, it’s better to see me in person for a 45-50 mins comprehensive assessment, as it’s helpful to touch and feel your tissue to see what treatment combinations will work best.
Those patients who live 3-4 hours away often want an online zoom consultation for an assessment. If they are treated with HA fillers or bio stimulating fillers, I ask that they stay locally for 3 days in case of rare adverse events. My online booking system is currently disabled and I’m only taking bookings through my personal assistant Lisa. See the details below.
Our normal working days are: Tuesdays, Thursdays & Fridays and once a month Mondays.
If you would like to book an appointment with Dr Kenningham or view availability please click : https://www.drkenningham.co.uk/contact-me/#appointments
I hope I can help you. Have a look at my other blogs for more information on common aesthetic concerns and non-surgical treatment options.
Dr Maeve Kenningham
(MBChB, MRCGP(2001), DipDerm(merit), DRCOG, DFFP)
Dr K’s Clinic
Kinross, Rosemary Lane