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As you get older, the skin loses its elasticity and may begin to droop. These effects are most noticeable on the face, especially around your eyes. Some may develop sagging skin in the upper and lower eyelids.

There are several ways your plastic surgeon can treat sagging eyelids that are highlighted below.

Why Do We Get Droopy Eyelids?

Sagging eyelid skin, baggy eyes, and dark circles are common as we age. This is because the skin around the eyes is thin, and it moves all the time. It also gets heavy sun exposure. These factors make the eyelid skin stretch with age and time, causing an older appearance.

Determining why and how severe the drooping eyelids are is complex. Your plastic surgeon will first look at the eyelid’s height, followed by the position of the eyebrow. Then, they look at the folded skin between the eyelid and eyebrow. Once the surgeon analyzes these factors, they’ll provide a treatment recommendation.

Further, the composition of our bodies changes as we get older. For example, we don’t have as much fat on our faces in the older years and can develop hollowed-out eyes, which puts contours and shadows on the eyelids.

What Makes The Eyes Look Different As We Get Older?

As you get older, several factors may make the eyes look undesirable. Fortunately, most of these issues can be addressed with a variety of non-surgical and surgical procedures highlighted later in this article:

  • Extra skin: As the skin relaxes and falls with age, it may cause bags and wrinkles below the eyes.
  • Dark circles: It’s common to develop hollows under the eyes as fat content in the face lessens and skin sags. The area that separates the cheek and eyelid also may hollow out. Cheek tissue also may drop with time, all of which can leave the eyes looking more hollow.
  • Fat tissue: If the upper or lower lids are puffy, there could be fat deposits there. The fat is normal, but it can move and give a baggy appearance under the eyes with time.
  • Ptosis: This is a weakness of the muscle that opens your eyes. It can make the eyes less open than usual and may make you look fatigued.
  • Tear troughs: This is the skin under the eye that can show indentations with age.

How To Fix Drooping Eyelids

Now that we understand what causes drooping eyelids and bags under the eyes, what can be done? More Americans are investigating surgical and non-surgical procedures to address these issues to make the eyes and face look younger.

Your surgeon will conduct a physical examination to determine if one of the surgical or non-surgical interventions below is best for your situation.


For less severe sagging and drooping, the surgeon may recommend Botox or Dysport injections to tighten sagging skin around the eyes temporarily. These injections also will reduce fine lines and wrinkles around the eyes.

These injectables work to temporarily address eyelid problems caused by weakening muscles in the corners of the eyes. In addition, some patients can have a mild Botox brow lift to eliminate some heaviness and folds in the upper eyelids.

Remember that Botox and Dysport injections need to be repeated at least every six months.

Dermal Fillers

Dermal fillers containing hyaluronic acid, such as Juvederm and Sculptra, increase volume to fill hollow cheeks and around the lower eyelids.

It’s possible to use dermal fillers under the eyes to remove some of the hollowness in the lower lids.

Like Botox and Dysport, dermal fillers are temporary and must be repeated periodically to maintain the effects.

Some surgeons recommend using both Botox and dermal fillers for the best non-surgical benefits. Together, they can temporarily address eyelid sagging and eye hollowness.

Eyelid Surgery

An upper and lower eyelid lift offer the most dramatic and long-term solution to eyelid sagging. Eyelid surgery, also called blepharoplasty, can remove extra skin and fat, reposition a small amount of fat, and tighten the remaining skin.

However, removing the skin from the lower eyelids is only part of the issue.

Fat Removal

Patients who want a more substantial improvement may need fat removed from the lower lids to eliminate those baggy eyes.

In the past, a lower eyelid lift involved just removing extra fat under the eyes. While this improved the bagginess problem, it didn’t do anything for the hollow region under the bags.

Repositioning Fat

Surgeons usually recommend moving the fat for that hollow area under the eye bags. The fat there can be used to improve the hollows, contours, and shadows under the eyes.

While the fat under the eyes is herniated, it doesn’t usually make sense just to remove it. Instead, the fat can be used to benefit your eyes’ overall appearance.

When Should You Get Treatment?

If sagging eyelid skin affects your vision, it’s essential to seek treatment as soon as possible. In this case, you may need an upper eyelid lift and possibly a brow lift. Your health insurance may cover the procedures when the treatment is considered medically necessary to improve vision.

If changes around the eyes with aging are hurting your self-esteem, this also is a valid reason to have a cosmetic procedure. For example, when you don’t like how you look, you might consider a procedure to improve your eyelids and eye bags.

Talk to your plastic surgeon soon about your eyelids, and they’ll provide the best recommendation for your needs and aesthetic goals.

Request An Eyelid Lift Consultation

Interested in an eyelid lift in San Antonio? Dr. Scott J Farber or Dr. Amita Shah of Hill Country Plastic Surgery can help. They will consult with you about your interest in an eyelid lift and help decide if it’s a good fit for your aesthetic and personal goals.


Nonsurgical Eyebrow Lift. (2021). Accessed at

Blepharoplasty. (n.d.). Accessed at

 The Best Options For Droopy Eyelids, Circles, And Sags. (n.d.). Accessed at

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