Cosmetic
A guide to non-surgical eyelid and brow rejuvenation — Botox, fillers, lasers, RF microneedling, and plasma — with honest guidance on when surgery is needed.
Medically reviewed by Thomas C. Spoor, MD, FACSOculoplastic SurgeonLast updated June 2026
Your Surgeon
Thomas C. Spoor, MD, FACS
Michigan Neuro-Ophthalmology & Oculoplastics
🏅 ASOPRS Fellow
Part of our complete guide to Periocular Rejuvenation — this page covers the non-surgical eye lift in depth.
The phrase “non-surgical eye lift” has become one of the most searched terms in aesthetic medicine. Patients want brighter, more rested eyes — but they understandably hope to avoid an operating room, sutures, and downtime. The good news is that a thoughtful combination of neuromodulators, hyaluronic acid fillers, energy-based devices, and skin resurfacing can meaningfully refresh the eye area in well-selected patients. The honest truth is that no injection or laser can replicate what surgery does when redundant skin, herniated fat, or a heavy brow are the real problem.
An oculoplastic surgeon sits in the unique position of being able to offer both. We perform blepharoplasty and brow lift surgery, and we also inject Botox and fillers and run laser platforms. That dual perspective matters: a practitioner who only injects has an incentive to treat every patient with what they offer, even when the result will be disappointing. A surgeon who can do everything can tell you honestly which approach will give you the best outcome for the time and money you spend.
Throughout this guide we will discuss each modality, who it helps most, what realistic results look like, how long they last, and the moment when a patient is better served by surgery. The goal is not to discourage non-surgical care — it is excellent when applied appropriately — but to set expectations honestly so you can make an informed choice.
Botulinum toxin (Botox, Dysport, Xeomin, Jeuveau, Daxxify) is the workhorse of non-surgical periorbital rejuvenation. It works by temporarily relaxing specific muscles. Around the eyes, the two most common applications are softening crow’s feet at the lateral canthus and creating a subtle chemical brow lift.
The brow position is determined by a balance between elevators (the frontalis muscle) and depressors (orbicularis, corrugator, procerus, and depressor supercilii). When the depressors are selectively weakened with small doses of toxin, the frontalis pulls the brow up unopposed. In a well-chosen patient, this can elevate the lateral brow tail 1–3 mm and open the eye aperture noticeably. Treatment typically uses 2–4 units at the lateral orbicularis on each side, often combined with corrugator and procerus injections to lift the medial brow.
The fan of wrinkles at the outer corner of the eye comes from orbicularis contraction during smiling. Toxin softens these dynamic lines beautifully. Static lines — creases visible at rest — respond only partially and may require resurfacing in addition.
Botox results begin in 3–5 days, peak at 2 weeks, and last 3–4 months. Learn more about technique and dosing on our Botulinum Toxin page.
A chemical brow lift of 1–3 mm is meaningful in a patient with mild ptosis of the brow. It is not meaningful in a patient whose brow sits at or below the orbital rim with heavy redundant upper lid skin draping over the lashes. In that patient, no amount of toxin will substitute for a surgical brow lift or upper blepharoplasty. Similarly, Botox cannot lift true upper eyelid ptosis — a drooping lid margin from levator weakness needs a surgical or pharmacologic (oxymetazoline) solution.
Hyaluronic acid (HA) fillers replace lost volume. As we age, periorbital fat compartments deflate and the orbital rim becomes more visible, creating a hollow appearance under the eye (the tear trough) and sometimes above the eye (a hollow upper sulcus). The right filler in the right plane can dramatically restore a rested look.
This is one of the most technically demanding injections in aesthetic medicine and one of the most commonly performed badly. The ideal candidate has a true volume deficit at the orbital rim with thin, healthy skin overlying it. The injection must be placed deep — on bone, beneath the orbicularis — using a low-G′, low-hydrophilic product such as Restylane, Restylane-L, or Belotero Balance. Volume should be conservative: 0.3–0.6 mL per side is typical.
A deeply hollow upper lid can be improved with a tiny amount of filler placed deep along the superior orbital rim or in the sub-brow region. This is an off-label, advanced technique that should only be performed by an experienced injector who understands orbital anatomy.
Important: Filler in the periorbital area carries the highest risk of vascular complications in the face — including blindness from inadvertent intra-arterial injection. This area should be treated only by experienced injectors who carry hyaluronidase and know the anatomy of the supratrochlear, supraorbital, and angular arteries.
Patients with significant lower eyelid fat herniation (a true fat bulge above the tear trough) usually look worse with filler, not better — the trough fills but the bag remains and the entire region looks heavier. Patients with thin, festooned, or malar-edematous skin retain water around HA filler and develop a bluish, swollen lower lid that can persist for years. Both are surgical patients. A transconjunctival lower blepharoplasty with fat repositioning gives a far superior, longer-lasting result.
Skin quality — texture, pigmentation, fine lines, and tone — cannot be addressed with injectables. It is treated with energy. The eyelid skin is the thinnest on the body, which makes it both highly responsive and easy to injure, so settings and operator experience matter enormously.
Fractional CO₂ laser remains the gold standard for periorbital skin tightening without surgery. It creates microscopic columns of thermal injury that stimulate dermal remodeling and collagen production. Results include smoother texture, fewer fine lines, and modest tightening — often enough to delay surgical blepharoplasty in a patient with skin laxity but minimal fat herniation. Downtime is real: 5–10 days of redness, swelling, and crusting, followed by weeks of pinkness.
Devices such as Morpheus8, Genius RF, and Sylfirm X deliver radiofrequency energy through microneedles. They cause less surface injury and shorter downtime (2–4 days) but more sessions (typically 3) are needed and the tightening effect is more subtle.
See our Lasers and Skin Rejuvenation pages for additional detail on device selection.
Plasma pen devices (Plasma Pen, Plamere, NeoGen) create small arc-discharges of ionized gas that contact the skin and produce tiny carbonized dots. These dots contract surrounding tissue immediately and stimulate collagen remodeling over months. Marketing has been aggressive, often framing the technique as a “non-surgical blepharoplasty.”
Plasma fibroblast can produce modest tightening of upper eyelid skin in carefully selected patients with mild to moderate skin redundancy. The total amount of skin shortening is small — typically 1–2 mm — and the visible result depends heavily on operator skill. The treatment leaves visible carbonized dots for 5–7 days, followed by 2–3 weeks of crusting and pinkness.
Important: Plasma pen is largely unregulated in many jurisdictions, and most state boards have ruled that non-physician providers should not perform it on eyelid skin. Burns, hyperpigmentation, ectropion, and scarring have all been reported. If you are considering this treatment, see a board-certified physician.
For a patient with true upper eyelid hooding, the small benefit of plasma resurfacing is rarely worth the downtime when an actual blepharoplasty — performed in 45 minutes under local anesthesia with similar recovery time — produces a dramatically better, long-lasting result.
Barbed PDO (polydioxanone) or PLLA (poly-L-lactic acid) threads are inserted under the skin to mechanically reposition tissue and stimulate collagen as they dissolve over 6–12 months. In the brow and midface, threads can produce a temporary lift of 1–3 mm.
Threads have a real but narrow role. The ideal patient has mild brow or midface descent, good skin elasticity, minimal fat herniation, and modest expectations. The patient who does best is in their late 30s to mid 40s — a patient who is not yet a surgical candidate but wants more than injectables can provide.
The most important question is not “can I avoid surgery?” but “what will give me the result I actually want?” The following table summarizes when non-surgical options work well and when they fall short.
| Concern | Non-Surgical Works | Surgery Is Better |
|---|---|---|
| Crow’s feet | Dynamic lines | Deep static lines + skin damage |
| Brow position | Mild lateral droop (1–3 mm) | Brow at or below orbital rim |
| Upper lid hooding | Very mild laxity with good skin | Skin touching lashes or blocking vision |
| Lower lid bags | Pure tear trough hollow, no bulge | Visible fat herniation, festoons |
| Dark circles | Hollow-related shadowing | Pigmented or vascular skin |
| Drooping eyelid margin | Never (this is ptosis) | Always |
A useful mental test: pinch your upper eyelid skin gently between your fingers. If you can grasp a meaningful amount of redundant skin, no amount of injection or energy device is going to remove that skin. Skin must be cut to be removed. The same is true for lower lid fat — once it herniates forward, only surgery returns it to where it belongs.
The periorbital region is the most anatomically complex and risk-laden area on the face. A poorly placed filler can cause blindness. An overaggressive laser can scar eyelid skin and cause ectropion. A heavy hand with Botox can drop a brow or create lagophthalmos. An honest practitioner needs to know not only how to do a treatment but also when not to do it.
An oculoplastic surgeon is an ophthalmologist who completed an additional ASOPRS fellowship dedicated to the eyelids, orbit, lacrimal system, and brow. We spend our careers operating in this region. We know the supratrochlear and angular arteries by name. We can diagnose ptosis, distinguish true brow ptosis from dermatochalasis, and recognize when an apparent “bag” is actually a malar festoon, lymphedema, or thyroid orbitopathy.
Just as importantly, because we can offer the full spectrum of treatment — from a single Botox session to a complex four-lid blepharoplasty with brow lift — we have no incentive to push you toward what we sell. We recommend what will work.
Ready to learn what will actually work for your eyes? Find an ASOPRS-trained oculoplastic surgeon in your area for an honest consultation that considers both surgical and non-surgical options.
The best non-surgical eye lift is one Dr. Spoor would also have chosen if they could not perform surgery — because it is the right treatment for your anatomy, not the only treatment Dr. Spoor offers. Visit our Find a Doctor directory to locate a fellowship-trained specialist who can guide you through every option with the expertise your eyes deserve.
Your Surgeon
Thomas C. Spoor, MD, FACS
Michigan Neuro-Ophthalmology & Oculoplastics
🏅 ASOPRS Fellowship Trained
Schedule a consultation with Thomas C. Spoor, MD, FACS to learn if this procedure is right for you.