SF 415 255-9510  |  MARIN 415 464-8801

SF 415 255-9510  |  MARIN 415 464-8801

The Science of Upneeq and Droopy Eyelids (blepharoptosis)

Science of Upneeq and Droopy Eyelids (blepharoptosis)

Upneeq (product info and before and after photos) is a first-in-class treatment with a mechanism of action that lifts upper eyelids, drooping due to acquired ptosis (low-lying lids), a common condition that affects adults of all ages. Upneeq lifts the lid’s muscles from one to three millimeters — a difference that can literally be eye-opening!

Upneeq’s active ingredient, 0.1% oxymetazoline hydrochloride, stimulates receptors on the eyelid’s muscles, which trigger a contraction. In clinical trials of once-daily use, patients noticed an improvement in as little as five minutes, with full results in two hours and lasting for about eight hours.

Elevation of the upper eyelid is largely provided by two muscles, the levator palpebrae superioris and the superior tarsal (Muller’s) muscle.

The levator originates from the lesser wing of the sphenoid bone at the orbital apex and inserts onto the anterior surface of the superior tarsal plate. It also attaches to the skin of the upper eyelid, which contribute to the formation of the lid crease.

Unlike the bulky skeletal muscles in your arms and legs, the levator muscle is small, smooth, and atrophies rather than strengthens with overuse, says Raymond Douglas, an aesthetic reconstructive and oculoplastic specialist and global head of scientific affairs for Upneeq. “Once the muscle weakens and the lid drops, it does not restore to the previous level.”

Muller’s muscle receives signals from the sympathetic nervous system and is unique in that it consists of thin fibers of smooth muscle.

Upneeq directly activates a-adrenergic receptors in Muller’s muscle, stimulating contraction and elevation of the upper eyelids.

levels of acquired ptosis (droopy eye lids)


“Oxymetazoline hydrochloride has been safely used for decades for nasal decongestants, although the concentration in Upneeq is far less,” says Bruce Moskowitz, an assistant clinical professor of ophthalmology at Icahn School of Medicine at Mount Sinai in New York City.

The treatment has a very low incidence of side effects, says Moskowitz — general irritation, dryness, redness, or sensitivity in less than five percent of patients.


Surgeries which involve repair of ptosis must be very precise when resecting portions of the upper eyelid and so should be done with careful consideration of the risks vs benefits. Upneeq achieved significant visual field improvement In clinical trials, and has helped patients with acquired ptosis starting on the first day of treatment, making it a viable and cost-effective alternative to surgery.


In clinical trials*, UPNEEQ helped patients with acquired ptosis achieve significant visual field improvement:

• 87.8% of patients had some level of improvement.
• 40.8% of patients had at least a 50% improvement on day one (two hours after applying Upneeq).
• On average, UPNEEQ demonstrated three times greater improvement in visual field compared to a placebo in clinical trials, as measured by LPFT on Day l and Day 74 of treatment. (LPFT = Leicester Peripheral Field Test—a measurement of the superior visual field).

* Two randomized, multicenter, double-masked, placebo-controlled, Phase Three studies compared once-daily Upneeq in 304 subjects with acquired blepharoptosis. Efficacy was assessed by points seen in the superior visual field using the LPFT and photographic measurement of Marginal Reflex Distance-7 (MRD-7). There was a statistically significant difference in change in the number of points seen in the superior visual field from baseline after instillation of UPNEEQ and a placebo, with significantly greater increases in the study eye of the Upneeq group evident at the 2-hour point and maintained at the 6-hour time point. Greater eyelid lift (increased MRD-7) was observed for the Upneeq group on Day One at 6 hours post-dose and on Day Seventy-Four at 2 hours post-dose.

415 255-9510

415 464-8801



Gene V.
I love Hayes Valley Medical and Esthetics! I've been coming for a while now for Botox and filler treatments. Linda is AMAZING! She knows just the right amount of product needed in all the right places to bring out my best facial features. I feel more handsome every time!!

The front desk staff are super sweet and helpful. They always ask exactly what I want and I never feel like I'm being 'upsold' or encouraged to do anything other than what I came in for. I would highly recommend HVME to anybody that is on the unsure about trying some of the services they offer. You won't be disappointed. Thank you!!
Click Here
Julie S.
This was my first experience with any filler/injection treatment and it was very pleasant, professional and everyone there made me feel safe, welcome and I felt very knowledgeable coming out of my treatment about what to expect. I will absolutely be back!
Click Here
Tina B.
Diana at the front desk is so sweet, the medical assistant was amazing & personable and Kate who did my procedure is my favorite! As I walked out and met my husband, I told him how much I enjoy being there & what a good vibe Hayes has.
Click Here
Cher B.
Sheila and Linda took great care of me and I look younger and vibrant.  I do not trust anyone else for injectables.  Linda is careful, thoughtful, and respectful of one’s budget. I have followed her from Marin into SF and I will continue to follow her where ever she practices.
Click Here
Emily N.
I highly recommend Hayes Valley Medical & Esthetics!! All the front desk staff are warm, friendly and professional and Denise is the best for laser, she goes above to make you feel comfortable and at ease. Andrea is exceptional at explaining the services they offer. They are the best in SF in my opinion and I do my research!
Click Here
Kathleen F.
Excellent customer service, advice, and care. Botox and Microneedling. Melonie is a gem. She is extremely knowledgable, sincere and honest. Everyone here is helpful, They carry a fabulous array of skin products too. I am so pleased with my results!
Click Here

Results May Vary

Receive 10% off your first treatment at either location!