How to Fix a Droopy Eyelid

This week Dr. Raymond Douglas discusses what causes droopy eyelids and how to fix them.

What is Ptosis?

Ptosis is the medical term for droopy eyelids. It’s the sagging or downward displacement of the upper eyelid, which can happen in one or both eyes. It can be barely noticeable or bad enough to affect your vision. Besides vision, ptosis can also change the shape of your face, making you look tired, old or less alert.

Types of Droopy Eyelids

There are different types of droopy eyelids, each with its own cause:

1. Congenital Ptosis: Born with it and usually due to underdeveloped eyelid muscles.
2. Age-Related Ptosis: As we age, the muscles that lift the eyelid can stretch or weaken.
3. Neurogenic or Traumatic Ptosis: Caused by nerve damage, neurological conditions or trauma.

How It Affects Daily Life

For many people, droopy eyelids are more than just a cosmetic issue. In moderate to severe cases, sagging lids can block your vision, making daily tasks like reading or driving hard. Even mild ptosis can affect your self-esteem especially if it looks like you’re tired or sad.

Causes of Droopy Eyelids

• Age-Related Ptosis: Over time, the levator muscle (the muscle that lifts the eyelid) can weaken or separate, causing the lid to droop.
• Genetics: Congenital ptosis can run in the family and often presents in childhood.
• Medical Conditions: Conditions like Horner’s syndrome, Myasthenia Gravis or third cranial nerve palsy can damage the nerves or muscles that control eyelid movement.
• Injury or Surgery: Trauma or complications from cataract surgery can cause droopy eyelids.

If Your Eyelashes Are Low

One anatomical cause is the position of the eyelashes. The eyelid is attached to the eyelashes and if the eyelashes are low, that could cause the look of a droopy eyelid. This often results in eyelids that can be asymmetric or one contour of the eyelid can look different than the other, mostly on upper eyelids. 

Too Much Skin

Another common cause of droopy eyelids is having too much skin, which can crowd into the eyelid, meaning there is no longer an eyelid platform. The platform is the strip of skin, often where women place makeup above the eyelashes. When there is too much skin, it can appear saggy and older, which Dr. Douglas emphasizes is not a thing that most people desire, leading to patients seeking out his ability to help improve this. 

Eyebrows

Another component is often the eyebrows. As we age the eyebrows not only come down but can turn in and create a slightly sad look. Dr. Douglas states that one of the procedures he does often is raising the outside portion of the brows, which dramatically reduces the appearance of droopy eyelids in patients by creating a lifting up of the skin. The lift can be done in the office using botox, fat injections, fillers, or it can be done surgically with a temporary brow lift. 

The Difference in Patients’ Eyelids Between The Ages of 40 and 60

Dr. Douglas attests to the significant difference in appearance for patients in their mid 40s/50s who desire a more youthful and natural appearance. He states that treatment may include removing a bit of skin to address the droopy appearance, in order for the eyelid to look appropriate.

Creating a Natural Appearance for Your Eyelids

It is important that a patient does not have wide-open eyelids because it can appear strange, as if someone has had too much surgery. It is very important for Dr. Douglas to create a natural appearance for fixing droopy eyelids by utilizing the three steps above. 

Can You Fix Droopy Eyelids?

Yes! However, Dr. Douglas states how to fix droopy eyelids can be complicated. He explains that droopy eyelids are caused by three different factors. 

Treatment Options for Droopy Eyelids

Non-Surgical Options

• Botox and Fillers: These can be used to lift the brow and surrounding skin for temporary results for patients not ready for surgery.
• Eyelid Exercises: In some mild cases, exercises to strengthen the levator muscle may help.
• Non-invasive Devices: Eyelid lifting strips or special glasses with a lifting support can hold the eyelid in a better position for temporary relief.

Surgical Options

• Blepharoplasty (Eyelid Surgery): A common and effective procedure to remove excess skin, fat and muscle from the upper or lower eyelids. Recovery is quick and results are long lasting.
• Ptosis Surgery: If the muscle function is compromised, ptosis repair surgery tightens or repositions the levator muscle to lift the eyelid.
• Lifting Procedures: For some patients, a lateral brow lift or endoscopic brow lift may be more appropriate especially if the heaviness is more related to the brow than the eyelid itself.

Droopy Eyelid Recovery and Aftercare

After any droopy eyelid treatment, especially surgery, patients can expect some bruising, swelling or mild discomfort. Cold compresses, rest and prescribed medications can help. Dr. Douglas recommends no strenuous activity for at least a week after surgery and all follow up appointments to ensure proper healing. Most patients are back to normal in 10-14 days with results continuing to improve over time.

Contact Dr. Douglas Today For Your Thyroid Eye Disease Consultation! 

If you or someone you know is suffering from thyroid eye disease, contact our office today to schedule an appointment with Dr. Douglas – (310) 657-4302. If you do not live in Los Angeles, ask us about our Out-of-Town Patient programs.