Tim Abou-Sayed, MD

In general, eyelid ptosis results from anatomic or functional impairment of the ability of the muscles that elevate the eyelid margin to do their job with full excursion and power. It's like trying to raise a piano up to a window in a tall building with a rope and pulley - if the rope snaps or the rope is too slack, the piano won't make it up.

Oculoplastic specialists (ophthalmologists with extra expertise in surgery of the eyelids and orbits) are usually best suited to correcting this problem. They will often perform eyelid ptosis repairs under local anesthesia in awake patients to be able to control the position of the lid in repose.

Most plastic surgeons receive limited exposure to true ptosis repairs; the terms "ptosis" and "blepharoptosis" are often incorrectly used to describe "droopiness" of the lids which may be due to simple excess of skin, or due to a low-lying brow with fullness of the tissues below the eyebrow resting on the lids.

Hence, many plastic surgeons who say they treat "ptosis" of the lids are actually treating "dermatochalasis" or extra skin on the lid, while doing nothing for function of the lid itself.

If the problem is an inability to move the muscles in the lid with power and excursion, visit an oculoplastic surgeon or a plastic surgeon with SPECIFIC experience in ptosis repairs.

Good luck.