Is 26 Too Young for Ptosis and Can it be Fixed Without Surgery?

I started to have a droop on my upper right eye, (seemingly within just a week!) then a year later the left started to do it and now the right seems twice as bad. I am only 27, I have no idea what could be causing this or how to fix it. Thanks!

Doctor Answers 9

Eyelid ptosis requires careful evaluation

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From the picture, it does appear that you have mild ptosis (eyelid droop), left greater than right. You also have mild skin excess. You and your surgeon need to clarify what is really bothering you. Is it the slightly lower position of the left eyelid (the ptosis) -- or the skin folds on the upper lid (the skin excess)?

Correction of the skin excess can be achieved under local anesthesia in the office using a skin-only blepharoplasty; this may slightly improve the ptosis by "unloading" the eyelid (removing the weight of the excess skin). A ptosis repair is more complex; there are several methods, all of which tighten the levator mechanism (the eyelid muscle's attachment to the upper eyelid internally). If your vision is not affected by the ptosis, you may want to remove the excess skin with the blepharoplasty and observe the ptosis for now.

I hope this helps. Please feel free to email other questions or come to Beachwood for a consultation.

Cleveland Plastic Surgeon
5.0 out of 5 stars 168 reviews

Ptosis (Droopy Eyelid due to muscle weakness)

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From your one single photo you do not demonstrate any ptosis ("toe-sis") significant enough for surgical repair. There are no non-surgical options that are viable for eyelid ptosis correction. You also have a very slight asymmetry in the creases of your upper eyelids. Being 26 years old is not really the issue here, your facial anatomy is. You need an in-person consultation with a board-certified, fellowship-trained Oculofacial Plastic Surgeon with extensive experience in ptosis repair and eyelid surgery. During your exam, the surgeon can do a much needed, thorough physical examination of your eyelids, the function of the eyelid muscles, and he/she can assess the symmetry of your eyelids and face. Please avoid any doctors that do eyelid surgery part time, they cannot help you. Good luck with your exam!

Damon B. Chandler, MD

Harvard-Penn Trained Oculofacial Plastic Surgeon

Damon B. Chandler, MD
Philadelphia Oculoplastic Surgeon
5.0 out of 5 stars 8 reviews

Ptosis requires an oculoplastic surgeon evaluation

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Ptosis in young patients needs a careful exam before treatment. This involves looking at the surface of the eye, looking under the eyelid and a careful history.It is very difficult to assess this from a photo. Go see someone and get checked

Chris Thiagarajah, MD
Denver Oculoplastic Surgeon

Eyelid Position

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Based on the provided photograph, your eyelids appear to be within the normal range and do not show evidence of ptosis. However, if you have been noticing fluctuation or a change in the eyelid position compared to their baseline appearance, I would suggest evaluation with an oculoplastic surgeon. Certain things such as trauma or history of contact lens wear can lead to earlier-onset ptosis, but so can other conditions such as myasthenia gravis. Further work-up would be needed before deciding on the best treatment plan.

Mahsa Sohrab, MD
New Haven Oculoplastic Surgeon

At 26 you need to find out if there is a medical reason to be having the ptosis

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At 26 you need to find out if there is a medical reason to be having the ptosis.  It could be a muscular problem which might be treated with medication.  After determining that the ptosis is not medically related or doesn’t require medical intervention, there are different options for treatment.  Sometimes surgery is indicated.  But with a new onset of ptosis in a young person, I would definitely see someone promptly to make sure there is no medical reason and then you can look at options for correction, if necessary.

Joseph A. Eviatar, MD, FACS
New York Oculoplastic Surgeon
4.7 out of 5 stars 68 reviews

Mild ptosis and excess upper eyelid skin

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As mentioned in other responses, you have a mild droopiness [ptosis] of the upper lids, left greater than right. In addition, there is a subtle difference between the upper eyelid skin folds that could be addressed with a conservative skin excision.

There is no subsitute for an "in-person" consulation with an ASOPRS oculoplastics surgeon.

A.J. Amadi, MD
Seattle Oculoplastic Surgeon
5.0 out of 5 stars 42 reviews

26 years old is not too young for ptosis repair if you truly have ptosis

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It does seem like you have ptosis, but you really should have a complete work-up by an Oculoplastic Surgeon. If it is ptosis then it can be fixed and 26 would not be too young. There are no good non-surgical options for the correction of ptosis. If there is an underlying problem causing the ptosis (i.e. some eyelid inflammation) then treating the underlying problem can help the ptosis.

Sam Goldberger, MD
Beverly Hills Oculoplastic Surgeon

Ptosis needs surgery to be fixed

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You have some mild signs of ptosis of the upper lids in the picture.  Hard to tell from the picture if it is bad enough to warrent surgery.  Unfortunately the only way to fix it would be surgery.  Do you wear contact lenses?  Sometimes pulling the lids to put the lenses in can cause ptosis in someone  younger than expected.

Janet M. Neigel, MD
Florham Park Oculoplastic Surgeon
4.6 out of 5 stars 21 reviews

There may be no obvious reason for this.

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Dear Vbee

You do have some facial asymmetry.  The left upper eyelid is subtly ptotic compared to the right side.  I would recommend a careful work up by an oculoplastic surgeon.  I can recommend Julian Perry in Cleveland or Jill Foster in Columbus.  It is important to go to the right surgeon so that you can be appropriate and accurate advice.  

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.