Droopy eyelid - is eyelid surgery the only way to fix it? (photos)

Question

Hi, I am 37 year old female from Europe. I was born with a "damaged nerve" in my eyelid (what I have been always told) and had a lazy eye as a child. The lazy eye issue resolved itself in my childhood but the droopy eyelid remined. It used to be the worse after crying and when tired but now it is bad and very noticeable all the time. Is there a name for this condition? What are my options in terms of treatment? Is eyelid surgery the only way to fix it? Thank you.

Jason Emer, MD · Answer

As we age, our eyelids naturally sag and droop. A combination approach would be best to see visible improvement. In terms of non-surgical treatment options, I would recommend a Chemical Brow Lift (using Botox, Dysport, Xeomin, or Jeuveau) and filler injections to rejuvenate the temples, eyebrow, eyelid, eye troughs, upper eye hollows, and forehead. I typically combine this with Ultherapy and thread lifting to lift the brow; RF and skin tightening laser treatments to stimulate collagen production and rejuvenate the skin; and laser or superficial RF devices for improvements in texture, color, and any crepey skin around the eyes as needed. In some cases, surgery is the best solution to achieve the desired results. See an expert for a formal consultation. Best, Dr. Emer.​

Thomas Buonassisi, MD · Answer

Hello! It sounds like you're experiencing a condition known as ptosis, which is characterized by a drooping eyelid. This can occur due to various factors, including nerve damage or muscle weakness. While eyelid surgery (blepharoplasty or ptosis repair) is a common treatment option, there are alternatives depending on the severity of your condition and your specific needs. Non-surgical options like eyelid lifts using neuromodulators or certain exercises might help improve appearance and function. I recommend consulting with a specialist who can assess your situation and discuss the best treatment plan tailored for you.

Jonathan Kulbersh, MD · Answer

Thank you for your question and photo. It appears that you may have ptosis of the left eyelid, causing the muscles that lift your eyelid to weaken and produce a slight drooping appearance. This can be corrected with blepharoplasty surgery to tighten the muscle and provide a subtle lift. This procedure can also address hooding by removing excess skin and modifying the fat in this area to achieve the desired aesthetic. I recommend scheduling an in-person consultation with an experienced, board-certified facial plastic surgeon. They will be able to review your medical history, conduct a thorough examination of the eye, and determine the best course of action for you.

Michael A. Persky, MD · Answer

Hi Sorrayah,
You have ptosis of your upper eyelid.  It is only corrected with surgery by an opthalmologic surgeon.  Good luck and be well.
Dr. Persky

Andrea Lora Kossler, MD, FACS · Answer

You have 2 options: Ptosis surgery or ptosis eye drops.Ptosis surgery is an extremely effective procedure with long-term results. You are a good candidate for surgery. There are several ways to perform ptosis surgery. Due to the mild nature of your ptosis, I recommend internal ptosis surgery (no visible incision). It is important to see a surgeon who specializes in eyes, typically an oculofacial plastic surgeon (aka oculoplastic surgeon), to ensure you have the most natural and safe results. During your consultation, your surgeon will place drops in the right eye (to temporarily lift the eyelid) to ensure you do not have a Herring's response, which is when the other eyelid relaxes/droops once the droopy eyelid is lifted. A thorough exam can ensure the correct surgery is selected. Your surgeon will also want to be careful not to overcorrect and to ensure the medial eyelid contour is addressed. A drop was recently approved by the FDA to temporarily lift the eyelid. It is called Upneeq. You can consider using this for temporary improvement of your eyelid position until you are ready for surgery. It lifts the eyelid by an average of 1 mm and lasts about 6-8 hours. It is not a long-term solution, but an option.

Droopy eyelid - is eyelid surgery the only way to fix it? (photos)

Answers (5)

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