Lower Eyelid Ptosis? (photo)

I got brow ptosis, but my main concern is lower eyelid ptosis. Could I do anything about it? I've heard it's very hard to fix.

Doctor Answers 3

Lower eyelid retraction (scleral show)

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Lower eyelid retraction results in lower scleral show. Mild lower eyelid retraction is much easier to address than moderate/severe lower eyelid retraction. There are nonsurgical (filler injection to push the lower eyelids up) and surgical techniques available. See an oculoplastic surgeon.

Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 91 reviews

Lower eyelid retraction

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Just to clarify that we are on the same page:  When you say lower eyelid "ptosis", you must be referring to lower eyelid "retraction". This is the case when the lower eyelid is sagging below the cornea so that the white of the eye is visible [scleral show].

This can happen for a variety of reasons:  aging, thyroid eye disease, prior surgery or trauma, or sometimes just plain old anatomic variance.

This can be treated using grafting to the inside of the eyelid. There are a variety of different grafts that are available, but most experts agree that the hard palate is the "gold standard".

I would recommend a consultation with an ASOPRS trained Oculoplastics surgeon. You can find one close to you by using the link below.

Good luck

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

Lower eyelid ptosis after Blepharoplasty/ eyelid lift

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Hello 'Giselle_9', thanks for your question.  Without more information or doing a full physical examination, it is difficult to ascertain the extent of your concerns.  Based on your photos you appear younger, and I am not sure if you underwent any surgery, but I do not see any appreciable lower eyelid ptosis.  Thus, I will speak in general terms.  Lower eyelid ptosis (sagging) can be due to a number of different factors.  Many times with aging, people can develop weakness and laxity of their lower tarsal sling mechanism, which is the cartilaginous support layer of the lower eyelid.  Neurologic problems, such as Bell's Palsy or after a stroke, can affect the facial nerve that innervates this support mechanism, also leading to ptosis.  Post-surgical problems after blepharoplasty can also lead to this condition, especially when excessive lower eyelid skin is removed pulling down the lower eyelid, or if the lateral canthal angle is not appropriately fixed and tightened after surgery, leading to laxity.  Depending on the cause of the ptosis, there are definitely surgical options to help fix this problem.  If you have a concern about this, I recommend seeing your local board-certified plastic surgeon who can perform a more thorough examination and go through the options with you in more detail. Hope that helps!


Parviz Goshtasby, MD, FACS
Newport Beach Plastic Surgeon

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.