I do not like the way my eyes look.. Do it have ptosis? (photos)

I am only 20 years and feel like my eyes make me look much older because they are so droopy! I'm not sure what could be done about it, or the cost? I notice when I'm driving I have to lift my eyes up to see better and I get frequent headaches. I would love to have really nice almond shaped eyes. Thank you for reading

Doctor Answers 3

You do have ptosis since your eyelids are covering your iris and pupil - look at older photos to see how long you've had it

Thank you for your question. You state you’re 20-years-old and you don’t like the way your eyelids look. You describe often having difficulty keeping your eyes open when you’re driving, and you have frequent headaches that cause you to wonder whether you have ptosis.

I can certainly give you some guidance on this matter. To give you a little information about myself — I am a Board-certified cosmetic surgeon and a Fellowship-trained oculofacial plastic and reconstructive surgeon, practicing in Manhattan and Long Island for over 20 years. I was first trained in eye surgery, and then underwent additional specialty training in plastic and reconstructive surgery of the eyelids. In all the years I’ve been in practice, I have dealt with many cases of ptosis, and treating this condition is certainly one of the cornerstones of my practice.

Ptosis essentially means drooping. When there is drooping of the eyelids, it’s called eyelid ptosis; however this can also affect other areas of the body as it can also affect the breast, and this is called breast ptosis. The normal position of the eyelid is typically 1-2 mm below the upper part of the iris (the colored part of the eye), so that there is at least 2 mm of distance from the approximate center of the pupil or light reflex or margin eyelid reflex.

After reviewing your photo, I think it is safe to say you do indeed have ptosis. When someone like you comes to my practice, I would first have to determine whether this is congenital ptosis or acquired ptosis. Congenital ptosis means that you were born with this condition, and it can slightly worsen as you get older. Acquired ptosis means that ptosis developed later on in your life, and this type of situation requires a bit more examination before moving forward with any surgical procedure.

In order to help determine which type of ptosis you have, it is important for you to look at old photos of yourself — anywhere from one to five years earlier — to see if you’ve always had this trait or if it was something that just recently developed. Often, people who were born with ptosis don’t notice they have it, or will be described by family and friends as having sleepy-looking “bedroom eyes”. This can also simply be your natural appearance, although technically and medically speaking, it is ptosis.

If the position of your eyelids has been stable for a long time, then you can consider a surgical procedure to have them look more even. However, if this appearance is something that has manifested more recently, I would advise that you visit a neuro-ophthalmologist first, to rule out whether this change is due to any neurologic causes.

It is difficult to give a more concrete diagnosis based on a single photo. When I examine a patient for ptosis, I usually have them look up and down, I take measurements of muscle function, and I review a number of photos. In some cases, I will even have the patient come back more than once so I can see how they look at different times. Establishing the correct diagnosis is crucial, and taking all the necessary steps towards that makes all the difference.

Ptosis surgery can be very effective and can change the appearance of the whole face when done correctly. It is a very complex procedure working with the delicate musculature of the eyelid, namely the levator muscle. This muscle requires careful and meticulous handling, depending on the level or degree of ptosis. Since ptosis falls under the category of advanced eyelid surgery, it requires a substantial amount of experience and finesse from surgeons, even with which there can still be variability with the outcome. Sometimes the eyelid can be too low or too open so revision surgery may be needed, which is not uncommon since you are dealing with millimeters of skin.

In order to avoid such scenarios as much as possible, it is routine for us to have a patient sit up during the actual ptosis procedure so we can adjust the height, contour, shape, and symmetry of the eyelid — all to ensure the most optimum eyelid position.

That said, I recommend you meet with a medical doctor or an ophthalmologist, and get a proper evaluation so that you can rule out any other causes for your ptosis. You may need to see more doctors to at least eliminate any neurologic causes before proceeding with ptosis surgery. Once all other causes are ruled out, seek out a ptosis surgery specialist who you feel comfortable with.

As a side note, I have met patients who have been to other oculofacial plastic surgeons, but felt they focused more on the medical aspect of the procedure and not so much on the cosmetic aspect, and they felt more comfortable after finding someone like me who takes both aspects into consideration.It’s important you seek out a specialist who also considers the cosmetic aspect of ptosis surgery so you get good functionality and appearance of the eyelid. This is just one perspective based on my experience after having decided many years ago to focus on the cosmetic elements in the reconstructive types of surgeries I do.
I hope that was helpful and I wish you the best of luck!

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New York Oculoplastic Surgeon
4.3 out of 5 stars 61 reviews

Bilateral Ptosis

Thank you for sharing your concerns and photo. You have ptosis (drooping) of both upper eyelids. There are a few techniques that an experienced Oculoplastic Surgeon can use to easily correct the problem. See a doctor in person for complete evaluation and thorough discussion of treatment plan.
Good luck,

Yes, you have bilateral upper eyelid ptosis.

With the right ptosis surgery, you can have this corrected and it will make you look fantastic.  It is essential that you find a highly qualified oculoplastic surgeon.  This is not blepharoplasty.  This is corrected by repairing the deep eyelid tendon, the levator aponeurosis.  Even without performing a neosynepherine test, I would not recommend a posterior approach mueller muscle conjunctival resection ptosis surgery.  You have a levator dehiscence ptosis.  For that reason it is essential that you have an anterior levator resection repair with an anchor blepharoplasty.  Please study my free ebook on eyelid surgery.

Kenneth D. Steinsapir, MD
Los Angeles Oculoplastic Surgeon
4.9 out of 5 stars 23 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.