Ptosis and Exercises?

Just curious about something. Why is it that the levator muscle in mild cases of ptosis can't be strengthened with exercise but pretty much every other muscle can? There must be alternatives to surgery if the underlying cause isn't neurological or something, right? Thanks for your time.

Doctor Answers 13

Why Exercise will not help Eyelid Ptosis

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The reason that you cannot strengthen the eyelid muscles to correct ptosis is that the ptosis is measured when the muscles are at rest. When they are functional, the eyelid can be elevated to a proper position. The surgery is necessary to shorten the muscle or it's attachment to the eyelid to a point where the eyelid sits at the proper place when the muscle is not contracting.


Highlands Plastic Surgeon

Loose connections to the lid

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The levator muscle is one of two muscles which elevate the eyelid. Ptosis may be due to poor connections of the levator muscle to the eyelid. There are several other causes as well which can be evaluated in person by an oculoplastic surgeon. 

Eyelid exercises of no benefit for upper eyelid ptosis

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Eyelid exercises will be of no benefit because this is usually not a question of muscle strength but it is a good question.  The problem usually occurs due to a stretching of the tendon attached to the muscle.  

Does exercises help with ptosis (droopy eyelid)?

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The main reason for eyelid ptosis is that the attachment of the levator muscle/tendon to the eyelid loosens (and the eyelid drops), so strengthening the muscle, even if possible, won't be useful.  Moreover, it is a special muscle that is working and lifting the eyelid ~15,000 per day, so it is already doing the best it can to keep in shape!  Further exercise won't help. Luckily, the muscle can be tightened/advanced (ptosis surgery) in order to help lift the eyelid. See an oculoplastic surgeon for consideration.

Exercise do not work

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In most cases of eyelid ptosis, levator muscle weakness is not the problem. The problem is the fact that the muscle attachment to the eyelid has slipped and that no matter how strongly it contracts, it will not fully lift the eyelid.

I can make this analogy:  lets say you have a hugely powerful bicep muscle. but if your hand isn't holding onto the weight, no matter how much the muscle contracts, the weight isn't going to be lifted off the floor.  Same thing with levator muscle and the eyelid.

Hope that helps

A.J. Amadi, MD
Seattle Oculoplastic Surgeon
5.0 out of 5 stars 41 reviews

Many causes of eyelid drooping.

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Blepharoptosis, or eyelid sagging has many causes. If the problem were as simple as the muscle being weak, then exercise would help. Problems with the nerve, the muscle, the muscles attachment and restriction by surrounding tissues can all play a part. A proper diagnosis is key to the proper treatment. Seek a qualified surgeon with experience for an evaluation.

Joseph Mele, MD
Walnut Creek Plastic Surgeon
4.5 out of 5 stars 17 reviews

Exercise doesn't help ptosis

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The most common kind of ptosis is called aponeurotic ptosis. The levator muscle turns into a tendon most inferiorly where it attached to a fibrous part of the eyelid called the tarsal plate.  In most cases, the tendon slips off of its natural attachments and the muscle becomes loose.  Generally in these cases, the muscle is completely normal.  It's just not attached to the appropriate position...and that's why  no amount of exercise will improve it.  It isa  mechanical problem!

The good news is that surgery is often very successful.

Good luck

There's a reason there isn't an eyelid exercise machine at your gym

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It seems to make sense that exercise would strengthen a weak muscle in the eyelid causing a droopy lid. Unfortunately, this doesn't work.

The most common form of eyelid ptosis is caused by a stretched or separated upper eyelid muscle, not a weak one.  Strengthening the muscle won't reattach the muscle insertion, just as stomach crunches won't repair an abdominal hernia. 



Brett S. Kotlus, MD, MS
New York Oculoplastic Surgeon
5.0 out of 5 stars 63 reviews

Eyelid Ptosis

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Ptosis usually occurs because of a separation between the tendinous insertion of the muscle and the eyelid soft tissue. Under these circumstances, strengthening the muscle would have no impact upon the ptosis. For this reason, the vast majority of patients with clinically significant eyelid ptosis require surgery to treat the problem.

Aquired Ptosis

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Aquired ptosis also referred to as senile ptosis is a disinsertion (lack of connection) of the levator muscle tissues to the eyelid.   In other other words the muscle strength is good but it lacks good connections to the eyelid.

Craig Mezrow, MS, MD, FACS
Philadelphia 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.