Tightening my Upper Eyelid Muscle by Going Through the Underside?

My doctor wants to perform blepharoplasty by only tightening my upper eyelid muscle, by going through the underside of my upper eyelid. I cannot find anything like this in he internet. Does this procedure sound like it is saf and/or possible?

Doctor Answers 5

Internal Ptosis Repair Tightens Eyelid Muscle

Upper eyelid surgery through the underside of the eyelid is done to tighten the upper eyelid muscle and correct droopy upper eyelids. By droopy in the sense of how high the eyelashes are raised compared to the iris of the eye. I don't mean droopy in the sense of loose, saggy skin.

This is a procedure commonly performed by oculoplastic (eyelid plastic) surgeons. It is used for a droopy eyelid, and the end result is a more refreshed, less tired appearance. No skin or fat is removed, so if loose skin or pockets of fat are your problem, the internal muscle tightening procedure will not help. The technical term for this surgery (that you can search for online for more information) is called "muellerectomy".

Beverly Hills Oculoplastic Surgeon
5.0 out of 5 stars 40 reviews

Ptosis repair vs blepharoplasty

When we evaluate the upper eyelids, there are three components that need to be addressed:

1. Brow position

2. Upper eyelid position [as it sits on the eyeball].This is called eyelid ptosis if its low.

3. Excess eyelid skin [dermatochalasis]


It sounds like you and your surgeon are not on the same page. He/she is recommending

surgery to address the droopy eyelid [condition 2] while you are focusing on condition 3.

You need to have another conversation with your doctor so that he/she can explain things a bit better for you.

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

Ptosis surgery versus blepharoplasty

Your surgeon is likely describing upper eyelid ptosis (droopy) surgery by tightening the muscle (levator) responsible for elevating the eyelid.  This muscle can either be tightened from anterior (skin) approach or from posterior (underneath the eyelid) approach.  The posterior approach is actually the preferred approach for mild to moderate ptosis because it is more predictable with better eyelid contour.  Blepharoplasty is a different operation where only skin (plus) fat is removed from the upper eyelid; it does not actually lift the eyelid.  It can be combined with ptosis surgery if necessary.  Consult an oculoplastic surgeon.

Mehryar (Ray) Taban, MD, FACS
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 74 reviews

Eyelid muscle tightening

I think from your description, you are having ptosis repair. There different ways to do that and going through the underside is one of them. It is a safe procedure if done for the right reasons.

Moneer Jaibaji, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 15 reviews

Tightening eyelid muscle through the underside

  Please review the difference between blepharoplasty and ptosis repair.  It sounds like your doctor is suggesting ptosis repair, not blepharoplasty, through the underside.  There is nothing wrong with this approach for ptosis, and it is used by many surgeons (including myself).  Those who do ptosis repair in this manner believe that this approach offers greater predictability of results.  It may be combined with blepharoplasty of the upper lid.

Lawrence Kass, MD
Saint Petersburg Oculoplastic Surgeon
4.9 out of 5 stars 134 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.