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Question: Blepharoptosis versus blepharoplasty?

Dr. Prasad: Distinguishing if you need blepharoptosis repair or blepharoplasty is based on the position of the eyelid relative to the pupil. In fact, it is common for ptosis to be missed because plastic surgeon assumes that the eyelid appearance will be improved with blepharoplasty alone. This results in eyelids being droopy and the person looking tired in spite of having eyelid surgery.

Let's just get some terminology clear. Excess skin over the eyes causing hooding and a tired appearance is called dermatochalasis. When the eyelid margin is lower than it should be, this condition is called blepharoptosis. Very often a person can have both dermatochalasis and ptosis at the same time. This can be a challenge to make the proper diagnosis and surgical plan. During my evaluation, I routinely lift up the excess skin to determine if the eyelid margin position improves. If the eyelid position is still low, then the patient has ptosis, which can be addressed appropriately.

Understanding the Difference Between a Hooded Eye and a Drooping Eyelid

Dr. Amiya Prasad discusses differentiating factors between blepharoptosis (drooping eyelid surgery) and blepharoplasty (hooded eyelid surgery), and how in some cases it is possible to have both conditions.