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What are droopy eyelids?

Droopy eyelids, otherwise known as ptosis, refers to the sagging of the eyelids over the eyes.

This can affect one (unilateral ptosis) or both of the eyes (bilateral ptosis). Drooping eyelids are not painful and the degree of drooping can vary greatly from person to person.

Most of the time, this drooping is barely noticeable. But in extreme cases, the droopy upper lid can cover the eye enough to cause visual impairment. The extent of this depends on how much of the pupil is covered by the drooping lid. In extreme cases, the eyelids can obscure the vision so much that a person has to tilt their head backwards in order to see properly, for example when holding a conversation. Someone with ptosis may find they need to raise their eyebrows to lift their lids to allow for better vision. In some cases, ptosis can cause eye strain, headache and brow ache.

Ptosis can make the eyes appear tired and they may ache. Drooping eyelids may cause the eyes to water or feel extremely dry.

Anyone can have drooping eyelids as the condition is not prevalent in any particular gender or ethnicity. However it is far more common in older adults. The condition may come and go, or it may be permanent. It can be present from birth (congenital ptosis), or develop later in life (acquired ptosis), through age, trauma, or some other medical condition.

Although eyelid drooping is usually just a cosmetic issue, you should consult a doctor to ensure that the ptosis is not a sign of an underlying medical condition.

If your vision is seriously impaired by drooping eyelids, you should not drive until the condition has been treated. 

Ptosis surgery is the only effective treatment for drooping eyelids.

What causes ptosis?

Anyone can get drooping eyelids, although it is more common in older adults as it is part of the natural ageing process. The levator muscle, which is responsible for lifting the eyelid, stretches with age, causing the eyelid to droop. When children are born with ptosis, it is because this levator muscle has not developed properly. Ptosis in children, if left unchecked, can cause a lazy eye to develop.

The eyes and eyelids are very delicate and excessive rubbing has, in some cases, been shown to cause droopy eyelids. So it is important to avoid situations that may lead to excessive rubbing of the eyes. For example if you suffer from hayfever, you should take an antihistamine if possible in order to avoid eye irritation.

There are certain other factors which may put you at risk of developing droopy eyelids, including certain underlying medical conditions. If one eyelid is drooping, this could be the result of a temporary stye or nerve injury. This might follow an injury or disease which affects the ligaments and muscles. This can damage the nerves which control the eyelid muscles, leading to drooping.

Routine laser or cataract surgery, which stretch the eyelid, may also be the root cause of eyelid drooping.

More serious medical conditions, such as brain tumour, stroke, and cancer of the nerves of muscles, can also trigger eyelid droop. A tumour of the eye can also cause ptosis.

Neurological conditions such as myasthenia gravis, a relatively rare neuromuscular disorder that causes weakness in the skeletal muscles, can also lead to ptosis.

Consult with your doctor if you are unsure of the cause of your drooping eyelids or if you are experiencing any other symptoms.

What is ptosis surgery?

The only really effective ptosis treatment is surgery.

Blepharoplasty, otherwise known as eyelid reduction surgery, is the one lifting procedure which rarely needs to be repeated. Blepharoplasty involves the removal of loose skin and excess fatty tissues around the eye area, tightening the relaxed muscles and giving the skin a firmer, more youthful appearance.

At the start of the procedure, you will be invited to lay down and anaesthetic drops will be put in your eyes. The treatment area will be cleaned and the surgeon will mark up the areas of skin for removal. A local anesthetic will be administered.

The surgery is quick and usually takes around 45 minutes per eye. Due to the anesthetic, you will feel no pain, but you may experience a slight tugging sensation on your eyelid during the potsis surgery. 

The wounds are then closed with stitches, ointment is applied and special dressing is placed on the affected eye(s). Once you have spent some time recovering in the clinic, you will be free to leave on the same day with a friend or family member to continue your ptosis surgery recovery at home.

Your eye may be sore for a day or two after ptosis surgery. Over-the-counter painkillers should help with this.

Blepharoplasty surgery can give life-changing results and our experienced expert surgeons will not change the shape of the eyes, unless this is the aim. Surgery has evolved in recent years and less muscle fat and skin are being removed.

Whilst the occasional non-surgical touch-up may be required to maintain the full effects of droopy eyelid surgery, another skin excision is unlikely and you can expect droopy eyelids to be restored following one surgery.

Ptosis surgery can be combined with a brow lift for an improved result.

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Why do people have it?

There are a number of reasons why someone would opt for ptosis surgery:

Who is suitable?

Ptosis surgery is suitable for anyone who wants to rid themselves of drooping eyelids for whatever reason. If the condition is affecting your vision and this is significantly impacting on your day-to-day life, then surgery is highly recommended.

People who have unilateral ptosis may seek out droopy eyelid surgery in their 30s. For age-related ptosis, most patients are aged in their 50s and 60s, although this surgery can be performed on older people.

Droopy eyelid surgery can be performed on children to help avoid future vision problems from developing.

What are the non surgical options for ptosis treatment?

One of the most common questions we are asked is ‘can you fix ptosis without surgery?’.

Unfortunately, the non-surgical treatment options for ptosis are very limited. Many of these which claim to alleviate the condition do not produce the same results as surgery and can result in a lot of wasted time and money.

The root cause of the ptosis could be treated, depending on what is behind this drooping of the eyelids. In the case of medical causes, ptosis can disappear naturally if the condition is successfully treated, for example where the drooping eyelids are caused by neurological condition myasthenia gravis. Sometimes ptosis can be caused by a heavy brow, which can be treated with anti-aging injectables, without the need for surgery.

Sometimes glasses fitted with a ‘ptosis prop’ or ‘ptosis crutch’ can be prescribed to help hold the drooping upper eyelid in its correct position. However this treatment is really only effective for temporary drooping.

Eye patches, dietary changes and vitamin supplements are not effective treatments for ptosis.

Frequently Asked Questions

There are a number of creams available on the market which claim to tighten the eyelids. However, there is often little or no evidence that these actually work. Facial exercises are not effective treatments for ptosis.  In our experience, eyelid reduction surgery is by far the best treatment available for drooping eyelids.

We advise total rest for several days following droopy eyelid surgery, including at least one week off work. UV light should be avoided for two to three weeks to help with the healing process. Try to avoid irritating the affected eye(s). This includes taking part in activities such as swimming in the weeks following surgery. You should quit smoking as this irritates the eyes and hampers healing.

Your vision is likely to be blurred just after the procedure and you should expect some swelling and bruising following ptosis surgery. This will disappear within a few days.

It is important that you follow all the aftercare instructions issued by your surgeon in order to aid the healing process.

Blepharoplasty, or drooping eyelid surgery, leaves minimal scarring.

The skin of the eyelids is excellent at hiding scars, and any blepharoplasty scars will be hidden in the fold of the upper eyelid, making them nearly invisible on most people.

We ask that you come in and see our nursing team one week after surgery to ensure your incision sites have been properly reviewed. At this juncture we also recommend you meet with one of our on site aestheticians to discuss ongoing treatment to support the healing and scarring process.

Once the bruising and swelling has settled you should expect to see results in four to six weeks post-surgery. However it may take up to six months for a full result.

Droopy eyelid surgery is highly effective and in many cases it is a permanent solution to ptosis. However some patients may find that the drooping returns later on in life, therefore another procedure may be needed. This depends on the individual patient and the cause of their ptosis.

Blepharoplasty procedures at the Cadogan Clinic start from £4,000, however every individual is different, and an accurate price will be quoted depending on your individual needs. The cost will be higher if you are having more than one treatment, for example droopy eyelid surgery coupled with a brow lift. Book a consultation at our clinic to find out exactly what your surgery will cost and what will be required for your particular case.

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