What is a droopy eyelid?

Droopy eyelid also known as  ptosis, which is a term to describe the appearance of the upper eyelid when the eyelid lash margin is a constantly at a lower level than what is normally expected

 

What causes a drooping eyelid? (ptosis)

The upper eyelid muscle that is responsible for lifting the upper eyelid and keeping it open becomes overstretched and loses its elasticity and tone similar to an overstretched rubber band. It is unable to lift the upper eyelid and hence the eyelid lash margin sags or droops.
 
Levator muscle weakness may be present at birth (when it is called congenital ptosis). However, in majority of cases the cause is acquired or due to ageing changes.
 
With age, the muscle that opens the upper eyelid stretches and loses its elasticity. The laxity of the skin and eyelid muscles, combined with changes to the muscles around the eyes (the muscles that lift the eyelid) and the fat distribution in those areas, can lead to saggy, lazy, baggy looking eyelids, under eye shadows and vision impediment.
 
Other causes of droopy eyelids are frequent rubbing of eyes, use of contact lenses, cataract operation, repeated episodes of eyelid swelling due to allergies, and eyelid trauma can also cause overstretching of the levator muscle and cause eyelid ptosis or droopy eyelid. 
 
“It's important to note that if forehead wrinkles associated with drooping eye lids are treated with muscle relaxant injections, the eyelid droop may become more obvious.  But most people don’t understand the inter-connections between different signs of ageing; including the relational dynamics of eyelid skin ptosis and lines across the brow.”
 

The most common  cause of droopy eyelids (ptosis)

  • Overstretching and disinsertion of the muscle and the tendon that opens the upper eyelid due to age related changes

Other causes include

  • Eyelid growth, tumours or swelling
  • Muscular and neurological problems
  • Nerve damage in the eye muscles.
  • Trauma to the eyelid structures including nerve injury
  • As a complication of anti-wrinkle injections.
 

Why do droopy eyelids (ptosis) affect your function? 

Droopy looking eyelids together, with laxity in the eyelid skin and muscles around the eyes leads to a puffy, tired look.
 
Gradually it begins to impact your vision and/or leads you to frequently and constantly raise your brow to function. Often, but not always the excess eyelid skin droops and falls over the eyelid margin and restricts your vision.
 
As a response, forehead wrinkles often develop when there is skin laxity around the upper eyes. In fact, deepening lines across the forehead area can be one of the earliest signs of drooping eyelids; as these skin folds deepen due to constantly raising your brows to combat the drooping eyelid skin. 
 
It’s often done subconsciously and you’re not even aware you’re doing it, but if you’re showing signs of eyelid ageing and your brow area is being impacted by lines, it’s likely a combined effect from puffy eyelids.

Can a 30-year-old have droopy eyelids?

Although it is not common, it is possible to suffer from droopy eyelids in your 30s.
 
Typically, these patients are born with a mild form of congenital eyelid ptosis that is not severe enough and hence not a visible concern for the patient. However, as patients get older it becomes more obvious because the surrounding soft tissues that were strong in youth begin to become weak and less supportive.
 

Ptosis Drooping Eyelid Surgery

 

What is the recommended treatment drooping eyelids? (also known as Ptosis)?

Fortunately, Plastic surgery of the eyelids (blepharoplasty) can correct droopy eyelids (ptosis) by tightening the overstretched levator muscle and removal of excess skin above the eyes. There are no non-surgical options such as injections, skin tightening devices that can address droopy eyelids.

 

Why do people have  droopy eyelid (ptosis) surgery?

Droopy eyelids will restrict the field of vision which in turn will affect your ability to work efficiently.
 
People have surgery to correct the problems listed above, primarily lax skin that impedes vision or leads to puffiness; or to help reduce the impact on the brow muscles that leads patients to suffer headaches and facial muscle fatigue.
 
Following surgery, you may feel the eyes has been lifted or are lighter.
 

Is eyelid surgery to correct droopy eyelids (ptosis) classified as functional or cosmetic?

Droopy eyelid surgery or correction of eyelid ptosis is mainly functional because it improves the visual field and symptoms such as headaches, heaviness of the eyes.

 

Benefits of ptosis surgery

Droopy eyelid (Ptosis) surgery has functional and medical benefits as it improves vision and practice of daily life activities,.

 

Find out if you are the ideal candidate for droopy eyelid (ptosis) surgery

You are an ideal candidate for Droopy Eyelid Surgery if you have:
  • Over hanging excess upper eyelid skin or eyelid hooding
  • The hooding or excess skin restricts your visual field or causes heaviness in the eyelids
  • Droopy or weak eyelids that make you look tired or sleepy
  • Eyebags or Fatty bulges in the under-eye area that make you look tired
 

What happens during the consultation with Dr Naveen Somia?

The in-clinic eyelid surgery consultation usually lasts about 45 – 60 minutes and is an interactive process to help you determine whether eyelid surgery will address your concerns and, whether you trust me as your Surgeon.
 
I take a detailed medical history followed by evaluation of the structure, function and aesthetics of your eyelids and how they relate to your face. This is followed by clinical photography which is an important record. All these help me to determine whether you are a suitable candidate. Bringing a couple of photos from your 20s or 30s will help.
 
This is followed by a discussion of all risks and benefits of the proposed surgery. I expect you to have questions and there will be ample time to ask them. After the consultation you will be given information that describes the blepharoplasty (eyelid) surgery procedure, lists the risk factors and complications of surgery and cost guides.
 
It is standard practice that we schedule a second consultation which provides you another opportunity to clarify the doubts and ask questions and be reassured of your safety.
 

Is surgery for droopy eyelid (ptosis) covered by Medicare or private health fund?

Upper eyelid surgery may be partly covered by Medicare and private health fund if it classified as medical by fulfilling certain criteria. If the upper eyelid changes affect your vision as proven by a visual field test done by an Optometrist, your surgery may be eligible for cover. 

 

How long does the operation take?

Droopy eyelid (ptosis) surgery is performed in a licensed facility and usually takes 2 hours, but this can vary from patient to patient depending on the additional procedures performed.

 

What happens after the operation?

Immediately after the operation you will spend some time in the recovery ward where you will be closely monitored till you are fully awake. There will be no bandages on the eye, and you will be able to open and close your eyes. You will need regular lubricating eye drops, eye ointment to the suture line and ice packs over your eyes. 
 
It is recommended to stay overnight for regular monitoring because during the first 12 hours after eyelid surgery, there is a risk of bleeding, pain, nausea and vomiting due to the anaesthetic and general drowsiness due to a slow recovery from the anaesthetic leading to an increased risk of bleeding. In addition, the blurred vision following surgery can make the patient anxious.  Staying in hospital where you will be monitored, and your eyelids looked after .
 

How long is the healing process?

Healing and recovery vary from patient to patient but on average, the healing process takes two (2) weeks or more. Please ensure you allow adequate healing time after eyelid surgery and follow all the helpful healing instructions and don’t try to do too much too soon; you will need to rest your eyes a lot during those 2 or more weeks of healing.



What results can I expect after surgery for droopy eyelid (ptosis)

Generally speaking, eyelid surgery will improve your visual fields, relieve symptoms of heavy eyelids and improve the practice of daily activities of life.  Although most changes are noticeable straight away, we recommend waiting for a good 6-12 weeks for all the temporary changes including swelling to resolve to experience the final result. 
 
Upper blepharoplasty (eyelid) surgery will get rid of loose and excess eyelid skin, tighten and lift droopy eyelids. If you have eyelid hooding, it can be addressed. If you notice that your “eyeshadow space” is no longer visible and your eye shadow smudges, upper eyelid surgery to address excess and over hanging eyelid skin can help.

 

Risks of droopy eyelid (ptosis) surgery

Most droopy eyelid surgery or ptosis correction procedures are very complex operations requiring technical expertise and aesthetic finesse. That’s why it’s so important to choose a Specialist Plastic Surgeon, who has had extensive training and experience in eyelid surgery.

If your doctor gets your eyelid surgery wrong and botches your blepharoplasty, you could end up with some unwanted complications and appearance concerns – some of which won’t be able to be repaired easily. 
 
Be sure you choose someone with the Specialist qualifications of a Plastic Surgeon with FRACS and someone who has extensive expertise eyelid surgery.
 
Complications of blepharoplasty eyelid surgery include: 
  • constantly flowing tear ducts or watery eyes
  • dry eyes
  • very uneven eyelid appearances
  • being unable to fully close your eyes or blink
  • other surgery complications (you’ll be given a full list in your consultation)
 

Reducing risks of eyelid surgery (blepharoplasty)

Healthy patients who choose a fully qualified Specialist Surgeon for droopy eyelid surgery, instead of a doctor who is not a Surgeon can reduce some surgery risks by:
  • Making sure their surgeon is very experienced in eyelid procedures
  • Carefully following instructions before and after surgery
  • Not trying to do too much too soon
  • Avoiding driving, and not wearing contacts or eye makeup, until your Surgeon has cleared you to do so after surgery
A botched operation can leave you with some serious eye lid problems it’s just not worth it and will cost you more in the long run. Instead, have a consultation with a Specialist Plastic Surgeon and find out what’s involved, including healing times, potential appearance enhancements and potential risks.
 
“All eyelid surgery requires intensive planning around varying facial features, eye area anatomy and precision surgical techniques. That is why it’s so important to choose a fully qualified Specialist Plastic Surgeon, one who has extensive experience and expertise in eyelid surgery procedures.” 
 

Things to do to improve outcome of eyelid surgery to correct droopy eyelids

 

Before droopy eyelid surgery (blepharoplasty)

  • Book a consultation with Sydney’s eyelid specialist, Dr Naveen Somia
  • Read the materials provided and discuss your surgery objectives, desired outcomes and facial anatomy including surgery costs, surgery schedules, time frames, recovery care, healing times and risks
  • Consider the PROS and CONS of the surgery and what you want accomplished
  • Ask any and all questions you have about eyelid surgery including risks 
  • After doing your homework, decide to proceed 
  • Schedule your surgery, work out your payment options and attend pre-consultations
  • Follow Dr Naveen’s recommendations for pre-surgery preparation
  • Stay healthy to enhance your healing period and help prevent healing delays
  •  

Immediately after droopy eyelid surgery

  • Avoid wearing contacts for the designated time 4 weeks post surgery (ask Dr Naveen for specific information on stopping wearing contacts before your eyelid surgery)
  • Before surgery, read and re-read your post-op instructions
  • Have the post-operative eyelid care instructions laminated and place them by your bedside, using very large font sizes, for when you get home after surgery
  • When you’re cleared for discharge, make sure you have someone to drive you home

 

After droopy eyelid surgery

  • Stay out of the sun for the designated period of time
  • Make sure you’re choosing good nutrition and drinking plenty of water 
  • Rest your eyes and do not drive until you are cleared by your Surgeon
  • Care for your eyes and sutures as instructed by Dr Naveen
    • You may be asked to sleep in an elevated position 
    • You may be able to use gently applied cool packs to minimise swelling, but check with Dr Naveen as these must be used only according to instructions
  • You may feel your eyes appear swollen or your eyelids ‘tight-feeling’; you may have some bruising or discolouration around the eyes after surgery 
  • Report any concerns or questions 
  • Attend follow up appointments and have your sutures removed about a week later (this can vary slightly and frequently doesn’t hurt)
  • In approximately two (2) weeks’ time, your eyelids should be mostly healed, however, the scar may take up to 12 months to fully mature
  • Follow Dr Naveen’s scar minimisation instructions
 

 Copy of LEARN MORE

  eyelid guide snapshot (2)

_TOP 10 FAQS SNAPSHOT (2)

 
For more information about Dr Naveen Somia visit his page on Eyelid Surgery in Sydney
 

OUR PROCESS 

You will generally see Dr Somia 3 times before your surgery.   If you prefer one of these consultations can be held via telehealth.    Two consultations are required by law before a date for surgery is scheduled.   This is to allow you plenty of time to ask questions and feel comfortable about the procedure.   Your third consultation will assist us to prepare you for your surgery (ie paperwork, pre-operative testing). 

 

PROCEDURE DETAILS 

The surgery takes approximately  1.5 hours to 2.5 hours depending on the procedure recommended and requires an overnight stay in hospital.   Our fees include specialist plastic surgeon, specialist anaesthetist, fully accredited hospital theatre, accommodation and 6 months aftercare.    A formal estimate will be provided after you have discussed your goals and what is possible to achieve them with Dr Somia.  

 

RECOVERY 

Each patient recovers at a different rate and anothers recovery should not be compared with yours.

Generally, initial recovery from swelling and bruising is approximately 3-4 weeks.   A return to normal activities can usually be expected after 6 weeks.   Full results can be expected 3-6 months after.  

You can return to work when you feel well and if your employer has lighter duties for you and will allow you to take time to rest and move around.    Most patients take 2-3 weeks off work if they work in an office context.   Patients working outdoors or in a physical capacity may need to take up to 6 weeks off work whilst they recover.   Talk to us about your specific occupation and surgery.   

You can drive when the anaesthetic has worn off, your vision is clear, and you are pain free getting in and out of the care and whilst performing an emergency stop.   You should check your vehicle insurance policy for their requirements in this situation.  

 

RISKS 

All surgery carries risks. When travelling overseas on a plane whilst the expectation is a safe journey and arrival, it is understood things could go wrong. The choice of the airline based on safety record and flight path are important elements in determining risk. Similarly, for your surgery, the experience and expertise of your Surgeon, the skill of your anaesthetist and the standard of the hospital will determine the risk. Risks, both general and specific, will be discussed during your consultations and written information will be provided for you to take home.    

General risks include pneumonia, deep venous thrombosis and pulmonary embolism, stroke, heart attack, allergies, awareness, death, bleeding, infection, sensation change, haematoma and seroma, skin contour irregularities, damage to deeper structures, firmness, delayed healing and tissue death, exposed sutures, dog ears or additional skin golds, dressing issues, asymmetry, scars, lymphoedema and unsatisfactory results. 

Risks specific to Blepharoplasty (Eyelid) surgery are:  injury to the eye globe, need for extra tissue,  loss of vision, changes to tear secretion,  conjunctival oedema and chemosis, exposed sutures,  upper eyelid malposition, difficulty closing the upper eyelid and corneal exposure, lower eyelid malposition and eyelash loss.                                

 

BEFORE AND AFTER PHOTOGRAPHY

Our practice privacy policy prevents sharing patient before and afters online. Indicative before and after photos can be viewed during your consultation.  

 
DISCLAIMERS:   All surgical procedures are performed by Specialist Plastic Surgeon, Dr Naveen Somia (MBBS PhD, FRACS - APHRA Reg:  MED 0001189889).  For full information on Dr Somia's qualifications and risk/recovery information on procedures please visit the procedure page on this website.  From July 1, 2023 all surgical procedures require a GP referral.
 
All surgery carries risks.  information provided is general only.  Outcomes experienced by one person do not necessarily reflect the outcomes of others given factors such as genetics, diet and exercise.  Please seek a 2nd opinion from a qualified Specialist Plastic Surgeon.  

Book a consultation

or call: 02 9387 2110

fracs

Royal Australasian College of Surgeons

psruol

Plastic Surgery Research University of Louisville

trcosof

Royal College of Surgeons of Edinburgh

paces

PACES Plastic Surgery Atlanta USA