April 4, 2013
The reasons for drooping upper eyelids can be medical or cosmetic in nature but either can affect vision and self-esteem, and both can be repaired with relatively uncomplicated plastic surgery procedures. Medical, or functional, eyelid drooping results from a problem with the working of the eyelid skin and muscle, while cosmetic eyelid drooping is typically a result of weakened or saggy skin due to the effects of aging.
Ptosis is a medical, or functional, situation in which the upper eyelid blocks too much of the iris, the colorful part of the eyeball that regulates light levels and vision. Ptosis becomes more common with aging, and can be caused by a weakness in the eye's levator muscle, which is responsible for the eyelid opening and closing. Blepharochalasis is another medical condition, in which the upper eyelid is properly located on the iris, but excessive skin causes the drooping lids. These two conditions sometimes occur together.
The cosmetic reason for drooping eyelids can be hereditary, or more commonly aging-related. Sometimes the eyelid skin stretches or the levator muscles become lax, or weakened. Fat deposits may also develop above and below the eye. A drooping upper or lower eyelid can result in a person looking tired or older than their age.
"Besides affecting vision, having drooping eyelids can affect the way a person feels emotionally," says
Nebil Bill Aydin, M.D
, assistant professor of Surgery at the
New York Medical College
, attending surgeon at the Westchester Medical Center, and a Reconstructive and Cosmetic Surgeon with the
New York Group for Plastic Surgery
. "Hearing from people how tired you look can negatively affect feelings about yourself, and you may indeed start to feel drained and downcast."
How can you tell if your eyelid ptosis is cosmetic or functional? A medical specialist can determine if eyelid drooping is due to medical or cosmetic causes, but Dr. Aydin offers some signs that it's more likely a medical, or functional, rather than a cosmetic issue:
- Pinch — don't lift — the upper eyelids. If vision is unchanged, the problem is likely functional.
- Look in the mirror, or ask a friend, to see if there's a discrepancy between the two eyelids, with one drooping significantly more than the other. (Normally, the lower eyelid sits just at the level of the limbus — the edge of the iris — whereas the upper eyelid should just barely cover the iris.) If so, the problem is likely functional.
"I believe that 'the eyes are the windows to the world' but the eyelids are the curtains, and if the curtains don't sit well on the windows the world does not look right," says Dr. Aydin. "Fortunately, there are common plastic surgery procedures that can repair the eyelids to unblock vision and improve appearance."