Ptosis (Droopy Upper Eyelids)
The term ptosis implies droop of anything (eg. Facial ptosis= facial droop), whereas the more specific term blepharoptosis specifies droop of an eyelid (Blepharo- = Eyelid). However, in practice the shortened term “ptosis” is most commonly used to suggest droopy upper lid(s). Proper upper eyelid positioning and good clearance of the visual axis (greater than 2mm above the pupil) is dependent upon three main factors: 1) Appropriate positioning and movement of the Forehead /Eyebrows 2) Normal anatomic alignment and functioning of the muscles that elevate the eyelid (Levator / Muellers), and 3) Absence of excess skin or fat of the upper lids that could be weighing down the lid or skin draping over the lid margin. Descent of the eyebrows or upper lids either congenitally (present at birth) or acquired may result in encroachment of the upper lids upon the superior field of vision. When approaching the visual axis the droopy lid(s) may cause interference of with normal daily activities, including: reading, driving, or watching TV; potentially induce headaches from straining of the brow or neck to clear the visual axis; or cause a more tired or fatigued appearance. The drooping may occur by a variety of mechanisms, including: age-related with descent of soft tissue or weakening of the muscles that elevate the brow (brow ptosis), slippage or weakening of the muscles that elevate the eyelid (blepharoptosis /ptosis), or excess skin and/or fat of the upper lid (dermatochalasis). A thorough evaluation will help distinguish the relative impact of each of these potential causes. And, based upon your symptoms, we may recommend one or a combination of repairs.
Upper Eyelid Ptosis Repair Both Eyes
Upper Blepharoplasty Repair Both Eyes
Ptosis Repair Both Upper Lids in and a 102 year-old patient
Note that before surgery patient needed to use pull brows upward in order try to clear the visual axis; however, post-operatively the patient had a more normal brow position, but a new deeper fold between the brows (glabellar furrow) that made her appear more angry.