Patients often complain of droopy or heavy upper eyelids. It is important to distinguish between two different forms of droopiness.
Ptosis (pronounced “toe-sis”) is the medical term for lowering of the upper eyelid margin, with the eyelid obstructing the pupil, at least in part. Dermatochalasis is the medical term for excess skin of the upper eyelid. The excess skin can, at times, hang over the eyelid margin and thereby block the pupil to a degree. With either condition, patients often raise their eyebrows in an effort to raise the drooping eyelids. In severe cases, people may need to lift their eyelids with their fingers to see. While surgery to correct mild cases of dermatochalasis is considered cosmetic, severe cases can potentially be covered by insurance.
Children can be born with ptosis of one or both upper eyelids. They may develop amblyopia (“lazy eye”) from visual developmental delay because of limitation of their vision. Their ptosis should be corrected at an early age to allow for normal visual development.
The Causes of Ptosis
The most common cause of ptosis is age-related weakening or stretching of the major muscle that lifts the eyelid, the levator muscle. Relatively rare causes are neurologic diseases, trauma, or congenital weakness. Ptosis may also occur following lasik or cataract surgery as a side effect of some of the instruments used in surgery. Children may be born with ptosis or may acquire it due to trauma or neurologic reasons.
Correction of Ptosis
Ptosis can be corrected surgically, usually by tightening either the levator muscle through a skin incision or a second deeper muscle within the eyelid through an incision on the underside of the eyelid. Other techniques can be used or in severe cases with poor eyelid muscle function. The goal is to raise the eyelid to allow for improved visual field and to obtain symmetry with the opposite upper eyelid.
The Cause of Dermatochalasis
The most common cause of dermatochalasis is age related decrease of skin elasticity, allowing the skin to loosen and sag. Sun exposure and heredity can contribute to this condition. Brow ptosis (or droopy eyebrows) can bring additional eyebrow skin to the eyelids, apparently worsening dermatochalasis.
Blepharoplasty Surgery to Correct Dermatochalasis
Dermatochalasis can be corrected by blepharoplasty surgery, which predominately involves the removal of excess skin. Removal and/or sculpting of underlying bulging fat is often performed to achieve the best aesthetic outcomes, resulting in a more youthful appearance.
Ptosis surgery and blepharoplasty surgery are the most common surgeries performed by Dr. Dal Canto. Part of your evaluation will help determine whether the procedures will be considered medically necessary and covered by your insurance company. We will work on your behalf to obtain preauthorization when possible.
While most patients only require one of the procedures, some will benefit from both surgeries performed simultaneously. These may be functional (insurance-based) or a combination of functional and cosmetic.
Before and After Photographs
(WARNING: Some of the photographs may be graphic in nature.)
Patient #1: Upper Eyelid Ptosis Repair and Blepharoplasty
Patient #2: Upper Eyelid Blepharoplasty
Patient #3: Congenital Ptosis: Left Upper Lid Repair
Patient #4: Upper Eyelid Ptosis Repair and Blepharoplasty
Patient #5: Upper Eyelid Blepharoplasty
Patient #6: Upper Eyelid Ptosis Repair and Blepharoplasty