Face / Droopy Eye Lids
There are various causes of upper eyelid droopiness.
Eyelid droopiness (ptosis), can be caused by congenital (born with it), traumatic, neurologic and most commonly age-related loosening/weakening of the levator muscle tendon (the muscle responsible for lifting the upper eyelids). The elevator muscle lifts the upper eyelids about 15,000 times per day every day! One can imagine that the tendon attachment can get loose, which causes the upper eyelids to drop. This weakening of the elevator muscle or tendon can be exacerbated by any previous eye surgery due to stretching of the muscle or tendon.
The most important factor to consider in evaluating true upper eyelid ptosis, is to rule out other causes of pseudo-ptosis, including upper eyelid dermatochalasis (excess puffy upper eyelid skin/fat) and droopy eyebrows. As mentioned earlier, the position of the upper eyelid is determined by the elevator muscle/tendon. Excess or puffy upper eyelid skin will NOT change the upper eyelid height but give the illusion of it.
The treatment for this would be upper lid blepharoplasty where excess skin/fat is removed from the upper eyelids.
Droopy eyebrows can also cause heaviness of the upper eyelids and give the appearance of droopy upper eyelid. The treatment for this would be brow lifting. Many patients have combination of the tree factors that contribute to “droopy” upper eye lid (ptosis, dermatochalasis, and droopy eye brow), requiring a combination of ptosis surgery, upper blepharoplasty and/or brow lifting.
How it is corrected?
Upper eyelid ptosis surgery works by surgically tightening of the elevator muscle to raise the droopy upper eyelid. There are various techniques available to tighten the levator muscle, depending on the type and severity of the ptosis. Ptosis surgery can be performed through a posterior eyelid approach (internal ptosis surgery or mullerectomy), resulting in scar-less surgery with excellent eyelid contour. It could also be performed from the front skin approach (external ptosis surgery), where the incision is hidden in the eyelid crease line. In congenital ptosis or ptosis due to very weak elevator muscles, the upper eyelid has to be linked to the forehead muscle (frontalis muscle) in order to use the forehead muscle to lift the droopy upper eyelids. This technique is called frontal sling.
PTOSIS REPAIR, BLEPHAROPLASTY AND UNDER EYE RESURFACING :
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