Why upper eyelids droop
Why the upper eyelid droops — loss of skin elasticity, a descending brow, a weaker lid-opening muscle — and which approach suits each cause.
There is more than one reason an eyelid can look droopy. The suitable approach depends on the cause, so the consultation first establishes which cause is the main one.
Main causes
- Loss of skin elasticity — with age the upper lid skin thins and stretches, covering the crease and lashes
- A descending brow — as the brow drops, the skin beneath it piles up over the eye
- Weaker lid opening (ptosis) — the muscle or tendon that lifts the lid loosens, so the lid itself drops
- Changes in fat — lid fat may bulge or, conversely, shrink so the eyes look hollow
Factors that speed drooping
Frequent eye rubbing, years of contact lens wear, UV exposure and smoking can all contribute.
Approaches by cause
- Mainly loose skin → upper blepharoplasty
- A markedly low brow → a below-brow incision or a forehead/brow lift
- Weak lid opening → ptosis correction
- Several causes together → a combined plan
Frequently asked questions
If the drooping blocks my vision, do I need surgery? If it blocks your field of vision, functional correction is considered as well. The degree is assessed at the consultation.