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I have had a heavy upper eyelid since childhood. What are my options?

Published on September 9, 2012

There is often confusion regarding what part of the eyelid is heavy. Eyelid surgeons draw an important distinction between a full upper eyelid fold (which is actually part of the eyebrow just below the eyebrow hair) and a heavy or ptotic eyelid margin. Ptosis means fallen and it is a general term than is used to describe a number of anatomic issues. How we address a ptotic upper eyelid margin and how we deal with a heavy eyebrow are very different. Upper eyelid ptosis where of margin of the upper eyelid rests low on the eye itself, is often present from childhood onward. The condition can pose both aesthetic and functional problems. Depending on the nature of your case, you may be dissatisfied with a “droopy” appearance of the eyelid, you may have concerns about asymmetry noted by other people, or you may have visual impairment and diminished peripheral vision. Heavy eyelids may be described as “bedroom eyes,” or sleepy eyes. Because the heavy eyelid convey a lack of attention, the presence of upper eyelid ptosis can be undesirable in both social and work situations. In contrast, an eye that is open correctly makes you look alert, interested, and engaged and is socially desirable in both work and social situations.

Ptosis usually does not go away on its own, particularly if this is a problem you’ve had since childhood. Ptosis can also develop after childhood. Considering how the upper eyelid tendon in held in the eyelid, it is actually quite amazing that more people do not have this condition. After a few million blinks of the eyelids, it is common to see some degree of upper eyelid ptosis. If you have a bothersome heavy upper eyelid and are beginning to consider your treatment options, it is important to research upper eyelid ptosis and clearly understand your choices. Ultimately there is no substitute for consulting with a qualified oculoplastic surgeon because every eyelid is different.

Correcting eyelid ptosis requires upper eyelid surgery. The challenge is determining the best approach that is right for your needs. This is not a place for having work done by a non-specialist lacking training, skills, and experience. Having ptosis correctly diagnosed increases the likelihood that surgery will correctly address your issues. Having things done the right way the first time is so much better than needing to undo the wrong surgery. Ptosis surgery can often be done in conjunction with other cosmetic eyelid procedures. The surgery will elevate the eyelid to an appropriate, natural level. It can also address eyelid asymmetry. Having the heavy eyelids corrected can make a huge difference in your confidence level, the business world, and personal interactions.

The first step is to consult with a cosmetic surgeon who specializes in eyelid surgery, including concerns related to ptosis, heavy eyelids, and asymmetry. At your consultation, your physician should give you a close and thorough examination, discuss your options and probable outcomes, and the likelihood of a surgery’s success and factors that can complicate surgery. The doctor will also make a formal diagnosis at this time, which will identify the ptosis and any compounding issues. For example, some individuals also have a heavy brow or dark under-eye circles, which may exaggerate the problem. Your surgeon should specialize in understanding on how each part of the face functions and relates to the other parts, and also advocate for nonaggressive surgery for natural-looking results. He or she can then design an individual treatment plan for you that leaves you with an overall balanced look.

The first step really begins by seeing the right surgeon. The key to being happy with your results is to never take a shortcut in choosing a surgeon. Your surgeon must be a true specialist in ptosis correction, and similarly will not take any shortcuts or use a “one size fits all” approach to your care. It is important to understand the value of seeing an aesthetically oriented, fellowship trained oculoplastic surgeon. The plastic surgeon who did your girlfriend’s breast surgery or nose is all too often the wrong choice because they lack specialized training in ophthalmology and in oculofacial surgery. To be a fellowship trained oculoplastic surgeon means the surgeon is board certified in ophthalmology and has spent a minimum of two additional years training in eyelid plastic surgery. Dr. Steinsapir is board certified in ophthalmology and completed three years of training in oculoplastic surgery fellowships and two additional years of cosmetic surgery fellowship training. This advanced training early in his career has helped propel him to the forefront of his field.

A highly qualified cosmetic eyelid surgeon is the best option. Surgeons do vary, so it is recommended that you review unretouched before-and-after photos of eyelid surgery; spend time with the surgeon beforehand discussing your options, plan, and follow-up care; and understand your doctor’s treatment philosophy, which should advocate for a nonaggressive, individualized approach.

Dr. Steinsapir is highly qualified to treat eyelid ptosis, asymmetry, and related concerns. With particular attention to individualized care, multiple fellowships in eyelid surgery, and a specialization in ptosis correction, he can help you with your goal to realize a bright and natural appearance. Dr. Steinsapir is internationally regarded as a top eyelid surgeon. Call us today to schedule a consultation and finally take that next step in addressing your longstanding concern. You shouldn’t have to wait any longer.

About Dr. Steinsapir

Dr. Steinsapir is a board certified eye surgeon and fellowship-trained in oculoplastic surgery and cosmetic surgery in Los Angeles where he specializes in balanced facial cosmetic surgery for natural results, with an emphasis on minimally invasive techniques, fast recovery time, and leadership in medical technology. Dr. Steinsapir has a private practice and also serves as an Associate Clinical Professor of Ophthalmology at the Jules Stein Eye Institute, at the David Geffen School of Medicine at UCLA. Contact us today to learn how Dr. Steinsapir’s experience and training make him an expert in cosmetic surgery, which can be a vital part of your evidence-based treatment plan.

Services described may be “off-label” and lack FDA approval. This article is informational and does not constitute an advertisement for off-label treatment. No services should be provided without a good faith examination by a licensed physician or surgeon and an informed consent with a discussion of risks, benefits, alternatives, and the likelihood of treatment success. Only you and your treating physician or surgeon can determine if a treatment is right for you.