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The levator palpebrae superioris and Mullers muscle are responsible for lifting the upper eyelid. When this muscle is weakened in any way, the eyelid cannot open as wide resulting in a droopy appearance and overall tired look.
Drooping anywhere on the body is known as ptosis, which comes from the Greek word for “falling.” When this drooping occurs in the eyelid, the Greek word for “eyelid” is combined with ptosis to become blepharoptosis.
Droopy eyelids can occur at any age. Some people are born with droopy eyelids which is called congenital ptosis and is rare. When droopy eyelids appear in adults, the condition is known as acquired ptosis.
As part of the aging process, skin loses collagen and elasticity, and muscles weaken. The combination of a stretched out, weakened levator muscle and excess lax upper eyelid skin weigh down the eyelid and obstruct field of vision.
In addition to the natural aging process, lack of sleep and fatigue can cause droopy eyelids. There are also medical causes of ptosis such as a stroke, brain tumor, cancer, or myasthenia gravis. These conditions affect the nerves or muscles of the upper eyelid and result in drooping.
Myasthenia gravis is an acquired autoimmune neuromuscular disorder that causes generalized muscle weakness that worsens with activity and improves with rest. The muscle weakness is often most notable with eye movements. There is no known cure for this disorder, but there are medications that can help with the symptoms.
Ptosis symptoms include the sagging of one or both upper eyelids and can also involve an altered field of vision, extremely dry or watery eyes, eyestrain, headaches, and fatigue.
If the eyelid drooping is severe or comes on suddenly, it may be a result of improper Botox injections, injury, or disease. Inflammation and swelling of the eyelid, such as from too much sun exposure, can also cause droopy eyelids.
Droopy eyelids can be treated with surgery and more recently eye drops called Upneeq. While mild ptosis may not be noticeable or cause vision problems, it can make you look tired. Severe ptosis can impair field of vision and surgical intervention is often necessary for optimal treatment. Oculoplastic surgeon specialists can recommend the appropriate treatment.
Options to eliminate droopy eyelids can include a combination of the following procedures:
Blepharoplasty – An eyelid surgery that removes excess skin on the upper eyelids.
Brow lift – a forehead surgery that lifts the tissue of the forehead which in turn lifts the brows and upper eyelid skin.
Blepharoptosis repair – An eyelid surgery that tightens the eyelid-lifting muscle, the levator palpebrae superioris, through an incision in the upper eyelid.
A minor brow lift treatment can be performed in the office under local anesthesia while a more extensive brow lift surgery requires intravenous sedation at an ambulatory surgery center. Three of the most common brow lift procedures include:
Direct brow lift – An incision is made just above the eyebrow or is camouflaged within existing forehead wrinkles. This procedure allows for precise repositioning of the brow and is best suited in cases of unilateral brow ptosis.
Endoscopic brow lift – Small incisions are made in the scalp and hidden in the hairline. Droopy brows are elevated by lifting forehead and brow skin from the underlying tissues. After the forehead lift, the brows are pulled up and anchored to the underlying bone before the incisions are closed.
Temporal brow lift – One small incision is made on each side of the scalp, hidden behind the hairline. This procedure only lifts the outside edge of the brow.
Adults with excess skin on their upper eyelids and a family history of ptosis are most at risk for droopy upper eyelids and brows. Diabetes, neurological disorders, sleep apnea, and chronic eye rubbing also increase the risk of developing ptosis.
If a droopy upper eyelid is left untreated, vision problems may result from the weight of the extra skin. Vision problems can include amblyopia in young patients (lazy eye), which occurs when eyelid ptosis affects only one eye, causing the brain to turn off signals from the weaker eye and rely only on the stronger eye.
Severe eyelid ptosis can affect your appearance and visual field. Lazy eye symptoms include:
Eyes that appear not to work together
Droop in one or both eyelids
Poor depth perception
Squinting or head tilting
Abnormal results of vision screening tests
Sofwave™ Synchronous Ultrasound Parallel Beam (SUPERB™) technology lifts your eyebrows without requiring surgery and minimal down time (can’t really say no prolonged healing time when it takes 3 months to see the result). Patients experience minimal discomfort that is very short lived during Sofwave™ treatments.
This innovative technology requires no needles, no incisions, and topical anesthesia to eliminate droopy eyelids. The is goal of this article (lids or brow) – leaving your hairline and forehead unchanged (also need to fix, I did see texture and skin quality improvement in my forehead), with no scars from surgery and no danger to your eyelid muscles or eye socket.
Is Sofwave™ procedure safe?
Sofwave™ SUPERB™ technology is cleared by the U.S. Food and Drug Administration (FDA) for non-surgical eyebrow lifts, minimization of facial lines and wrinkles, and lifting of lax skin of submental and neck tissues. The Sofwave™ process penetrates the skin at a controlled depth, and the system’s Sofcool™ cooling mechanism protects skin from burning – thus ensuring safety.
As the Sofwave™ ultrasound energy is delivered, patients may feel warmness of the skin. Following this 45-minute treatment, patients can immediately resume their activities.
We have seen a successful eyebrow lift and the elimination of eyelid droop after just one or two Sofwave™ treatments.
The collagen regeneration process can take up to 12 weeks. Results can be seen as soon as one week after treatment, with improvements continuing for up to three months after treatment.
Elle magazine’s 2021 Future of Beauty Awards honored Sofwave™ technology in its “In-Office Skin Treatment” category as one of the best in the world in providing patients a younger appearance.
For more information on how you can receive a non-surgical Sofwave™ eyebrow lift, please go to Sofwave™’s Providers List and find a provider near you!
Dr. SEAN PAUL
Oculofacial Plastic Surgeon in Austin
Dr. Paul is a board certified surgeon of the American Board of Ophthalmology (ABO), and a member of the American Society of Ophthalmic Plastic and Reconstructive Surgery (ASOPRS). He specializes in eyelid and facial plastic (cosmetic and reconstructive) surgery. He uses a blended approach of non-surgical treatments and surgery, including minimal incision techniques, to provide the best patient care. He resides in his home state with his wife and two children.
DR. JEANIE LUJAN
Facial Plastic Surgeon in Austin
Dr. Lujan is a board certified and an American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) fellowship-trained surgeon specializing in both cosmetic and reconstructive facial plastic surgery. She offers a wide spectrum of aesthetic surgery and non-surgical treatments. Dr. Lujan is passionate about providing personalized care for her patients and delivering natural results. She is an active member of the American Academy of Facial Plastic and Reconstructive Surgery and has published on preservation rhinoplasty and nasal physiology.
DR. CHRIS SCHNEIDER
Dr. Chris Schneider is a plastic and reconstructive surgeon, who also specializes in microsurgery. Dr. Schneider offers a wide range of both cosmetic and reconstructive surgery of the face, body, and breast. He believes that all procedures, whether reconstructive or cosmetic, should be approached with a thoughtful aesthetic objective. His artistic nature and precise surgical techniques allow him to deliver safe and excellent aesthetic results.