Bel Red Center for Aesthetic Surgery
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1260 116th Ave NE, Ste 110, Bellevue, WA 98004

3 Causes of Droopy Eyelids | Bel Red Center for Aesthetic Surgery

Drooping eyelids can be caused by three different conditions, each handled differently. As a facial plastic surgeon at Bel Red Center for Aesthetic Surgery, Dr. Zemplenyi discusses different conditions that may cause eyelids to sag, and surgical treatments for each:

1. Dermatochalasis

The eyelids begin to droop in the 40s for nearly everyone. As time progresses, the excess skin over the eyelids makes them appear tired and feel heavy. This condition is virtually universal for the folks above the age of seventy. It is not unusual for severe cases to affect the vision. While the primary cause of dermatochalasis is aging, other factors that exacerbate eyelid droop are smoking, excessive sun exposure and a familial, genetic tendency.

While we can’t stop the aging process, taking care to protect your skin from excessive sun exposure and not smoking may decrease the severity of eyelid droop you will ultimately experience as you age. Generally, the earliest symptoms of dermatochalasis include the eyes feeling heavy or tired. As the condition worsens, peripheral vision may be impaired; this can affect driving, reading and other activities. Progressing with age, dermatochalasis can actually droop over the pupil, obstructing your central vision. Once the peripheral vision is documented to be significantly impaired a surgical correction (blepharoplasty) may be covered by insurance. Dr. Zemplenyi prefers to perform blepharoplasty under twilight anesthesia though only a local numbing medicine (local anesthesia) may be used in some patients. The surgery involves removal of excess skin and some fatty tissue. The recovery tends to be fast, and the surgical scar is hidden by the lid crease and becomes inconspicuous in several months.

2. Brow Ptosis

When the brow droops, it is referred to as brow ptosis. A condition caused by the pull of the gravity on the face and the aging process, the eyelid(s) will appear to droop, when in fact the problem is the brow. Generally, the ideal placement of the eyebrow for men is just at the bony rim above the eyes. For women, the ideal placement is just above the bony rim. Often, brow ptosis occurs in conjunction with dermatochalasis, and both need to be addressed at the time of the surgery. Brows are elevated with a brow lift (also known as the forehead lift). Dr. Zemplenyi has a large experience with an endoscopic brow lift, but he finds that a brow lift performed through an incision just at the forehead hairline gives more long-lasting, predictable results. Another, older approach is through the coronal scalp incision, and this technique may be desirable in some patients. During your consultation at the Bel-Red Center for Aesthetic Surgery Dr. Zemplenyi will discuss your options, and the best surgery to treat your drooping eyelids. at your first consultation. Following a thorough examination to determine your specific needs and conditions, Dr. Zemplenyi, the Bellevue eyelid/brow specialist, can help decide the best plan of treatment for you.

3. Ptosis

Eyelid ptosis is observed when the eyelid margin is close or at the level of the pupil thus causing the above appearance. It may involve only one eyelid but is usually bilateral (both eyes). It is not a condition related to excess skin or brow droop due to gravity. While sometimes congenital (born with), but the majority of eyelid ptosis is acquired through the aging process, nerve injuries or neuromuscular conditions such as myasthenia gravis.

Because acquired ptosis can be an indication of a more serious condition, a thorough examination may be needed by an ophthalmologist (eye physician). Once it is determined that a patient suffers from an acquired eyelid ptosis, caused by a weak attachment between the eyelid structures and the muscles, surgery may be recommended. Dr. Zemplenyi will correct some acquired eyelid ptosis when the condition is also accompanied with age-related excess skin condition. Often, Dr. Zemplenyi will refer patients with eyelid ptosis for surgery by an ophthalmic plastic surgeon.