A droopy eyelid can alter your whole look: it can make your eyes appear smaller, irregular, and make your entire face seem exhausted even when you feel perfectly fine. What causes a droopy eyelid can differ between people. For some, the weight of excess or loose skin can place a burden on the eyelid, resulting in its sagging. For another person, the eye’s heavy appearance may be due to a problem concerning the muscle that is responsible for lifting your eyelid. If you are considering droopy eyelid surgery, then it is important that you have a proper understanding of your condition’s root cause. Knowing this allows you to make informed decisions when determining the right surgical approach to correcting your problem.
Understanding Droopy Eyelids: Do you have muscle weakness or just extra skin?
Having muscle weakness or extra skin in your eyelid gives a similar result: a drooping appearance. However, these two conditions are anatomically distinct and require different approaches through surgery.
Ptosis vs Dermatochalasis
Ptosis (pronounced as toe-sis) develops when the primary muscle tasked to lift the upper eyelid (levator palpebrae superioris) becomes detached, stretched, or weakened from the site where it is attached.
- Cause: Ptosis can be congenital, meaning it is present from the day you were born. It can also develop as you age or due to other factors like wearing contact lenses for a long time, trauma to your eyes, or rubbing your eyes persistently.
- Anatomical effect: Your eyelid’s whole upper margin droops abnormally lower, often covering the top portion of the pupil due to the levator muscle’s lack of strength or tension.
- Determining factor: If you have ptosis, you will find yourself unconsciously raising your eyebrows using your forehead muscles often to compensate for your eyelid’s weakness. This can lead to side effects, such as facial fatigue, forehead wrinkles, or tension headaches.
Dermatochalasis is characterised by the sagging and stretching of the skin and soft tissues beneath the upper eyelid.
- Cause: This occurs when your skin lacks collagen and elastin as you grow old. In a tropical climate like Singapore, the eyelid’s thin and delicate nature loses its elasticity over time, especially when you are frequently exposed to the sun’s UV rays.
- Anatomical effect: The excess skin of your eyelid folds over its natural crease. In some severe cases, the sagging skin can hang over the line of your eyelash and block your peripheral view.
- Determining factor: Dermatochalasis does not affect the eyelid’s levator muscle. This means that the margin of the eyelid sits at the correct height above your pupil and the muscle is able to perform its function normally. The main concern of your droopy eyelid is simply the excess skin hanging over your lid.
Correcting Your Condition with Droopy Eyelid Surgery
Your droopy eyelid condition needs a personalised surgical approach depending on its primary cause: dermatochalasis, ptosis, or a combination of both. Below are the types of surgical methods that can be used to improve your condition:
Ptosis Repair for Muscle Weakness
If the cause of your condition is muscle weakness, then you need to undergo a droopy eyelid surgery that is specially designed to repair the eyelid muscle:
- Step 1: Accessing the muscles. An incision is made in the crease of your eyelid or the underside of the lid to reach and expose the levator muscle.
- Step 2: Reattachment or tightening of the muscle. The levator aponeurosis is either reattached or shortened to the tarsal plate to improve its capacity to lift your eyelid.
- Step 3: Symmetry modification. Your surgeon assesses the contour and height of your eyelid while you are sitting or during the operation to ensure both of your eyes’ natural symmetry.
Upper Blepharoplasty for Extra Skin
When your eyelid’s concern is only extra skin, an upper blepharoplasty is recommended:
- Step 1: Incision. A strategic cut is performed within your eye’s natural double eyelid fold.
- Step 2: Excision. The extra skin, excess pads of fat, and muscle strips underlying the eyelid are repositioned or entirely removed.
- Step 3: Closure: The incision is sutured, placing the scar inside your eyelid crease to make it unnoticeable.
For Asians, a droopy eyelid can be caused by a poorly defined upper eyelid crease or excess skin existing simultaneously with a weak levator muscle. For this particular condition, your surgeon can perform droopy eyelid surgery through a combination of ptosis repair and blepharoplasty. These two techniques help achieve functional elevation as well as an aesthetically appealing eyelid crease.
Droopy Eyelid Surgery: What to expect during your consultation, procedure and recovery in Singapore
Pre-surgical Evaluation
Your surgeon will conduct a complete ophthalmic and aesthetic assessment during your pre-surgical consultation. You will undergo:
- Measurement of the Margin-Reflex Distance (MRD-1) to assess your eyelid position relative to the center of your pupil.
- Assessment of your levator muscle function. You will be asked to gaze up and down to check how far your eyelid moves.
- Dry eyes syndrome or corneal issues screening.
- Evaluation whether your droopy eyelid surgery is purely aesthetic or functional.
During the Surgery
- Administration of anaesthesia: Droopy eyelid surgery is usually done as a day surgery under local anaesthesia with light sedation.
- Duration: The procedure typically lasts between 1 to 2 hours based on the number of eyes needing correction and the type of techniques used.
- Precision: Your full cooperation is needed during the entire operation. Your surgeon may ask you to open and close your eyes while performing the surgery. This will allow them to make accurate adjustments to your eyelid height during the procedure.
Recovery Timeline
- 1-3 days after surgery: You will experience bruising, mild swelling, and tightness around your eyes. This is normal following your droopy eyelid surgery. Apply cold compresses to minimise fluid build up around your eyes.
- 5-7 days after surgery: The sutures will be removed from your eyelid.
- 2-4 weeks after surgery: The bruising around your eyes should subside. You can return to your normal routines, social engagements and do light work.
- 3-6 months after surgery: The tissues around your eyelids should finally settle. Once they heal completely, your eyelid contour should appear refined with a crisp crease.
Benefits of Droopy Eyelid Surgery
- Expanded vision: Your upper peripheral vision will become clearer as the obstructing skin is removed.
- Long term results: Surgical corrections done on the structure of your eyelids provide durable and stable results for a long time.
- Improved facial appearance: Your face will look more lively and alert once your heavy eyelids are removed.
- Reduced facial fatigue: You can experience relief from any strain on your forehead muscles, tension in your eyebrows and headaches caused by droopy eyelids.
Conclusion
A droopy eyelid can be caused by different factors. It can be due to muscle weakness, extra skin, or a combination of both. This condition can be corrected through droopy eyelid surgery. However, for you to get the optimum results from a droopy eyelid surgery, it is crucial to know the exact cause of your concern. The right diagnosis plays a heavy part in improving your eyelid’s condition along with the expertise of your chosen surgeon.
Book a consultation with a qualified surgeon today.
Allure Plastic Surgery – Dr Samuel Ho
435 Orchard Road #22-04 Penthouse Floor
Wisma Atria Singapore 238877
Phone: + 65 6734 9988
