What causes the eyelid to droop and does blepharoplasty take care of it?
Have you noticed how something you may have been totally unaware of suddenly becomes front and center every time you look in the mirror? It used to be called the “yellow Volkswagen” phenomenon. You may have never noticed Volkswagens, of any color, until someone you know buys a yellow Volkswagen or maybe one rear-ends you in a parking lot. Whatever the case, once yellow Volkswagens enter your awareness, you see them everywhere! It’s the same when you first notice a drooping eyelid. One day, you’re at lunch with friends and someone asks “What’s wrong with your eye?” From then on, every time you look in the mirror, your drooping eyelid is pretty much the only thing you see.
Causes for Drooping Eyelids
Aging tends to come with bodily changes that are more challenging than beneficial, and drooping eyelids can be added to this list. As with other parts of the body, the process of growing older results in the loss of tissue elasticity. This, coupled with the inevitability of weakening muscles and the constant assault of gravity, causes sagging and drooping in many areas, including the eyelids. In fact, the eyelids are especially susceptible to this because the skin is relatively thin, which leads to a tendency to bunch and fold.
Not all drooping eyelids can be attributed to aging. Some of the other more common causes are muscles or nerves that have been damaged by:
- Injury
- Disease
- Birth defect
Whatever the cause, when there is significant sagging, it can affect the quality of life, either functionally, aesthetically or both. The most common means of treatment for drooping eyelids is blepharoplasty, also known as eyelift surgery.
Blepharoplasty became part of the medical vocabulary in the early 1800s and comes from the Greek words “blepharon”, which means eyelid, and “plastos”, which means formed. Accounts of the procedure, itself, however, date all the way back to 1478, in Rome’s De re Medica. Currently, there are two types of blepharoplasty, although a patient’s goal can include both. These types are:
Functional Blepharoplasty – this is when the condition is such that it is deemed medically necessary due to vision being affected by the drooping eyelid. The extent of impairment is often determined through testing with the Humphrey Visual Field (HVF) Analyzer. Depending on the results of the test, a functional blepharoplasty may be covered by health insurance.
Cosmetic Blepharoplasty – when vision is not impaired and the goal is aesthetic, the procedure is classified as cosmetic blepharoplasty. This surgery may be done on the upper eyelid, the lower eyelid or both. Medical insurance does not normally cover this type of procedure.
Reasons for Eye Lid Surgery
All surgeries are unique based on the individual, but some of the more common conditions addressed by eyelid surgery include:
- Loose, drooping or sagging skin that changes the shape of the eyelid and may or may not affect vision
- Buildup of fatty deposits that give the appearance of puffiness
- Bags under the eyes that are not the result of being overtired or from lack of sleep
- Lower eyelids being pulled down to the point where the sclera, or white part, is visible below the iris
- Wrinkles in the lower eyelid due to excess skin
Whether your goal is to improve vision that is being affected by drooping eyelids or regain a more youthful appearance, blepharoplasty can make a significant difference. If you think it may be right for you, the first step is consultation with a highly skilled and experienced plastic surgeon.
Dr. Brian D. Cohen is a Board Certified Plastic Surgeon with extensive training in cosmetic/reconstructive plastic surgery and has had years of experience performing a wide array of cosmetic surgery procedures, specializing in procedures of the face, eyes, nose, breast and body and is known for his exemplary and compassionate care by his patients. Knowing that Dr. Cohen has been selected by his peers in Super Doctors for 6 years in a row in 2018 gives you the confidence that he is highly respected for his performance in his specialty.