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Droopy Lids, Ptosis & Tired Eyes

The eyelids are a key feature of our face and subtle changes can significantly impact the expressed and perceived emotion when we interact with others. A difference in just a millimetre in the position of the eyelids can be detected by others, and when low can make you look tired. A droopy eyelid, known as Ptosis is when the lid margin of one or both eyelids droop to a position lower than normal. This is a common presentation to FaceRestoration’s oculoplasticsurgeons and can be seen along with hooded skin. Ptosis can make the eyesappear tired, feel heavy and cause visual disturbance as well as reduce thefield of vision.



A droopy eyelid can affect one or both eyes and be asymmetrical.

In Children

Droopy lids can occur in children, termed congenital ptosis, or present in older age. When severe and covering the pupil in a child, it may prevent maturation of the vision and lead to a lazy eye. Congenital ptosis in this instance needs early intervention.

In Adults

Once the vision is fully developed, there is no threat to the visual development, but ptosis can cause other symptoms depending on its severity. It can make you look tired, cause eye strain and fatigue particularly when trying to read. There is often a compensatory raising of the eyebrows to help lift the eyelid, which can also result in eyebrow ache. When only one of your eyelids has a ptosis, the other eyelid may appear higher than it would be at rest, due to nerve impulses firing to both sides equally to attempt to lift the droopy side.

What causes brow ptosis?

Ptosis usually occurs in adults resulting from problems with the levator muscle that lifts the eyelid.  It can be acquired following mechanical trauma, inadvertent placement of Botox too close to the levator muscle, long term contact lens wear with repeated stretching of the eyelid to insert the lenses, and previous intraocular surgery like cataract surgery if the muscle is stretched. Other conditions attacking the muscle such as myasthenia gravis and myotonic dystrophy can cause progressive ptosis.  Occasionally the abnormal side is where the eyelid is too high and retracted such as with Thyroid eye disease, and the normal side looks droopy in comparison.

Problems with the nerve supply to the levator muscle and smaller muscle called Mueller’s muscle may also result in a ptosis. This can occur in conditions such as nerve palsies and Horner’s syndrome.

Why does droopy lids and ptosis happen with age?


As you age, your skin loses collagen, hydration, elasticity and support.  The eyelid skin is the thinnest in the body and often shows the earliest signs of ageing.  When there is significant hooding of the eyelid skin it can cause additional mechanical drooping of the eyelid, worsening a ptosis.

When should I seek help for Droopy Lids, Tired Eyes, & Ptosis?


It is important to seek urgent medical attention If your ptosis develops suddenly or over a few hours to days with no known cause, particularly if it is associated with blurred vision, double vision, headaches, slurred speech, difficulty swallowing or other muscle weakness elsewhere in the body.

When the droop is slowly progressive and causing eye strain, vision problems or eyebrow and headaches treatment, there is less urgency but treatment can result in significant symptom relief.

A persistent droopy eyelid can make you look tired and be cosmetically noticeable.

What treatment is available for Droopy Lids, Tired Eyes, & Ptosis?

Medical treatments are suitable for ptosis caused as a complication of Botox or when due to active autoimmune disease such as myasthenia. In some cases, with slowly progressive muscle abnormalities, conservative measures are more appropriate, using struts to support the eyelids.

Surgical treatment, however, remains the mainstay and in adults is better performed under local anaesthetic for the best functional and cosmetic results.

When there is also droop of the brow and hooding of the skin, these can all be addressed at the same time.

As this is a critical part of your face for perceived and expressed emotion, symmetry and eyelid position are important and this is better assessed during surgery without a general anaesthetic.

Contact us at FaceRestoration and we would be pleased to advise you.

How we can help

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Your consultation

We will then discuss with you your symptoms and advise you on how best to proceed with helpful guidance on treatments through our expert knowledge and training.

Treatment after care

Once an appointment has been arranged, we will then begin treatment and support you along the process, including specialised aftercare.