Blepharoptosis is a form of ptosis (descent) referring to drooping of the upper eyelid. There are many causes for this condition, including: disease, injury, congenital birth defects, previous eye surgery/trauma, eyelid rubbing (e.g., allergies, habit), contact lens wear, and aging changes. Most causes of ptosis do not improve with time and can cause significant visual issues. Patients with ptosis often notice trouble with reading, driving (e.g., missing red lights), headaches, and sometimes accidental head trauma (e.g., bumping into cabinets). Some patients will adopt a head tilt (“chin lift”) position to compensate for droopy eyelids. Others will also chronically and subconsciously use their forehead muscles (the frontalis) in an attempt to pull the eyebrows and eyelids upward to see better. This can lead to frontal area headaches and fatigue towards the end of the day after using the forehead muscles all day long to compensate.
Ptosis can refer to almost any form of tissue descent, and it also may involve the forehead where it is described as “brow ptosis.” This can cause the brow tissues to fall below their normal positions and cause “bunching” of the upper eyelid skin and visual problems. Oftentimes, brow ptosis can be coexistent with excess upper eyelid skin. At other times, a patient may be seeking or incorrectly referred by their doctor for an “eye” lift, but their actual problem is brow ptosis. This means that they won’t get the improvement they are seeking by an upper eyelid lift (blepharoplasty) alone.
Dr. Burroughs frequently performs simultaneous brow lifting, blepharoptosis (“ptosis”) repair, and blepharoplasty surgery. In fact, he has published numerous surgical textbook chapters on these techniques. Unfortunately, some insurances (e.g., Medicare and some commercial insurances) won’t cover each of these problems simultaneously, but Dr. Burroughs does his best when they are causing visual interference problems to fix each of the issue together in one surgery. The mid-face and lower eyelid can also descend with age and cause a patient to look tired, sad, or “worn out.” This can also compromise eye health because, if there is tension pulling the lower eyelid downward, it can lead to dry eyes, incomplete eye closure, and eye redness/irritation. Some patients need these issues addressed medically to improve eye comfort and vision, especially if an upper eyelid lift blepharoplasty or ptosis repair is done since this will increase the ocular surface area of exposure to air and drying out.