What can be done for sunken droopy eyes?
My eyes have gotten worse over the past year.
I'd rather not look like I haven't slept in years.
Any suggestions?
Thank you for your question!
You submitted a photo with an isolated view of just your eyes and you stated how your
eyes has progressively drooped and you don’t want to look like you’re always sleepy.
So based on this single photo, I can certainly give you an opinion as to what my initial
impression is in this single photo and this brief history that you provided.
I’m a cosmetic oculofacial plastic surgeon practicing in Manhattan and Long Island for
over 20 years.
My background in case you’re not familiar with is eye surgery.
This field of ophthalmology followed by specialized training of surgery of eyelids, lacrimal system
and face called oculofacial plastic surgery.
So to begin with, identifying and introducing the appearance of your eyes is critically
important.
What appears that you have is eyelid ptosis.
Ptosis is drooping.
Now eyelid drooping is typically and the most common type of eyelid ptosis is called involutional
ptosis.
this basically means that as we get older, there appears to be a genetic tendency but
this attenuation or thinning of a muscle typically the tendon of the muscle called the levator
aponeuorosis.
The levator muscle is like the word elevator, it lifts the eyelid and the tendon of that
muscle is called the aponeurosis.
What happens overtime is this aponeurosis becomes thinner or even detaches.
So we refer to it as levator aponeurosis attenuation or levator muscle dehiscence.
But in the end, what we’re talking about is not about skin but rather the muscle that
lifts the eyelid.
So how do we correct this?
Well, the typical approach that we apply is something called levator muscle advancement.
At what that means is, under local anesthesia, we actually take the muscle that is stretched
or detached and we make this evaluation during surgery and I move the muscle forward restoring
it to its proper position.
Now this type of surgery is very delicate, very sensitive and is very much the dominant
in terms of our specialty, oculofacial plastic surgery.
The reason is that this muscle, the particular muscle and activity can be very sensitive
in how it impacts the shape, height and contour of the eyes.
So what we do in our practice is we’ll actually have the patient sit up during surgery.
And that sounds a little strange but when there’s no pain, because there’s local
anesthetic, I am able to assess, having the patient open and close their eyes both in
the laying and seating positon.
And I stand in front of you, I’ll have several of my assistant as well and we all look and
make sure that we like the shape, height and contour.
And once I make these adjustments, more than 99% plus of the time, it’s predictive it
will look good after the surgery.
Now one of the risks of this surgery does mean it involves enhancements.
As far as this muscle is concerned, sometimes the muscle tendon is thin or weak or sometimes
the stitches don’t hold.
There are a lot of different possibilities.
Sometimes people rub their eyes while they are sleeping inadvertently.
And so it is important to meet with specialist that can help you with this procedure.
And in our practice, we do our procedures in our own facilities.
We have our own Join Commission certified facilities which is the same body that certifies
hospitals and surgery centers and one of the things I tell my patients is that enhancements
are part of the nature of this type of surgery if required.
The results can be quite nice having going form tired sleepy eyes to open eyes is really
a nice effect on your appearance.
A lot of times, we see patients who had skin removed and didn’t have the muscle addressed
and usually that’s from a non-specialized plastic surgeon who felt that maybe the skin
was just enough to may be relieve that becomes sometimes skin can something called mechanical
ptosis.
so not disparaging our colleagues, but is just an area that recognizing what part of
the eyelid position is due to physical amount of skin versus the muscle.
So at this point, it’s ideal to now meet with qualified experienced oculofacial plastic
surgeons, that’s my recommendation.
And learn about their approach and their results and get their sense of style and looking at
before and after pictures.
And also understand that there are going to be distinctions between doctors.
Everyone can have the same similar training but practice is more about individual style
and capabilities that are not always identified by just background training.
So I hope that was helpful, I wish you the best of luck and thank you for your question!