Treatment of Upper Eyelid Ptosis

What Is Eyelid Ptosis

Upper eyelid ptosis (blepharoptosis) is the abnormal drooping of the upper eyelid. Ideally, the lower edge of the upper eyelid fold should not descend more than 1.5 mm below the iris. This is its optimal position for performing its anatomical functions — protection from damage and dust, and proper eye hydration.

Ptosis of the upper eyelid is diagnosed when the eyelid partially or completely droops, making blinking and fully opening the eye difficult. Without proper correction, ptosis can lead to both ophthalmological and neurological complications, such as:

• rapid eye fatigue;
• inflammation and excessive tearing;
• impaired vision;
• tension headaches;
• strabismus (crossed eyes).

At the first signs of upper eyelid ptosis, it is recommended to consult an ophthalmologist, as over time the issue can go beyond just an aesthetic concern.

Types and Causes of Upper Eyelid Ptosis

The upper eyelid is held in the correct position by the levator muscle and Müller’s muscle. When these muscles weaken, the tissues begin to “sag.” There are many reasons for this pathological condition of the upper eye muscles, including:

• age-related changes that lead to elongation (stretching) of the muscles and reduce their ability to contract;
• complications following eyelid plastic surgery;
• mechanical injury or infectious damage to the levator muscle;
• endocrine disorders and hormonal fluctuations;
• neurological conditions.

The main cause of upper eyelid drooping is a pathological state of the muscles, but the skin also plays an important role. It can lose its tone and form a fold that hangs over the eye and causes discomfort.

Types of Ptosis

The classification of upper eyelid ptosis is quite broad. When selecting a treatment method, the doctor always considers the cause, stage, and the patient’s individual health characteristics.

Ptosis is divided into two main groups:

1. Congenital ptosis usually becomes noticeable immediately after birth or within the first few months of life. The causes of congenital ptosis include underdevelopment of the muscle that lifts the upper eyelid (levator), as well as abnormalities in the nerve signals to this muscle. In some cases, ptosis may be associated with syndromes or genetic disorders.
2. Acquired ptosis can develop at any age due to external factors, the natural aging process, or illnesses.

Based on the causes of development, the following types of ptosis are distinguished:

1. Neurogenic ptosis – caused by impaired innervation of the muscle responsible for lifting the upper eyelid. This can result from nerve damage due to viral infections, neuritis, or trauma.
2. Age-related (involutional) ptosis – caused by the natural aging process, during which the tissues supporting the eyelid weaken or lose elasticity due to gravity.
3. Aponeurotic ptosis – develops as a result of weakening or rupture of the aponeurosis of the muscle that lifts the upper eyelid. The cause may be trauma, surgical interventions, or age-related changes.
4. Ophthalmologic ptosis – occurs as a consequence of eye diseases such as tumors, scarring, or inflammatory processes that affect the function of the eyelid muscles and surrounding tissues.
5. Myogenic ptosis – results from dysfunction of the muscle itself, such as due to myopathy or muscular dystrophy.

Each of these types of ptosis requires thorough diagnosis in order to determine the most appropriate treatment method.

Upper eyelid ptosis is classified into three degrees based on the level of drooping and the extent of vision impairment:

1. Mild degree. The upper eyelid covers only one-third of the pupil. Vision is almost unaffected, but the cosmetic defect may be noticeable.
2. Moderate degree. The eyelid margin covers half of the pupil. This partially restricts the visual field and causes significant discomfort for the patient.
3. Severe degree. The eyelid completely covers the pupil, leading to total vision loss in the affected eye. The patient often cannot open the eye independently, requiring urgent treatment.

How to Correct Eyelid Drooping?

The main goal of treating upper eyelid ptosis is to restore the contractile function of the levator muscle and Müller’s muscle, as well as to improve the condition of the skin by returning its natural firmness and elasticity. At the LeoDerm Clinic, non-surgical methods are used that allow for the correction of mild to moderate ptosis.

Microneedling RF Lifting

Microneedling RF lifting involves the use of high-frequency impulses to target the deep layers of the dermis. Radiofrequency waves penetrate precisely to a set depth, heating the cells up to 42°C. Under these conditions, a number of processes occur within the cells:

• damaged collagen is broken down;
• cells actively divide, accelerating tissue regeneration;
• the synthesis of collagen, elastin, and hyaluronic acid is activated.

What effects does RF lifting provide?

• increases the firmness and elasticity of the eyelid skin, tightening it and eliminating sagging folds;
• reduces fat deposits in the targeted area;
• improves skin tone and gives it a healthy glow.

Microneedling RF lifting is considered the gold standard in cosmetology and a worthy non-surgical alternative to eyelid lifts.

Endolift Lifting

Endolift lifting is a procedure that targets the deep layers of the dermis. Laser beams interact with collagen fibers, causing them to contract. Thanks to the active synthesis of collagen, the skin of the upper eyelid becomes firmer and visibly rejuvenated.

Endolift lifting provides a long-lasting effect — collagen production continues actively for 4–6 months.

What is recommended to prevent initial ptosis or its recurrence after treatment:

• regular cosmetic and hardware-based procedures aimed at increasing skin elasticity and firmness;
• massage — either at home (self-massage) or professional salon treatments;
• muscle strengthening — special eye exercises and face fitness that reduce the risk of upper eyelid drooping;
• monitoring overall health, hormonal balance, and body weight;
• prevention of deficiencies — taking vitamins and minerals, maintaining a balanced diet;
• minimizing stress and ensuring quality sleep.

If you notice signs of upper eyelid ptosis, it is not recommended to postpone treatment. Over time, drooping may become severe and negatively affect your vision. Schedule a consultation now with the specialists at the LeoDerm Clinic in Lviv — they will assess the condition of your eyelids, the degree of drooping, and select the most suitable non-surgical eyelid lifting treatment for you.