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What Causes Droopy Eyelids?

What Causes Droopy Eyelids?

Over time, your body parts weaken and give way to gravity’s merciless pull. You may notice your biceps getting “flappy,” your breasts heading south, and your tummy taking a downward turn. You can easily hide those sagging areas with strategic clothing, but when it happens to your eyelids, you’ve got nowhere to hide. 

The good news is that an eyelid surgery called blepharoplasty can shore up your eyelids, so you’ll only look tired, disinterested, or old when you really are. 

At Robert A. Guida, MD, in New York City and Staten Island, New York, we offer state-of-the-art eyelid surgery to address droopy lids and refresh your look. Here’s a closer look at the condition called ptosis and the treatment that can fix it.

What causes eyelids to droop?

Ptosis doesn’t hurt, and it’s not usually considered a medical problem, although in some cases, it can partially block vision. It can occur in one eye or both, and you may find you have to arch your eyebrows to lift your eyes open wide enough to see better or let in more light. 

There are several different causes of ptosis, including:

Birth defect

When a baby is born with sagging eyelids, it’s called congenital ptosis. If your child has this condition, you may notice them tilting their head back to see better, or they may arch their brows or lift their chin. It’s important to seek medical treatment for congenital ptosis early because if left untreated, it can lead to neck pain and poor vision development.

We typically diagnose congenital ptosis after age 3. It can affect both boys and girls, but boys tend to get it more often. It often runs in families and usually affects only one eye — about 68% of the time it affects the left eye only. 

Nerve damage

If you suffer from a condition that affects your nerves, you may experience ptosis. For example, Horner syndrome disrupts nerve pathways between your face and your brain and may affect your eyelids. 


Trauma to your eye can affect the nerves and muscles, especially the levator muscle that’s responsible for lifting your eyelid. If you’ve been involved in an accident or have undergone eye surgery — like LASIK or cataract surgery — you may develop ptosis.


A tumor in your eyelid can weigh it down and make it droop too low. In fact, any growth, such as a large mole or skin tag, can make your eyelids sag.

Muscle disorders

If your levator muscle isn’t working correctly, it can lead to ptosis. Certain health conditions put you at risk for ptosis, including myotonic dystrophy, mitochondrial myopathy, and myasthenia gravis.


Age-related eye drooping isn’t technically ptosis, but it has the same results — sagging eyelids. As you age, you may accumulate a little extra skin and fat in your eyelids that cause them to hang down and even cover part of your pupil.

Eyelid surgery

Eyelid surgery removes excess skin and reattaches your muscle so it can function more effectively. Dr. Guida is highly experienced, double-board certified, and performs many blepharoplasty procedures every year, so you can be certain your eyes are in good hands. He also skillfully hides the small incision in the fold of your eyelids so it won’t show after it heals. 

If you have chronic bags under your eyes, Dr. Guida can address those as well with a lower eyelid procedure that removes extra fat. He makes the incision for this procedure inside your lower lid, so there’s no visible scar.

To find out if you’re a good candidate for blepharoplasty, give us a call, or book an appointment online today.

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