Eyelid Issues: Can You Fix Your Natural Double Eyelids?

Regarding double eyelids?

I would like to ask, if someone is born with double eyelids but they only appear when the eyes are forcefully opened, otherwise the eyelids almost cover half of the pupils, is this considered ptosis? I didn't have this issue when I was younger, which is why I underwent double eyelid surgery, but I am not satisfied with the current results.
Can I remove the current double eyelids and "treat" my natural double eyelids?

ASD, 20~29 year old female. Ask Date: 2009/05/01

Dr. Zhou Hongzhang reply Plastic Surgery

1.
The definition of ptosis is that when both eyes are looking straight ahead, the eyelids should cover the corneas by approximately 2 to 3 mm.
If the coverage exceeds 2 to 3 mm, it is considered ptosis.
2.
"Having double eyelids that only appear when the eyes are forcefully opened" resembles what is commonly referred to as "internal double eyelids." 3.
The sutured double eyelids can be removed, but there is no guarantee that they will return to their original state.
4.
This case appears to be quite complex, so it is advisable to consult with a plastic surgeon for the best treatment options.

Reply Date: 2009/05/01

More Info

When it comes to eyelid issues, particularly the concern of having a natural double eyelid that only appears when you force your eyes open, it is essential to understand the underlying causes and potential solutions. Based on your description, it sounds like you may be experiencing a condition known as "ptosis," which is characterized by the drooping of the upper eyelid. This condition can obscure part of the pupil, leading to the appearance that your eyelids are not functioning as they should.

Understanding Eyelid Anatomy and Function
The eyelids serve several important functions, including protecting the eyes from debris and excessive light, distributing tears across the surface of the eye, and aiding in vision. The muscles that control eyelid movement, particularly the levator muscle, play a crucial role in how your eyelids function. If this muscle is weak or if there is an issue with the eyelid's structure, it can lead to ptosis.

Possible Causes of Your Condition
1. Genetics: Some individuals are genetically predisposed to have eyelids that may not fully open without effort. This can be due to the structure of the eyelid or the strength of the muscles involved.

2. Aging: As we age, the skin loses elasticity, and the muscles may weaken, leading to drooping eyelids.

3. Previous Surgery: If you have had previous eyelid surgery (blepharoplasty), it may have altered the natural structure of your eyelids, potentially leading to the current issue.

Options for Treatment
1. Surgical Options: If you are unhappy with your current eyelid appearance and functionality, you may consider revisiting a qualified oculoplastic surgeon. They can evaluate your eyelids and determine if a revision surgery is appropriate. This could involve removing the current double eyelid sutures and addressing the underlying ptosis, potentially restoring your natural eyelid appearance.

2. Non-Surgical Options: In some cases, non-surgical treatments such as fillers or Botox may help to lift the eyelid temporarily, but these are not permanent solutions and do not address the underlying muscle issues.

3. Ptosis Repair: If ptosis is diagnosed, a surgical procedure to tighten the levator muscle may be recommended. This can help improve the eyelid's ability to open without effort.

Considerations Before Proceeding
- Consultation: It is crucial to have a thorough consultation with a board-certified ophthalmologist or oculoplastic surgeon who specializes in eyelid surgery. They can provide a comprehensive evaluation and discuss the risks and benefits of any proposed treatments.

- Expectations: Understand that while surgical options can significantly improve eyelid appearance and function, they may not always yield perfect results. Discuss your expectations with your surgeon to ensure they align with what is realistically achievable.

- Recovery: Be prepared for a recovery period following any surgical intervention. This may involve swelling, bruising, and temporary changes in vision.

Conclusion
In summary, your condition may indeed be related to eyelid ptosis, and there are options available to address both the aesthetic and functional aspects of your eyelids. Consulting with a qualified specialist will provide you with the best course of action tailored to your specific needs. Remember, the goal is not only to achieve a pleasing appearance but also to ensure that your eyelids function properly, allowing for comfortable vision and eye health.

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