Aging is more than just creases, wrinkles, and fine lines. Droopy eyelids, also known as ptosis, is one of the primary signs of aging.

You might not realize your eyelids are drooping at first because the aging process is gradual. Instead, you might notice your reflection looking a little older or feel that you appear more tired than usual, even if you are getting consistent shut-eye.

In this article, we will examine potential causes of droopy eyelids, some of the most popular surgical treatments to correct aging eyelids, as well as a brand new FDA-approved non-invasive eyelid lifting option that we now offer at The Lett Center, as a quick, simple and non-surgical solution for droopy lids!

What Causes Droopy Eyelids?

The medical name for droopy eyelids is blepharoptosis or ptosis. Even minor drooping can make you appear tired, and your eyes may look smaller than they actually are.

But beyond aesthetics, droopy eyelids can also interfere with the function of your eyes.

In fact, in some instances, many insurance companies consider droopy eyelids a medical condition and cover all or portions of eyelid surgery to correct the issue.

There are several potential causes for droopy eyelids.

  1. Weakening of the eyelid muscles, causing stretching of the eyelid
  2. Build-up of fat deposits in the upper eyelid
  3. Excess skin
  4. Nerve damage
  5. Loose skin near the eyelid
  6. Injury
  7. Aging
  8. Disease (stroke, styes, diabetes)

What About Contact Lenses? Do They Cause Droopy Eyelids?

We didn’t list this as a primary cause of drooping eyelids because the research on whether this is true is mixed.

A study from 2013 found that wearing hard contact lenses caused eyelid drooping (blepharoptosis). The study was performed at a hospital in Japan by comparing an age-matched control group with the targeted research group. Researchers observed that people who wore hard contact lenses were 20 times more likely to develop ptosis than the control group.

Other smaller studies have documented that people wearing contact lenses tend to develop drooping eyelids. However, the sample sizes of these studies may be too small to apply to general populations.

If you are concerned that contact lenses could be the cause of your drooping eyelids, you should consult with your eye doctor or one of our surgeons here at The Lett Center.

Which Doctor Should I Visit If My Eyelids Are Droopy?

You may start by going to your primary doctor or ophthalmologist for an initial diagnosis.
However, treatment for droopy eyelids typically requires surgery. Therefore your doctor may refer you to a local board-certified plastic surgeon in Nashville, Lebanon, or Mt. Juliet.

Here at The Lett Center, we have a qualified team of board-certified surgeons performing numerous eyelid surgeries yearly.

Let’s examine what eyelid surgery is and whether you should consider it. Or if Upneeq®, the FDA-non-invasive eye drop we now offer at The Lett Center, is a better fit for you.

What Is Eyelid Surgery?

Droopy eyelids rarely cause discomfort or other health issues, so surgery is often not required. Most desire eyelid surgery for cosmetic purposes or to fix visual impairments.

If you desire eyelid surgery to repair droopy eyelids, there are three primary types of eyelid surgery one might consider.

  • Ptosis Repair Surgery
  • Upper Blepharoplasty
  • Lower Blepharoplasty

There are different criteria for selecting one eyelid surgical technique over another. These should be discussed and considered during a consultation for eyelid surgery.

Ptosis Repair Surgery
Many patients who seek our help in making their eyelids look more rejuvenated actually have eyebrow ptosis but think their eyelids are the problem.

Ptosis repair surgery, sometimes referred to as an eyelid lift, involves repairing the lifting muscle of the upper eyelid resulting in an elevation of the height of the entire upper lid.
This is slightly different from an upper eyelid blepharoplasty, which we will discuss next.

Some patients can benefit from both procedures, which can be done together in the same surgery.


Most commonly, when someone says they are getting eyelid surgery, they are referring to having a blepharoplasty, which focuses on treating drooping upper eyelids and/or the appearance of loose bags and loose skin in the lower eyelid. The goal is to improve aesthetics or to improve your vision.

During this eyelid surgery, the surgeon removes excess skin around the upper eyelid, lower eyelid or both, tightens the eyelid muscles, and/or reduces or repositions excess fat deposits.

There are two types of blepharoplasty surgery…

  • Upper Eyelid Blepharoplasty: During this procedure, droopy excess skin and/or fat hanging over the lashes are removed, resulting in the illusion of eye-opening. Occasionally, a thin strip of muscle known as the “orbicularis oculi” is also removed.

    Removing fat and/or muscle eliminates extra bulk that weighs the eyelid down, causing you to look older or have a sleepy appearance. It can also relieve strain on a patient’s eyes. That is exactly why, in some cases, an upper eyelid blepharoplasty is deemed medically necessary and covered by insurance..

  • Lower Eyelid Blepharoplasty: This procedure is used to improve the appearance of undereye bags and loose skin in the lower eyelid. It is performed very similarly to an upper eyelid blepharoplasty in that excess fat deposits, skin, and muscle that might be adding to the appearance of dark circles, wrinkles, and/or puffiness are repositioned or removed. However, during a lower blepharoplasty, the skin can sometimes be tightened via laser resurfacing or TCA chemical peels instead of being removed.

Surgery for bags under your eyes usually involves going under anesthesia for a lower eyelid blepharoplasty for the surgical removal of extra fat and skin cells. However, a plastic surgeon may use techniques to only remove subdermal fat tissue if no skin needs to be removed, or vice versa.

Depending on the patient’s needs, your surgeon can use one of the following techniques to provide lower eyelid blepharoplasty surgical treatment for under-eye bags and loose skin in the lower eyelid.

  • Skin Excision
  • Fat Transfer
  • Fat Repositioning
  • Light-based Therapy
  • Dermal Fillers

Lower eyelid blepharoplasty is almost always cosmetic and thus rarely covered by insurance.

Why Do People Get a Blepharoplasty?

The appearance of droopy eyelid tiredness is one of the main reasons that people get eyelid surgery, as well as to look younger. Many patients also notice they look more alert after their procedure and recovery process.

For some, droopy eyelids impact vision and can interfere with everyday life. In these instances, blepharoplasty might be necessary to improve quality of life.

What Eyelid Surgery Will Get Rid of Bags Under the Eyes?

Droopy bottom eyelids also add years to your appearance. As described above, lower blepharoplasty surgery is how we remove bags under your eyes.

However, lower blepharoplasty is actually a combination of several surgical techniques to treat sagging bottom eyelids.


Will Eyelid Surgery Make You Look Younger?

The short answer is yes! Sagging eyelids add years to your appearance, even if you don’t have that many lines or wrinkles.

What Are The Risks of Eyelid Surgery?

As with any surgical procedure, there are risks of complications associated with eyelid surgery.

  • Infection
  • Scarring
  • Eyelid Muscle Damage
  • Skin Discoloration
  • Temporary Loss of Eyesight
  • Abnormal Eyelid Folding
  • Problems Closing the Eyes

When you meet with your doctor or surgeon, you will have a thorough health history review to ensure that your risks are minimized. Your doctor can also help you figure out if blepharoplasty surgery is right for you based on your current health and other factors.

Your surgeon will also help you establish realistic expectations for the results of your surgery. We want patients to understand that it often takes months or even up to a year after their procedure before they notice the full effect of their results.

We want you to be happy with your appearance. Even if you don’t see your younger and more alert face after eyelid surgery, in time, the operated area will heal, and you will see your results.

Potential Side Effects of Blepharoplasty

During recovery from eyelid surgery, you may experience one or more of the following side effects:

  • Dry Eyes
  • Bleeding
  • Swelling
  • Discomfort
  • Watery Eyes
  • Itchy Eyes
  • Blurred Vision
  • Double Vision

Side effects are typically at their worst during the first few days after surgery but will fade within the next few weeks.

How Long Does it Take To Recover From Blepharoplasty Eyelid Surgery?

Every patient is different, but you can generally return to work about 10 days after your procedure. You will most likely see bruising and swelling around your eyelids for the first few days after your surgery.

The bruising should go away after about 3 days. The swelling will be the worst during the first 10 days, but after that, it should be much less noticeable.

To aid your recovery, you may:

  • Apply cold compresses to your face to reduce swelling.
  • Avoid or stop smoking or drinking alcohol.
  • Don’t rub your eyes.
  • Don’t participate in strenuous exercise for about a week.
  • Regularly clean your eyelids using prescribed eye drops.
  • Consider wearing dark sunglasses to protect the skin around your eyes.
  • Elevate your head to an angle above your chest when you sleep.
  • If you need to take something to help you manage post surgery pain, you can take acetaminophen.
  • Don’t take pain relievers like ibuprofen, aspirin, naproxen sodium, or naproxen, as they increase your risk of bleeding. You should also avoid any other supplements that might increase your risk of bleeding. When you meet with your doctor, they can guide you on which medications to avoid and when you can start taking them again.

If you notice any of these warning signs, you should seek medical attention immediately.

  • Severe eye pain
  • Bleeding
  • Problems seeing
  • Irregular heartbeat
  • Trouble breathing

Why Women Choose Blepharoplasty

As much as you may find yourself obsessing over laugh lines and other creases, the truth is that many physical factors contribute to an aged appearance. And one such factor is drooping eyelids.

Puffiness and sagging around the eyes are all-too-common concerns for women as they age. In fact, such seemingly ageless starlets as Jane Seymour have openly expressed their frustration about their aging eyelids and the steps they’ve taken to address it.

Eyelid surgery has also helped other stars and personalities advance their careers. For another star, Julie Chen, eye surgery was a career choice that helped her in her mid-twenties to overcome the racism she faced as an Asian reporter. Since talking about her surgery, she has become vocal about why she decided to get surgery at the young age of 25 and what young women should consider before getting surgery.

And as mentioned above, blepharoplasty is also something both men and women consider when droopy eyelids affect their vision.

Is Surgery The Only Option for Drooping Eyelids?

For many years, surgery was the only option for those suffering from drooping eyelids; not anymore!

There is a first-of-its-kind non-surgical treatment for patients with minor eyelid drooping, those not ready for eyelid surgery, or those who are suffering from low-lying eyelids due to BOTOX® injections.

It’s called Upneeq® – a prescription eye drop that temporarily improves droopy eyelids with a single daily dose.

How Does Upneeq® Work?

Upneeq contains oxymetazoline, an alpha-adrenergic agonist, that stimulates an involuntary eyelid muscle (the Muller’s muscle) to contract and raise the upper eyelid.

This ingredient might sound familiar, as it is the same primary ingredient in decongestant nasal sprays, such as Afrin®. In nasal spray, the ingredient works by stimulating the blood vessels to contract. In Upneeq, oxymetazoline works to stimulate eyelid muscle contraction.

In clinical studies, the average amount of upper eyelid lift was 1 mm. That doesn’t sound like much, but patients that use Upneeq say they notice a substantial difference.

Upneeq can safely be used once daily for a daily effect, or you can use it for only special occasions.

 How does Upneeq compare to eyelid lift surgery?

Upneeq will not give you the same dramatic, long-lasting results possible with surgery. Upneeq also can’t help correct loose lower eyelid skin or under-eye bags.

That said, Upneeq is an excellent alternative to surgery for those not prepared to have a surgical eyelid lift.

The minor lift Upneeq provides is cosmetically and/or medically beneficial for many patients that don’t want to undergo surgery.

Is Upneeq Permanent?

Upneeq is not permanent. Clinical studies show each dose of one drop per eye is effective for at least 6 hours. Upneeq should only be used as prescribed, which is one dose, once daily, so you would want to time out your dosage for when you most want to see the desired effect – such as the beginning of a workday or just before applying makeup for a special event.

Does Upneeq Have Any Negative Side Effects?

As with any prescription or non-prescription medication, there are potential risks. That said, most of our patients have no side effects when Upneeq is used as prescribed.

Clinical trials report the following side effects in about 1-5% of patients:

  • Redness
  • Dry eye
  • Blurred vision
  • Headache
  • Inflammation of the cornea
  • Eye inflammation or irritation
  • Eye pain around the time that the drops are used
  • Redness in the lining inside and at the front of the eye


Final Thoughts on Drooping Eyelids and the Corrective Options Available at The Lett Center

If your eyelid drooping isn’t severe or you want a non-surgical solution that can help the appearance of drooping eyelids, Upneeq® is certainly worth considering.

However, if you want a more dramatic and long-term solution for your drooping eyelids or a solution to under-eye bags, eyelid surgery might be a better option.

Both options can remove years from your appearance. If you are uncertain which best fits your unique needs, you can book a consultation at The Lett Center in Lebanon or Mt. Juliet, TN.

Dr. Lett and his attentive staff will help you understand everything you need to know about eyelid surgery and what your results will look like or help you decide if Upneeq® is a better fit.

In addition to eyelid surgery and Upneeq®, we also offer chemical peels, Botox injections, and more to alleviate some of the most frustrating signs of aging.

Contact us today to discuss your options.