Heavy eyelids are more than just a reminder of a late night or an overly long meeting.
When we talk about ‘heavy eyelids’, we’re referring to the excess, loose skin of the upper eyelids, a condition medically referred to as ptosis or dermatochalasis. Ageing, while being a major contributor, shares the stage with other factors such as genetics and lifestyle choices to cause heavy eyelids.
Sydney Plastic Surgeon Dr Michael Kernohan is a highly experienced surgeon performing blepharoplasty and other facial surgery in Sydney’s Southwest Suburbs and the Southern Highlands NSW.
Like numerous health-related conditions, heavy eyelids don’t have a singular cause. Instead, they’re the outcome of several intertwined factors, each contributing its strand to the complex web.
Ageing stands as a prominent cause of heavy eyelids. As time marches forward, so do the effects on our body, particularly our skin. The skin’s elasticity decreases with age, leading to loose skin in certain areas. This is pretty obvious on the face, specifically around the eyes, where the skin is thinner and more delicate, making it more susceptible to the changes induced by ageing. The levator muscle, responsible for lifting the upper eyelid, can also weaken over time, leading to the condition known as ptosis or droopy eyelids.
Our genetic blueprint, the code that forms the basis of our physical characteristics, can also be a cause of heavy eyelids. Some individuals might inherit a predisposition to weaker eyelid muscles or faster skin ageing. These genetic traits can lead to an earlier onset of heavy eyelids or a more pronounced manifestation of the condition.
The first and most noticeable sign of heavy eyelids is a consistent feeling of fatigue or strain in your eyes, even after a good night’s sleep. Your eyelids may feel weighty, as if they’re being pulled down. This can be accompanied by an increased difficulty in keeping your eyes open, especially towards the end of the day.
Your eyes may not appear as open as they once did, making you look constantly tired or uninterested. This change may be more apparent when you compare current pictures with those from a few years ago.
Another common sign is the frequent need to raise your eyebrows to lift your eyelids or reduce the heaviness. This involuntary action might lead to the formation of forehead wrinkles, another hint that your eyelids are heavier than they used to be.
In some cases, these factors may start interfering with your vision, particularly your peripheral vision. You might find yourself tilting your head back to see more clearly, or you might struggle with tasks that require a wide field of vision, such as driving.
There could also be physical discomfort, such as eye irritation, or aching around the eyes. Some people also experience increased tearing or discomfort while wearing contact lenses.
Heavy eyelids, though seemingly a minor inconvenience, can cast a shadow over daily life, affecting you in ways that are more than just skin deep.
The most evident and significant impact of heavy eyelids is the potential hindrance to your vision. Excess skin can obscure your field of vision, particularly your peripheral sight. This can make daily tasks like reading, driving, or simply navigating your surroundings more challenging.
Heavy eyelids can alter your facial aesthetics, giving a tired or aged appearance.
There can also be physical discomfort associated with heavy eyelids. This can range from a persistent feeling of fatigue or strain in the eyes, to aching, irritation, or increased tearing. If you’re a contact lens wearer, the condition might make it uncomfortable to use them.
In an attempt to mitigate the effects of heavy eyelids, you might find yourself frequently raising your eyebrows to lift the eyelids, which can lead to forehead fatigue. You may also find yourself needing to adjust your head or eye position to see clearly, which over time, can result in neck strain or headaches.
Depending on the severity of your symptoms, heavy eyelids may necessitate changes in your lifestyle. You might need to limit activities that strain your eyes, such as prolonged screen use. In severe cases, activities that require a broad field of vision, like driving, might become risky.
From non-invasive lifestyle changes to surgical solutions, there are treatment options available for heavy eyelids. Here are some of them:
In the realm of non-surgical treatments for heavy eyelids, wrinkle and volumising treatments have emerged as a viable option. These procedures can help alleviate concerns, without the need to undergo surgedry.
The use of specific medical treatments involves administering a substance that affects the targeted muscles by reducing their activity. When applied to areas around the eyes, these treatments can address concerns such as heavy eyelids by helping to relax specific muscles. This approach may provide a subtle lift to the eyebrows.
Outcomes can vary, but many individuals find that the effects offer a refreshed appearance. The benefits are temporary and typically last for 3-6 months, with follow-up sessions needed to maintain the desired effects. Always consult a qualified healthcare professional for advice tailored to your individual needs.
Certain volumising treatments can provide a non-surgical approach to addressing concerns like lost volume in the upper eyelid area. These treatments can help add volume and support to areas around the brow and upper eyelid, which may reduce the appearance of heaviness.
The effects are temporary, typically lasting between 6 months and 2 years, depending on the specific treatment and individual factors. Periodic sessions are needed to maintain the desired outcomes. For significant concerns impacting vision, surgical options may be more appropriate. Always seek advice from a qualified healthcare provider to determine the most suitable approach for your needs.
When non-surgical options don’t provide the desired results, or when the heavy eyelids significantly impact your vision surgical interventions may be considered.
When it comes to a definitive solution for heavy eyelids, blepharoplasty is often the go-to surgical option. This procedure, also known as an “eyelid lift,” aims to give your refresh the appearance of the eyes by addressing the issues that cause heavy eyelids.
Blepharoplasty can be performed on the upper eyelids, lower eyelids, or both, depending on the patient’s needs. In the case of heavy eyelids, the focus is on the upper eyelids.
During an upper eyelid blepharoplasty, the plastic surgeon makes an incision along the natural crease line of the eyelid. This strategic placement ensures that the scar remains hidden and is not noticeable when the eyes are open. Through this incision, your plastic surgeon removes or repositions excess skin, muscle, and fat causing the heaviness. The incision is then closed with sutures, leaving the eyelids looking more open and refreshed.
The procedure can be performed under local anaesthesia or general anaesthesia, depending on the patient’s health and preference, as well as the complexity of the procedure.
Recovery from blepharoplasty takes a few weeks. Initially, there might be bruising and swelling, but these subside gradually.
The results of a blepharoplasty are long-lasting. While the procedure does not halt the ageing process, it effectively turns back the clock, and the eyelids will continue to age from this new point.
While blepharoplasty targets excess skin, muscle, and fat in the eyelids, ptosis repair focuses on a different aspect of the problem: a weakened levator muscle.
Ptosis is often due to a weakening or dysfunction of the levator muscle, the primary muscle responsible for lifting the upper eyelid. Ptosis repair is a surgical procedure designed to strengthen or reattach this muscle, effectively raising the eyelid to a higher position.
Your plastic surgeon will make a small incision in the natural crease of the eyelid, through which they will tighten or reattach the levator muscle. The exact technique used can vary depending on the severity of the ptosis and the strength of the levator muscle.
Ptosis repair can be performed under local anaesthesia or general anaesthesia. In many cases, the procedure can be performed as an outpatient surgery, allowing you to return home on the same day.
After surgery most patients are able to resume their regular activities within a week or two. Initially, there may be some swelling, bruising, or discomfort, which will subside over time.
While ageing and genetics – two significant contributors to heavy eyelids – are inevitable and unmodifiable, there are still several proactive steps you can take to prevent or slow the onset of heavy eyelids. Here are some key preventative measures: