One of the quickest and easiest ways to look more youthful

The appearance of your eyes reflects your feelings, your personality and your age. If your eyes are looking tired because they are drooping or there are dark circles under your eyes, then you could consider doing something about this to look more youthful and feel it again.

Upper eyelids can gradually droop as we age. The drooping is called ptosis or blepharoptosis. It has many contributory causes. The main one of which is gradual thinning of the very fine tissues of the upper eyelid. Particularly the part of the upper eyelid called the aponeurosis, which is the first bit of the levator muscle, which lifts the eyelid. There are also slight bony changes to our orbit and our soft tissues as we age, making our eyes slightly more sunken in looking and this can also contribute to an appearance of drooping upper eyelids.
As we get older we compensate for the drooping of our upper eyelids by raising our eyebrows very slightly. This stretches out the excess skin on the upper eyelids so there is only a very small fold so that the surface does not form a significant fold down on to the eyelashes and irritate them. By raising our eyebrows very slightly we tend to reveal a somewhat higher skin crease so there is more upper eyelid skin showing between the eyelashes and the skin crease. This is known either as superior tarsal show or more simply just as lid show. The more lid show you have the more you will look slightly sleepy and ptotic, particularly if the contour of the upper eyelid becomes a little flattened. Raised eyebrows is also an ageing giveaway.

You will realise already that I love to talk about the eyelid and when I am looking at somebody’s eyelids, I am looking at the whole periorbital area to ascertain the position and shape of the brow, the position and shape of the upper lid skin crease and how much fold of skin there is, the amount of upper eyelid skin show and also the shape of the upper eyelid.

The shape of the upper eyelid is usually described as an almond shape in that it has a narrower part out towards the ear or laterally and a more open portion towards the nose or medially, but the maximum point of opening is just very slightly more medial or towards the nose than the half way point. That gives it the almond shape.

I also look at the eyelashes. I am very interested in the eyelashes because they will tell me a lot about your eyelids. If your eyelashes point upwards and are all perky, lively and wide open-looking, this suggests you got an excellent tight firm upper lid without much slippage of the little layers of tissue. However, if your eyelashes are pointing forwards or even slightly downwards this indicates a ptosis and a drooping of at least part of the eyelid, which may just be the skin or may be more evidence of slippage of the superficial layers of the lid, the skin and muscle with even a little bit of protruding of fat pushing the eyelashes down.

I also look to see whether the eyelid skin is sitting on the eyelashes in certain positions of gaze because if it is then the eyelid skin would be desquamating its dead skin cells straight on to your eyelashes and the lash roots and this adds to irritation to your eyes and can give you watering eyes.

You can see that we are getting close to the border between what is cosmetic and what is medically the effect of drooping eyelids. As drooping eyelids get worse medical symptoms appear and the medical symptoms of drooping eyelids include interfering with your vision by reducing the visual field in the upper part of your vision causing headaches by you having to raise your eyebrows all the time to lift the skin up or lift the eyelids up. Irritation and subsequent watering by the eyelid skin sitting on the eyelashes and lastly watering from a wick effect if there is lateral hooding and the excess tears get caught in a little rivulet at the lateral canthus or the part of the eye towards the ear and run down the upper outer cheek.

The quickest and easiest way to look more youthful if you have drooping eyelids is to consider having them corrected surgically to revitalise them and rejuvenate the periorbital area. If the upper eyelids are drooping, either blepharoplasty or ptosis surgery or a combination of both will help. If your lower eyelids look tired, then this is a matter of considering filler with hyaluronate gel or even lower lid blepharoplasty for excess skin. To look more youthful you can reverse the eyelid changes of age by oculoplastic eyelid surgery under local anaesthetic as a day case at Clinica London.

Before considering such surgery, you must seek oculoplastic advice. This can be from myself or another oculoplastic surgeon and all the oculoplastic surgeons across the country can be tracked by looking at the British Oculoplastic Surgery Society website and then looking at the map of Great Britain and you will be able to find out the names of surgeons near to where you live and then find out more about whether they regularly do oculoplastic surgery, blepharoplasty and ptosis correction.

At Clinica London I see patients who want to look more youthful because they have drooping eyelids for a 30-minute consultation where I take the history, I examine your eyelids, we do photographic documentation, and I look at the surface of the eye. I then make you a plan for surgery, which we write a comprehensive report and I provide you with a quote. You then need to reflect on this in your own time and decide if you wish to go ahead from a position of knowing the advantages, disadvantages and risks of eyelid surgery.