Eyelid ptosis or droopy eyelids as is commonly known, is an acquired condition in most cases associate to aging and tissue laxity in the muscle attachments that is responsible for lifting the eyelid itself. Other more serious causes most be ruled out during your consultation. If it is acquired, bilateral, and has progressed gradually it is most likely senile ptosis and no further testing is required. When the problem is unilateral, then a more thorough evaluation is required.
A droopy eyelid is a very different problem than just having a little extra skin in the upper eyelid. Interestingly enough, patients with either problem will complain of the same thing, I “Doctor, look tired all the time”. It is very important to identify and differentiate a droopy eyelid from excess upper eyelid skin as the surgical approach is different. In many case, both problems exist. If a patient with droopy eyelids is treated with a conventional blepharoplasty he or she will be unhappy with the results as he or she would still have a tired-looking appearance.
Cases like this require advanced techniques that I have learned during my oculoplastic fellowship and that I routinely use in my practice to be able to help patients with more complicated eyelids and periorbital problems.