Concerns with Sagging Lower Eyelid - 53

Sagging Lower Eyelid: How To Treat Your Concern

In some cases, the lower eyelids droop as a person ages and the skin around the eyes begins to sag. Sagging eyelid skin can cause an old and tired facial aesthetic, as well as impair the vision. However, droopy eyelids can be transformed into perkier and wider-awake looking lids with plastic surgery that removes excess skin and fat or tightens muscle to lift the area. Surgical procedures such as blepharoplasty ptosis surgery can be performed by a plastic surgeon to correct sagging eyelid problems.

The Skinny


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According to the Cleveland Clinic Hospital, age-related factors can be common causes of droopy eyelids. After all, skin tends to lose elasticity over time and eyelid muscles can weaken. Older individuals may develop wrinkles and bags near the eyes. The tear trough, which is the curved line that runs beneath the tear duct under the eye, can become more defined and obvious in appearance. The lower lid may puff out with fat tissue.

The lower lids can also appear to pull in a downward direction as time goes by. When the lower eyelids begin to droop and sag, it may merely represent a sign of aging, with the skin near the eyes weakening as people get older. However, it's important to get a thorough eye exam to determine the true underlying cause of the eye condition. Not all conditions that force the lower lids to sag, or affect other parts of the eye, are strictly age-related.

The Specifics

Eye Ectropion: Another Cause of Drooping Eyelids

Ectropion is a condition that features the eyelids turning outward. Since it generally causes both of the lower eyelids to turn outward more often than the upper lids, ectropion can make the lower lids look like they are sagging. That outward turning of the eyelids exposes the inner parts of the eyes and causes additional problems.

Ectropion might be a condition that an individual possessed at birth that accompanies other issues, such as Down syndrome. Or it could be one that was acquired over time. Scarring of the lower lid due to an eye infection, eye surgery side effects or eye injuries can also cause the condition.

Potential Causes of Ectropion

  • Developing an infection or corneal ulcer
  • Muscle weakness
  • Bell's palsy
  • Conditions or tumors that paralyze facial nerves, eyelid muscles, and cause facial paralysis
  • Previous surgeries - specifically prior eye surgeries
  • Facial skin cancer

Symptoms of Ectropion

  • Excessive eye dryness that causes irritation
  • The eyelid turns in an outward direction
  • Lower lids that lift away from the eyes
  • Excessive tearing
  • Light sensitivity
  • Blurred vision

To help treat the symptoms of ectropion, a patient might be prescribed moisturizing eye drops, artificial tears, steroid creams, or antibiotic ointments in the case of an eye infection. Although these stop-gap measures may provide a certain amount of relief, eyelid surgery is often necessary to fix the problem.

Treatments to Fix Drooping Lower Eyelids

According to the Mayo Clinic, if you are experiencing an issue with the appearance of your eyes, it is best to visit an ophthalmologist who specializes in oculoplastic eye surgeries for assistance. Such a specialist will be able to determine the best route to repair your eyelids, along with assessing the individual risk factors specific to your medical history via the health information provided.

The American Society of Plastic Surgery notes that a popular form of eyelid surgery - called blepharoplasty - helps improve problems with the upper and lower lids, including lower eyelids that droop so low or are turned outward so much that the white portion of the eye beneath the iris is revealed.

Blepharoplasty fixes droopy eyelids by excising any excess skin, potentially along with fatty tissues and muscle causing the lower eyelids to sag. The surgery can also help fix sagging upper eyelids that block a person's vision, such as in the case of congenital ptosis, whereby the upper eyelids are positioned lower than normal.

The eyelid surgery can be combined with other surgeries, like brow lifts and facelifts, or procedures that relocate fat from the eye socket into other locations.

Lower Eyelid Blepharoplasty with a Transconjunctival Approach This form of lower eyelid surgery features an internal lid incision that allows the plastic surgeon to excise extra fat and reposition it to help improve the appearance of dark circles and bags. However, it does not include the removal of excess skin although the fat movement helps address issues of sagging and stretched eyelids.

Lower Eyelid Blepharoplasty with a Transcutaneous Approach In this form of surgery on the lower lids, age-related concerns can be reversed with a surgical approach that features an external incision right below the eyelashes. The position of the incision allows for fat and excess skin to be removed and repositioned, while lower eyelid muscles are tightened. Doctors should not be too aggressive with this approach, because it can cause ectropion, which pulls the eyelids downwards when too much skin is removed.

Injectables & Fillers to Lift Droopy Eyelids Those folks who aren't ready to indulge in eye surgery to correct their sagging eyelids can choose from certain non-surgical options to try and lift their lids. Injections of neurotoxins, such as Botox® or Dysport®, help to smooth fine lines and wrinkles near the eyes. The relaxed muscular effect may provide a more wide-awake appearance.

Additionally, hyaluronic acid dermal fillers like Juvéderm® and Restylane® can bring volume to sagging crevices in the cheeks and near the lower lid region, filling out the hollow appearance below eye bags.

A combination of various dermal fillers and injectables may help provide an overall improvement of the eye area, although the effect may not be as dramatic as a surgical correction. Receiving injectables and dermal fillers is also a temporary process that requires follow-up treatments.

The Takeaway


Droopy lower eyelids can cause a host of problems, including dry eyes, infections, and an overall unwanted appearance. Whether the condition occurred as a result of age-related sagging skin and muscle weakness or was a condition that was present at birth, eye surgery can help reverse lids that sag too far downward.

Various forms of blepharoplasty surgery feature internal or external lid incisions, which allow for the removal of excess skin, muscle, or fat. Such surgical procedures can help address drooping lids, dark circles, or eye bags by repositioning fat, tissues, and other matter.

Meanwhile, dermal hyaluronic acid fillers and injectables containing botulinum toxins may also help improve certain eye area conditions — but not as dramatic nor as permanently as lower eyelid surgery.

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Source List


AEDIT uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

  1. Dailey RA, Wobig JL. Eyelid Anatomy PubMed; 1982-12-01
  2. Harry S Hwang The effect of "single" vs "double" eyelids on the perceived attractiveness of Chinese women; 2014-03-03
  3. Bhupendra C. Patel; Michael J. Lopez; Zachary P. Joos. Anatomy, Head and Neck, Eyelash; 2020-07-27


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