Ptosis Repair (Droopy Eyelid Surgery) in San Diego, CA
Many patients come in asking about “eyelid surgery” when what they actually have is ptosis — and the distinction matters, because the two conditions look similar but are caused by completely different anatomy.
What ptosis actually is
Blepharoplasty addresses excess skin. Ptosis is different: it’s a weakening or stretching of the levator muscle and tendon responsible for holding the eyelid open. When that muscle weakens, the eyelid margin itself — not just the skin above it — droops lower than it should, sometimes low enough to cover part of the pupil.
Ptosis can be present from birth, develop gradually with age, or result from prior eye surgery, contact lens wear, trauma, or certain neurological conditions.
Why the distinction matters for treatment
Because Dr. McCoy trained as an ophthalmologist before subspecializing in oculofacial surgery, diagnosing which condition you actually have — excess skin, a weak eyelid muscle, or both — is a core part of what she does. Treating skin when the real problem is the muscle won’t fix the underlying issue.
What the procedure involves
Ptosis repair works by tightening or reattaching the levator muscle and tendon to restore normal eyelid height and function. The surgery is usually done from the inside surface of the upper eyelid, leaving no visible scar. When the eyelid drooping is more severe, surgery is done through an external incision that is hidden in the eyelid crease and is virtually invisible after it heals. The type of ptosis surgery that is best for you — internal or external approach — is determined based on testing that Dr. McCoy does during your consultation. Like upper blepharoplasty, this can be performed in-office under local anesthesia, or at an ambulatory surgical center with conscious sedation.
“My practice philosophy is all about choice. It’s about empowering and educating people, providing a full suite of options that goes beyond surgery and focuses on their total health.”
~Dr. Allison McCoy
Recovery
Similar to blepharoplasty: bruising and swelling in the first one to two weeks, with most patients returning to normal activities within a week to ten days.
Am I a candidate?
If one or both eyelids sit noticeably lower than they used to, if you find yourself raising your eyebrows to see clearly, or if eyelid surgery elsewhere didn’t fully resolve the look or the vision impact, ptosis may be the underlying cause.
“My favorite thing about my work is the privilege of being trusted with a patient’s vulnerable side.”
~Dr. Allison McCoy
Frequently Asked Questions
What’s the difference between ptosis and just having “hooded eyes”?
Hooded eyes usually describes excess upper eyelid skin — treated with blepharoplasty. Ptosis is the eyelid margin itself sitting too low, caused by a weak muscle. Many patients have some degree of both.
Is ptosis repair covered by insurance?
Often, yes, when it’s demonstrably affecting vision — documented through eyelid measurements and a visual field test.
Can ptosis come back after surgery?
The levator tendon can stretch again over time, particularly with continued contact lens use, but results are durable for most patients for many years.