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Dr. Eftekhari operating

Shoulder stretches can help you avoid rotator cuff surgery. Physical therapy may get you out of back surgery. So what about eyelids? Can eyelid exercises fix that puffiness and sagging above the eyes?

Let’s clear up some common misconceptions.

It’s tempting to think that you can improve your wrinkles around your eyes or sagging droopy eyelids by exercising the muscles around them. That would be the best outcome, right? No plastic surgery and no cost to you.

But let’s try to talk through the anatomy to really clarify if eyelid exercises would work.

Facial aging happens because of three main factors: gravity, sun damage, and dynamic movements. Let’s break this down. Gravity is the inescapable law of physics. The more time we spend on this earth, the more things want to sag. In fact, facial aging due to gravity occurs in a characteristic pattern. A famous plastic surgery textbook accurately came up with the concept of “Facial Thirds,” which describes characteristic ways that we age over time. In one of his over 30 publications, Dr. Eftekhari described this process of forehead aging that you can see in the illustrations below:
Facial thirds
In the idealized, youthful face, you can divide it into perfect thirds from the hairline to the chin. As gravity takes its toll on the face, the forehead skin stretches, gets wrinkles and lengthens relative to the rest of the face. This takes the facial contours out of balance and puts downward pressure on top of the eyelids. That is why some folks get hooding of their eyelids where – if you look carefully – it is actually the eyebrows sagging down on top of the eyelids (see an example below).
Facial thirds in profile
There are also two muscles that open the upper eyelids – Muller’s muscle and the levator palpebrae superioris. These muscles are fine, delicate structures that, if we rub our eyes too much, we can actually stretch their tendons and make the sagging eyelids worse. So if you think eyelid exercises to massage the eyelids will help, they might actually not!
male patient before brow ptosis sagging eyelids
Gravity is the most important contributor to this effect of a sagging forehead, but sun damage also plays a role. Especially in Utah at high-altitude, we get a lot of sun! That causes our skin to stretch and thin and sag more easily.

Now, back to our original question: if I “exercise” my eyelids by opening and shutting them repeatedly, will that fix the sagging? Unfortunately (drumroll please) … NO! Actually, it might have the opposite effect. When we open and close our eyes or raise and lower our forehead muscles (think: making a surprised or sad face), this can actually cause the skin to stretch more. The more stretch, the more sag.

If you didn’t know otherwise, you would think that the patient in the picture above is angry, sad, or serious. In fact, he is the opposite when you meet him in person! But his eyes tell a different story. When we talk to patients during consultations at the Eyelid Center of Utah, we discuss our “natural” approach to restoring a more youthful you. You can see below in a picture taken just two weeks after upper eyelid, brow lift, and lower eyelid surgery, we have restored a younger looking appearance without creating something unnatural or “overdone.”

Dr. Kian Eftekhari is an eyelid plastic surgeon who is board-certified and a member of the American Society of Ophthalmic Plastic and Reconstructive Surgery. To schedule an in-person or telemedicine consultation at the Eyelid Center of Utah, click the appointment button on our home page or call us at 801-685-3398.
male patient after brow ptosis sagging eyelids

Posted on behalf of Eyelid Center of Utah

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Eyelid Center of Utah

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Salt Lake City UT 84102


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Draper UT 84020

Heber City

1716 North Highway 40, Suite 100
Heber City UT 84032