The mechanism that opens the eyelids is called the levator of the upper eyelids. This delicate mechanism opens and closes the eyes several thousand times every day. When the eyes are unable to open fully or effectively, ptosis (latin: to fall) of the upper eyelids is said to be present.

In general, 2 groups of patients present with ptosis. Young patients with congenital ptosis and older patients with senile ptosis.

Congenital ptosis results from congenital deficiency of the muscle that opens the eyes, resulting in inability to fully open the eyes. It can be surgically corrected by tightening and shortening of the levator of the upper eyelid and this can be done with the same incision that would be used for double eyelid creation.