Many people who go to certain institutions for double eyelid surgery are told that they have mild to moderate ptosis and that they have to pay extra for corrective surgery for ptosis when they have double eyelid surgery. In fact, most people have pseudo ptosis and only need a double eyelid piggyback to get rid of the ptosis symptoms. Pseudo ptosis is not uncommon. There are many common causes of pseudo ptosis, and most of them can be solved together with double eyelid surgery: 1. Upper eyelid fat and skin bloating: Many young people with single eyelids have thick upper eyelids, fat and bloating, bubble eyes, and when they open their eyes, although the eyelid margin is raised normally, the skin on the upper eye surface still droops, and the folded skin is lower than the eyelid margin, pressing down on the eyelashes and forming pseudo ptosis. This makes the eyes look dull and lifeless, and in order to see clearly they will habitually wrinkle their foreheads, forming head lines and making people look older. With double eyelid surgery, the bloated fatty tissue is removed and the skin is allowed to fold up naturally, which solves the problem of pseudo ptosis and head wrinkles at the same time. 2. Upper lid skin laxity: Older people have upper lid skin laxity that covers part or all of the pupil and blocks vision, which can affect vision in severe cases. After lifting the drooping upper lid skin, the lid margin is seen to be in a normal position and the functional examination of the levator muscle is normal. In this case, the loose upper lid skin is removed through double eyelid surgery. 3. Loss of eyelid support: Lack of small eyeball support in the upper eyelid, sunken eyeballs, and atrophy of the eyeball can also cause loss of eyelid support, resulting in eyelid collapse and lower than normal lid margin position. Residents of both regions are born with sunken eye sockets, significantly sunken eyeballs, and naturally drooping upper eyelids, which can also result in pseudo-hyperthalmia, a condition that can also be corrected with double eyelid surgery. When it comes to said ptosis condition, it is best to visit a few more plastic surgery offices at regular institutions and let the experts help you get an idea. How can I tell the difference between real and fake ptosis? Ptosis is a condition in which the upper eyelid muscle and müller’s smooth muscle are incomplete or lost, resulting in partial or complete ptosis, with the upper eyelid margin covering the upper cornea by more than 2mm or even covering part to all of the pupil in natural flat vision. In people with congenital ptosis, this can lead to amblyopia: to overcome visual impairment, people with bilateral ptosis have a special posture of tilting their heads to see what is around them. Pseudopelvic ptosis is not a true ptosis, it is a drooping of the upper eyelid, but the strength of the levator muscle is still normal and the position of the upper lid margin is normal on medical examination.