This is an eye deformity caused by an abnormality of the upper eyelid levator system. Simply put, it is a condition in which the muscles that lift the upper eyelid are not functioning properly or are lost, resulting in a partial or total drooping of the upper eyelid, giving the appearance of listlessness and lack of energy. Medically, this is called “ptosis” and is a disease state. Double eyelid surgery does not solve this problem, but requires treatment of the muscles that lift the eyelids. There are two types of ptosis: congenital and acquired. Those that are present at birth are congenital, while those that are caused by trauma, tumor removal, etc. are acquired. Most are congenital and are mainly due to problems with the neuromuscular system. Mild ptosis is just the appearance as if the eyes are not wide open, and the drooping eyelids only affect the appearance, not the vision. In severe cases, the pupil and cornea are completely covered, which can cause amblyopia and cervical problems. It is important to have a medical professional diagnose and treat ptosis, which is a complex surgery with a long recovery time and accompanied by greater risks. If an inexperienced surgeon just follows the normal double eyelid approach, not only will it fail to form a double eyelid and leave only superficial scarring, it may even aggravate the ptosis.