There is a muscle in the eye called the levator muscle, and ptosis is an eye deformity in which the lack of power in the levator muscle prevents the upper eyelid from being lifted. What happens if I have ptosis without a levator and only have an eyelid cut? Eyelid surgery removes excess skin and fatty tissue, but without correcting the levator muscle, the ptosis cannot be improved. The levator muscle is responsible for the “eye opening action” and when this muscle is lacking in power, the eyelids cannot be lifted. As we all know, the key to beautiful eyes is whether or not the black eye is fully exposed, not whether the eyelid is double or not, and as long as the eyes are big, single eyelids can be just as attractive. A big, beautiful eye is not necessarily a matter of a heavy eyelid line. The key to eye beauty is God. If you only do double eyelids without a lift, the beauty of your eyes will be greatly diminished, just like a person who is always awake. Eyes that have both double eyelids and a corrected ptosis will look and feel radiant. What about ptosis? The choice of surgical procedure for ptosis is not determined clinically by the width of the affected lid fissure, but by examining the amplitude of movement of the affected upper lid levator and understanding the function of the upper lid levator. When the upper lid movement is 8mm or more, the function of the levator muscle is good and the levator tendon should be folded; when the upper lid movement is 5-7mm, the function of the levator muscle is fair and the levator tendon can be shortened and migrated forward; when the upper lid movement is 4mm or less, the function of the levator muscle is poor and other muscle-based upper lid lifts should be used. If the upper eyelid movement is 4mm or less, the upper eyelid lift is poorly functioning and other muscles should be used to lift the upper eyelid, such as autologous tendon suspension or forked frontalis tendon suspension. Some patients ask: Is it okay to have double eyelid surgery first and then have an upper eyelid lift later? If you only have eyelid surgery for the first time and then have an upper eyelid lift for the second time, it is equivalent to having a blepharoplasty. Revision surgery is much more difficult, time-consuming, and expensive than the initial surgery. Whether it is an eye or nose job, the initial surgery is definitely better. Moreover, by doing both eyelid surgery and upper eyelid lift together, one surgery solves both problems and the recovery time is saved later.