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“I have trouble opening my eyes in the evening,” “The width of my double eyelids looks different on each side in photos”—when I see concerns like these, the first thing I want to check is whether you have ptosis. There are so many places to consult in Tokyo and Ginza that it’s easy to feel unsure about where to go, who to ask, and what to ask.

 

While using hyaluronic acid to plump up the upper eyelids and the area around the eyebrows can improve the overall balance of your appearance, it does not directly treat the underlying ptosis (weakness of the muscles that lift the eyelids) itself.

 

We believe in offering patients a step-by-step range of options—from non-surgical treatments to surgery—as needed, including the use of Botox and collaboration with cosmetic surgery, cosmetic dermatology, and cosmetic medicine specialists. This is the philosophy we value in the Ginza area of Tokyo.

 

In some cases, a hollow area above the eye can prevent the eye from opening fully. In such cases, adding volume with hyaluronic acid may help improve the eye’s opening. Additionally, in some cases, a “piling” injection technique—which provides support to the orbicularis oculi muscle—can help alleviate a heavy feeling around the eyes.

 

Results, pain levels, downtime, duration of effects, and risks vary from person to person. Therefore, during your first visit, we’ll conduct a thorough assessment and work with you to determine “the right first step for you right now,” taking into account your daily life and work schedule.

What You Need to Know First: How to Recognize Ptosis and Tips for Diagnosis

While ptosis often refers to a condition in which “the muscles and aponeurosis responsible for lifting the eyelid are weak, making it difficult for the eyelid to lift high enough to reveal the iris,” there are also pseudo-ptosis conditions in which the eyelid merely “appears heavy” due to volume loss (weight loss), a lowered brow position, or sagging skin.

 

At cosmetic surgery, cosmetic dermatology, and cosmetic internal medicine clinics in Ginza, Tokyo, we carefully evaluate not only your appearance but also your visual function, everyday vision, and feelings of fatigue.

 

Rather than focusing solely on the "before and after" changes shown in photos and videos, we also take into account differences between morning and night, as well as the effects of makeup and contact lenses, to ensure more accurate treatment decisions.

What You Can and Cannot Expect from Hyaluronic Acid

When hyaluronic acid is used to treat hollows in the upper eyelids or a lack of volume beneath the eyebrows, it can soften shadows and make the eye area appear brighter. There is also an injection technique that involves injecting the substance into the ligamentous area like a peg to support the orbicularis oculi muscle, which can help alleviate a heavy, droopy appearance.

 

This approach involves creating "support" to restore balance and can sometimes be effective for mild pseudoptosis. However, it is not a treatment that directly improves obvious ptosis itself (muscle weakness).

 

In clinical practice in Ginza, Tokyo, it is common to start with a small dose and adjust it gradually, after thoroughly explaining that an excessive dose can increase the weight of the eyelids—which may actually make them feel harder to open—as well as potential risks such as edema, a bluish tint (a change in appearance caused by light passing through the superficial layers), asymmetry, and vascular complications.

Is Botox Effective? Considerations for Combination Therapy

Botox is an injection that gently relaxes muscle movement; when used between the eyebrows or at the outer corners of the eyes, it can slightly adjust the position of the eyebrows, and as a result, some people find it easier to open their eyes.

 

Especially for mild cases of pseudo-drooping, cosmetic surgery and dermatology clinics in Tokyo and Ginza are increasingly offering treatments designed to achieve a subtle, refined transformation through a combination of Botox and hyaluronic acid.

 

However, it is crucial to design the procedure in a way that does not weaken the function of the muscles that lift the eyelids, and fine-tuning to accommodate individual differences is essential. We will work in collaboration with our cosmetic internal medicine department to ensure overall patient care, taking into account factors such as the patient’s physical condition and any medications they are currently taking to ensure safety.

Reducing Uncertainty Through Collaboration Among Cosmetic Surgery, Cosmetic Dermatology, and Cosmetic Internal Medicine

Even when people describe the same symptom—"heavy-feeling eyes"—the best course of treatment varies from person to person. In Ginza, Tokyo, cosmetic surgery, cosmetic dermatology, and cosmetic internal medicine clinics work together to provide a comprehensive roadmap that covers everything from non-surgical injections and Botox to treatments for sagging skin and surgical options.

 

Is hyaluronic acid enough, should we add Botox, or should we consider surgical options such as a levator advancement procedure at a cosmetic surgery clinic? We’ll work with you to explore these options based on your lifestyle and desired downtime.

Decision-making criterion: Which option is most likely to lead to satisfaction?

• Symptom Type: Pseudoptosis or Obvious Ptosis (Prioritize diagnosis)

• Tolerance for downtime: Do you want to get it done over just the weekend, or are you aiming for a long-term solution during a vacation?

• Estimated duration: Adjustments lasting a few months to about a year (such as hyaluronic acid or Botox) or more long-term changes (such as cosmetic surgery)

• A Focus on Texture: Plumpness or Sharpness?

• Overall Body Balance: Weight Fluctuations, Sleep, Posture, etc. (Adjusted from a Cosmetic Internal Medicine Perspective)

Common Concerns at Cosmetic Surgery Clinics and Points Where Misunderstandings Often Arise

At cosmetic surgery clinics, some people are influenced by “before and after” photos on social media and believe that “if I get the same hyaluronic acid injections, I’ll look the same.” However, everyone’s bone structure, skin thickness, and muscle tone are different.

 

By combining the perspectives of cosmetic surgery and cosmetic dermatology, and taking into account individual differences in how Botox works and the absorption process of hyaluronic acid, simulating how your appearance will change over time can help minimize any regrets.

Talk about risks and downtime honestly, without making it sound too scary

Hyaluronic acid and Botox treatments may cause redness, swelling, or bruising at the injection site, as well as rare vascular complications or asymmetry. Cosmetic surgery procedures may result in swelling or puffiness, effects from anesthesia, and may require time for the incision to heal.

 

There is significant individual variation in these factors, so it’s impossible to make generalizations. That is precisely why we ask about your current physical condition, medical history, medications, and daily routine, and work in collaboration with our cosmetic dermatology and cosmetic medicine departments to determine a safe range for treatment.

Treatment Process (From Initial Consultation to Follow-Up) and How to Interpret "Before & After" Photos

During your first visit, we’ll carefully ask not only about your appearance but also about any symptoms you’re experiencing—such as eye strain or headaches—as well as differences between morning and evening, and how the lenses work with your makeup.

 

At our various locations in Ginza, Tokyo, specialists in cosmetic surgery, cosmetic dermatology, and cosmetic medicine will evaluate patients on the same day or in rotation, as needed. We will work with you to determine whether to prioritize gradual adjustments using hyaluronic acid or Botox, or to proceed to a surgical consultation at an early stage.

 

After the treatment, we don’t just focus on the “Before & After” photos as the final goal; we also assess how you look in the mirror, how you appear at work, and the natural reactions of those around you, making fine adjustments as needed.

Fees and Estimated Frequency of Visits (General Guidelines)

Prices vary depending on the clinic and the type of treatment. At cosmetic surgery, cosmetic dermatology, and cosmetic internal medicine clinics in the Ginza area of Tokyo, treatments such as hyaluronic acid and Botox are typically administered “in small amounts and in stages,” and treatment plans are often designed with the expectation of fine-tuning from the first session through the first month.

 

When choosing a cosmetic surgery procedure, we’ll suggest a schedule that allows for plenty of flexibility, taking into account downtime, the number of follow-up visits, and any necessary adjustments to your work schedule.

How to Choose Between Botox, Hyaluronic Acid, and Surgery (A Simple Guide)

• Hyaluronic Acid: For those who want to soften shadows and hollows by adjusting volume in the upper eyelids or under the eyebrows. Available in small amounts at cosmetic dermatology and plastic surgery clinics in Ginza, Tokyo.

• Botox: For those who want to balance the muscles between the eyebrows and at the corners of the eyes to help lift the eyes and soften expression lines. The extent of improvement varies from person to person.

• Surgery (Cosmetic Surgery): For patients whose primary concerns are noticeable ptosis or sagging skin, and who are seeking long-term, fundamental improvement. We also provide comprehensive whole-body and skin care in collaboration with our cosmetic medicine and cosmetic dermatology departments.

Frequently Asked Questions (FAQ)

Can ptosis be treated with hyaluronic acid alone?

Hyaluronic acid is a treatment used to provide “support” and improve depressions; it does not directly treat ptosis itself (a problem with muscle function). At our cosmetic surgery clinic in Ginza, Tokyo, we will evaluate your condition, including whether surgery is appropriate, and—if necessary—use Botox in combination to correct the issue in stages.

Is there a risk that Botox will make it difficult to open my eyes?

Depending on the treatment plan, that concern is a possibility. At our cosmetic dermatology and plastic surgery clinic in Ginza, Tokyo, we start with a small amount and adjust the treatment based on how it works for you. Since there is significant individual variation, we take a cautious approach to treatment planning.

Can I attend even if I'm busy with work?

Hyaluronic acid and Botox treatments can often be completed in a relatively short amount of time, and in Ginza, Tokyo, appointments are available on weekday evenings and on weekends. For surgical procedures (cosmetic surgery), we’ll work with you to plan your time off.

Can this procedure be performed at the same time as liposuction or breast augmentation?

While this is possible, our team in Tokyo will coordinate the schedule to ensure that the recovery periods for liposuction and breast augmentation do not overlap with the timing of the eye area procedure. We will also provide support through our cosmetic internal medicine and cosmetic dermatology departments.

Do you take "before and after" photos?

Yes. It’s useful for objectively tracking progress. However, the “before and after” appearance isn’t everything; we also place importance on how easily you tire and how you’re perceived at work.

About Consultations in Ginza, Tokyo

In Ginza, Tokyo, we have established a collaborative environment where cosmetic surgery, cosmetic dermatology, and cosmetic internal medicine work together. From minor adjustments using Botox or hyaluronic acid to surgery for ptosis, and even plans for liposuction or breast augmentation upon request, we offer personalized treatment plans that fit seamlessly into your daily routine.

 

We won’t pressure you into making a reservation. Even if you’re just at the stage of wondering, “Is this right for me?” please feel free to contact us.

Summary: Hyaluronic acid has the “power to restore balance”; patient satisfaction depends on diagnosis and collaboration.

Hyaluronic acid treatment for ptosis is not a cure but rather a means of “supporting and correcting” the condition. While it is well-suited for mild cases of pseudoptosis, cosmetic surgery may be necessary for cases involving obvious muscle weakness.

 

Based on our experience in Ginza, Tokyo, we’ve found that when cosmetic dermatology, cosmetic surgery, and cosmetic internal medicine work together to carefully evaluate each step—including the role of Botox—the results tend to look more natural and leave patients more satisfied. If you’re unsure, start with a consultation. Let’s work together to find the best path forward for you.

 

In some cases, a hollow area above the eye can prevent the eye from opening fully. In such cases, adding volume with hyaluronic acid may help improve the eye’s opening. Additionally, in some cases, a “piling” injection technique—which provides support to the orbicularis oculi muscle—can help alleviate a heavy feeling around the eyes. Please feel free to consult with us.

 

▷ Eyelid Ptosis: Incision Method and MT Method Treatment Page

▷ Counseling Appointment Page