Eyelid Droop Surgery (Ptosis Correction)
Droopy eyelid (ptosis repair)
Ptosis, or droopy eyelid, occurs when the upper eyelid falls lower than normal, potentially impairing vision. It can affect one or both eyes and may be congenital (present at birth) or acquired later in life. The causes and severity of ptosis determine the appropriate treatment.Causes of Ptosis
Congenital Ptosis: Caused by the improper development of the levator muscle.Acquired Ptosis
- Age-related: Weakening of the levator muscle due to aging.
- Neurogenic Ptosis: Caused by nerve damage or neurological conditions.
- Myogenic Ptosis: Due to muscle diseases like myasthenia gravis.
- Mechanical Ptosis: Caused by eyelid tumors or scarring.
- Traumatic Ptosis: Occurs after injury to the eyelid.
Symptoms of Ptosis
- Drooping of the upper eyelid.
- Visual obstruction or difficulty keeping the eye open.
- Eye strain, tearing, or dry eyes.
Treatment Options for Ptosis
Surgical treatment is often necessary for ptosis, particularly when it impairs vision. The choice of surgery depends on the severity and cause of ptosis.Surgical Treatments
- Levator Muscle Resection: Shortens the levator muscle to lift the eyelid.
- Recovery: Mild swelling or bruising with full recovery in a few weeks.
- Müller’s Muscle-Conjunctival Resection (MMCR): Tightens the Müller’s muscle for mild to moderate ptosis.
- Recovery: Shorter recovery time with improvement seen within days.
- Frontalis Sling Procedure: Connects the eyelid to the forehead muscle, used in cases of weak levator muscles.
- Recovery: Longer adjustment period but effective for severe cases.
Ptosis Crutch
A non-surgical option using a crutch in glasses to hold up the eyelid, suitable for mild or temporary ptosis.Reconstructive Considerations
Post-surgical reconstruction ensures eyelid function and aesthetic appearance, involving techniques such as eyelid contouring, creating an eyelid fold, or performing canthoplasty to ensure alignment and support.Postoperative Care and Recovery
Swelling and Bruising: Common but typically subsides in 1-2 weeks. Ice packs and head elevation help reduce swelling.
Eye Care
Patients should avoid rubbing the eyes and use prescribed medications to aid healing.- Follow-up Visits: Regular follow-ups to assess healing and make necessary adjustments.
- Vision Improvement: Visual improvements are often immediate, but full results take a few weeks.
- Complications: Rare but may include under correction, overcorrection, infection, or scarring. Revision surgery may be needed in some cases.
Prevention and Long-term Care
- Eye Protection: Use protective eyewear to prevent trauma-related ptosis.
- Early Detection: Regular eye exams can catch ptosis early, preventing complications.
- Underlying Conditions: Managing health conditions like diabetes can reduce the risk of neurogenic ptosis.
Conclusion
Ptosis repair is an effective treatment that improves vision and restores the natural appearance of the eyelids. Surgical options, from levator resection to frontalis sling, are tailored to each patient’s condition, ensuring optimal results. Consultation with an experienced oculoplastic surgeon is essential for proper diagnosis and treatment.Gallery
Pre and 6 weeks post bilateral upper blepharoplasty, ptosis repair and browpexy (GENTLE BROWLIFT)
Conservative blepharoplasty and ptosis repair in a dry eye patient. She had no exacerbated symptoms post-operatively and greatly improved visual quality and cosmesis.
One week post-operative outcome of a patient who underwent a blepharoplasty and ptosis repair. The patient reported improved social interaction and work associations as her “tired-appearance” resolved.
The upper lids should be a few millimetres above the black part of the eye. This patient had improved vision after her blepharoplasty and ptosis repairs.
Swelling and bruising from lid surgery settles mostly after the first week or two after surgery, as seen in this photo.
Upper sulcus hollowing greatly amplifies the aged, tired appearance, and will be worsened by performing a blepharoplasty. This patient received a combination technique which gives a marked improvement one week after surgery, not only in lid height but also in volume which rejuvenated her natural features.