Ptosis Repair

Introduction

Drooping eyelids are frequently attributed to the natural aging process. The perception of heavy upper eyelids as an age-related problem may create a misperception that blepharoplasty, or even injectable treatment, may resolve the cosmetic and functional concerns that are present.
 
A drooping eyelid may be more significant than lax skin. In some cases, the eyelid appears heavy because of a condition called ptosis. It is important to differentiate this condition from aging in order to ensure a satisfactory outcome from treatment. As a specialized oculoplastic surgeon, Dr. Raymond Douglas can easily determine if your eyelid drooping is due to ptosis and recommend the proper treatment. Our motto is “Be You Again” and ptosis repair surgery can lift and elevate your sagging lids to rejuvenate your appearance.

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What is Ptosis?

Ptosis is a condition in which the ability to lift one or both upper eyelids is diminished. In addition to preventing complete eyelid opening, ptosis may also cause symptoms such as eye strain and fatigue or discomfort across the brow line or forehead. These symptoms may be worse when reading or performing up-close tasks during which increased effort is made to raise the eyelids.

A sagging eyelid or eyelids often decreases the upper field of vision. In severe cases, vision may be permanently affected due to the unaffected eye having to compensate for the affected eye. In such situations, the eye with ptosis is virtually left to degenerate.

It is possible for ptosis to develop at any time in life. When present at birth, the condition is referred to as congenital ptosis. An adult who develops the condition is said to have involutional ptosis. The drooping of the eyelid that occurs relates to the stretching or separation of the levator muscle that is situated in the upper eyelid.

What is ptosis repair?

Ptosis repair is performed with the goal of elevating the eyelid to restore appearance, function, and a normal field of vision. Dr. Douglas employs precise techniques to achieve the best outcome possible. Depending on various factors, however, full correction may not be possible.
 
Surgical repair for ptosis is almost always conducted on an outpatient basis. Patients are comfortable under local anesthetic that numbs the eye itself as well as the area around it. A sedative may also be administered intravenously. Throughout the procedure, an anesthesiologist monitors vital signs.

Before commencing with surgical repair, Dr. Douglas marks the area of incisions and also notates the position of the pupils. Pupil location is integral to the curvature of the eyelid at its highest point so to ensure adequate appearance and eyelid function.

In order to correct ptosis, the levator muscle may only need to be tightened. This is referred to as levator resection. In cases of moderate to severe muscle weakness, the levator muscle may need to be supported through what is called a frontalis suspension. This technique involves the placement of strands of fibrous tissue between the eyelid and the eyebrow. When a frontalis suspension is
performed, the eyelids can then be raised by raising the eyebrows.

During ptosis repair, the patient may be assisted into a sitting position. This allows us to observe the natural draping of the upper eyelid against the force of gravity and ensure the modified lid will close properly.

How long does recovery from ptosis repair take?

Patients should expect some bruising and swelling following ptosis repair. The tightening of the levator muscle may temporarily affect blinking, resulting in dry eye. If this occurs, eye drops or ointment may be used to keep the eyes adequately lubricated while the upper eyelid acclimates to its new position. Cold compresses and head elevation are recommended for pain and swelling management during the first several days of recovery.
 
Approximately 5 to 7 days after surgery, sutures will be removed. The scar that results from incisions will be well hidden within the natural crease of the eyelid. Patients typically return to work in 7 to 10 days, being mindful to avoid strenuous activities for another few weeks. By 3 weeks after surgery, it is usually possible to resume exercise and more vigorous physical activity.