Ptosis Surgery (Corrective Eyelid Procedure)

Ptosis correction involves different surgical approaches, depending on the severity of the condition and the strength of the levator muscle (the muscle responsible for lifting the eyelid). Common techniques include:

• Levator Resection: The levator muscle is shortened to improve its lifting ability. This is suitable for patients with moderate muscle function and is one of the most commonly performed techniques.
• Müller’s Muscle Resection: A minimally invasive technique often performed on patients with mild ptosis who respond well to a phenylephrine eye drop test. This method adjusts the Müller’s muscle, a secondary muscle assisting in eyelid elevation.
• Frontalis Sling Surgery: Used for severe ptosis cases where the levator muscle is too weak. A small sling, often made of synthetic material or the patient’s own tissue, connects the eyelid to the forehead muscle, allowing the eyelid to lift by using forehead movement.

The best technique for each patient is determined through a detailed preoperative assessment, including muscle strength testing and eyelid measurements.

Ptosis surgery is recommended for individuals experiencing functional or cosmetic concerns related to eyelid drooping. You may be a good candidate if:

• The drooping eyelid significantly affects vision, causing difficulty with daily activities.
• You experience eye strain, headaches, or frequent eyebrow lifting to compensate for the drooping.
• There is noticeable asymmetry in eyelid height, affecting facial balance.
• You are in good general health, with no uncontrolled medical conditions that could interfere with healing.
• You have realistic expectations about the outcome of the surgery.
• Children born with ptosis may require early intervention, especially if the condition interferes with vision development.

A consultation with an oculoplastic surgeon will help determine if surgery is the right option for you.

Understanding what to expect at each stage of ptosis surgery can help you prepare for the procedure:

Pre-surgery (few days before)

A detailed consultation, including a thorough eye examination, eyelid function tests, and discussion of medical history. Your surgeon will determine the best technique for your condition. You may need to stop certain medications before surgery, such as blood thinners, to reduce the risk of excessive bleeding.

On the day of surgery

The procedure is typically performed on an outpatient basis under local anesthesia with sedation or general anesthesia. The surgery takes about 45 to 90 minutes per eyelid, depending on complexity. Small, precise incisions are made to adjust the eyelid muscles, and sutures are placed to ensure optimal positioning.

Postoperative Stage

You will be monitored briefly after surgery before being discharged the same day. Initial swelling and bruising are common, but most patients see noticeable improvements within two weeks. Full healing and final results may take several months.

Anesthesia is an important aspect of ptosis surgery, ensuring comfort and a pain-free experience. The type of anesthesia used depends on the complexity of the surgery and patient preference:

Available Options:

• Local Anesthesia: Numbs the eye area while keeping you awake
• Local Anesthesia with Sedation: Provides additional comfort and relaxation
• General Anesthesia: Complete sleep throughout the procedure

Factors Influencing Choice:

• Preference and desired comfort level expected by the patient
• Extent of surgical correction to be done
• Medical history and overall health
• Duration of procedure

Recovery from ptosis surgery is relatively straightforward, but proper post-operative care is essential for optimal healing:

Immediate Post-Surgery (First 24 Hours)

Expect mild swelling, bruising, and temporary discomfort around the surgical site. Cold compresses can help reduce swelling. Keep your head elevated while sleeping to minimize fluid buildup.

First Few Days (Days 1-7)

Non-dissolvable sutures are typically removed within 5-7 days. Avoid rubbing or putting pressure on your eyelids. You may need to use prescribed antibiotic ointments or eye drops to prevent infection.

Early Recovery (Week 2-4)

Swelling and bruising gradually subside. Most patients can resume light activities, including work, after one to two weeks. However, strenuous activities, heavy lifting, and swimming should be avoided for at least four weeks.

Long Term Healing

While initial healing occurs within a few weeks, it may take a few months for final results to settle as swelling completely resolves and scars fade.

Undergoing ptosis surgery provides both functional and aesthetic benefits, including:

• Improved vision: Lifting the eyelid clears the visual field, reducing strain and making daily activities easier.
• Enhanced eye symmetry: More balanced and youthful-looking eyes contribute to facial harmony.
• Reduced eye fatigue: Eliminates the need for constant eyebrow lifting or squinting.
• Increased confidence: Restores a more alert and refreshed appearance, positively impacting self-esteem.

Most patients experience long-lasting results, although age-related changes can still affect eyelid position over time.

As with any surgical procedure, ptosis surgery carries some risks. While complications are rare when performed by an experienced surgeon, it’s important to be aware of potential issues:

• Temporary swelling, bruising, or discomfort (common in the early recovery phase).
• Dry eyes or irritation due to temporary changes in eyelid function.
• Asymmetry or under/overcorrection, which may require revision surgery in some cases.
• Infection or bleeding, though uncommon with proper post-surgical care.
• Difficulty closing the eye completely, especially in cases of aggressive correction.

Your surgeon will take precautions to minimize risks, and following post-operative instructions carefully can further reduce complications.