Ptosis repair is a surgical procedure for correcting drooping of the eyelid itself (ptosis) in which it partly covers the pupil. The procedure raises the eyelid by adjusting the connection between the eyelid and the muscle (levator) that raises it. Patients that have excess skin and fat in the upper eyelid will also benefit from ptosis repair.Ptosis repair (droopy eyelid surgery) is usually performed under local anesthesia with intravenous sedation. An Ophthalmologist or surgeon will make an incision in the eyelid skin crease or on the undersurface of the eyelid, depending on the degree and type of ptosis. Through this incision, the surgeon will reattach the levator muscle to the eyelid, recreating the same connection that existed before gravity and age stretched it. Depending on the incision, stitches may need to be removed after surgery. Only experienced professionals should handle this type of procedure.After ptosis repair, patients report more open vision and a more alert appearance. As with blepharoplasty, it is nearly impossible to detect when a patient has undergone ptosis repair.Some patients have both ptosis and dermatochalasis and require ptosis repair and blepharoplasty simultaneously.
Causes of Ptosis
There are natural causes of ptosis and medical conditions that cause ptosis. The aging process is the most common cause of ptosis. Aging causes the gradual stretching of the tissue that supports the upper eyelid. However, people of all ages can have this condition.In some cases, ptosis is caused by a weak levator muscle used to raised the eyelid. This is known as muscular ptosis. Age is not a factor when dealing with muscular ptosis. If a levator muscle is very weak, your Ophthalmologist may perform a frontalis suspension. During a frontalis suspension, small strands are placed between the eyebrow and eyelid. The strands are then tightened to raise the eyelid.If you notice that your eyelids are drooping, there could be an underlying medical condition responsible. If it is just one eye, it is most likely the result of a nerve injury or possibly a temporary sty. Sometimes ptosis is caused by more serious conditions such as brain tumor, stroke, or cancer of the muscles of nerves.
Symptoms of Ptosis
The main symptom is the sagging of one or both eyelids. In some cases, this can affect vision. You may also have dry or watery eyes and you may notice that your face looks tired. Some patients experience aching, and in severe cases, have to tilt their heads when speaking.
After Ptosis Surgery
Aftercare for ptosis surgery includes alternating ice packs and warm compresses and applying a topical antibiotic for 3-4 days. There is minimal discomfort that can be easily handled by acetaminophen. Non-steroidal anti-inflammatories (Advil, ibuprofen) and aspirin should be avoided. Wearing contact lenses should be avoided for 3 weeks after ptosis surgery. You should also be trained on how to ensure proper lubrication of the eye after surgery in order to avoid any complications.
How Much Does It Cost?
The cost of the droopy eyelid surgery depends on the anesthesia and facility costs as well as the type of procedure you are having. Ptosis repair is covered by insurance in most cases because the drooping of the eyelids directly obstructs the patient’s vision. Check with your doctor and your insurance provider.
Risks and Complications
The risks and complications of ptosis can vary from patient to patient and is dependent upon the procedure performed and patient compliance with aftercare instructions.
Unusual swelling or bruising after surgery
Infection
Asymmetric eyelid height
Undercorrection or overcorrection
Dry eyes requiring lubricants
Stiffness of the eyelid when gazing down
Additional surgical adjustments
Goals of Droopy Eyelid Surgery
The main goal of droopy eyelid surgery is to adjust the position of the upper eyelid so that the field of vision is normal. The surgeon will also attempt to create symmetry with the opposite eyelid.
Recovery
It may take up to 6 months to see the final results of ptosis repair, but the majority of the bruising and swelling should be gone 4-6 weeks after the surgery.
