Eyelid Ptosis Repair

Eyelid ptosis repair is a surgical procedure to improve the position of the upper eyelid. A lower sitting eyelid can make the eye appear smaller and can be seen on one or both eyelids. Vision can be affected if the eyelid is low enough to block the pupil of the eye. If the pupil of the eye is blocked by the low eyelid, some patients complain of neck aches as they lift their chins to compensate for the droopiness. Ptosis is different from having excess or hooded eyelid skin, which may also make the eyes look droopy. Ptosis may develop in childhood or adulthood as a result of a compromised or stretched eyelid muscle. One or both eyes may be affected. Patients often feel that the droop is more noticeable when they are tired and in photographs.

WHAT TO EXPECT?

Ptosis repair is a short surgical procedure done using a local anaesthetic and can be done in conjunction with sedation. The surgery is less than one hour and can be combined with other surgical and non surgical procedures.

An incision is then made in the natural crease of the upper eyelid. The levator muscle is tightened, and its attachment is repositioned to the connective tissue in the eyelid. Towards the end of the procedure, the patient is asked to open their eyes to ensure the best eyelid position, contour, and symmetry. In patients with ptosis and excess or hooded eyelid skin, ptosis surgery is usually combined with upper blepharoplasty for the best results. It can also be combined with lower blepharoplasty in those desiring to rejuvenate the entire eye area.

Ptosis correction recovery is approximately 1 week. Icing 10 min while awake is recommended for the first 48 hours while awake. The eyelids may feel tight, look droopy or open, and look asymmetric. This is all normal and improves as the swelling resolves and the tissues heal. Patients are usually seen 7 days after their surgery. Normal physical activity can be resumed 7-10 days after surgery and eye makeup after 10 days.

It is important to undergo ptosis repair performed by a board-certified oculoplastic surgeon who is familiar with the unique characteristics of this condition. While uncommon, there are a few risks associated with ptosis repair, including under or overcorrection, asymmetry, and dry eye. A revision or additional surgery may be undertaken in rare instances of failure to improve the eyelid position further.

WHAT ARE THE BENEFITS?

Ptosis repair improves the height of the upper eyelid and creates a more harmonious and balanced upper eyelid.

Canthoplasty or Canthopexy may be necessary.

Canthoplasty and canthopexy (canthal tightening) refer to procedures used to support or tighten the lower eyelid. The need for these procedures arises when there is lower eyelid laxity which can occur for a number of different reasons.

It is imperative to assess the eyelids for function, position, tone, laxity, and the configuration of the midface prior to cosmetic eyelid surgery. If left unaddressed, eyelid laxity can lead to postoperative complications and unsatisfactory results. Canthal tightening is an integral part of lower eyelid blepharoplasty to improve aesthetics, preserve normal eyelid function, and decrease the risk of postoperative eyelid malposition.