What Is Eyelid Ptosis?
Ptosis, sometimes referred to as Blepharoptosis, is the medical term for a drooping upper eyelid. This problem affects approximately 5 percent of the population and can affect vision and appearance. The prevalence of this condition increases in the elderly.
What Causes Eyelids To Droop?
Eyelid ptosis can occur from many causes. The most common cause is aging, when the attachments of the eyelid lifting muscle weaken with advancing age. The muscle works, but its tendon does not have the same lifting ability and hence the eyelid droops. Some patients are born with a congenital defect in the muscle also causing ptosis.
Droopy Eyelids in Children
Children that are born with drooping eyelids suffer from “congenital ptosis”, which is caused by issues in the muscle that lifts the eye. Additional symptoms of this disorder include asymmetrical upper eyelid creases. Children born with this condition tend to develop habits of lifting their eyebrows and tilting their heads backwards to make up for their vision impairment. In many cases of congenital ptosis, both eyelids begin to droop.
Droopy Eyelids in Adults
When adults develop Ptosis, it is due to the gradual weakening of the eyelids. Patients tend to exhibit difficulty reading and increased vision impairment.
What are the Symptoms of Ptosis?
The condition can be either unilateral (one side) or bilateral (both sides). When the drooping is mild, it may be barely noticeable and not impair vision. When severe, the upper eyelid can encroach upon the pupil, causing loss of peripheral vision (side vision). The central visual acuity, the vision necessary for reading an eye chart, is usually not impaired.
Ptosis is easily diagnosed. The obvious asymmetry of the droopy eyelids are a give away to this condition. However, there are some differences between Blepharoptosis in children and in adults.
How is Ptosis Surgery Performed?
A surgical procedure, similar to blepharoplasty, can be performed to repair drooping eyelids and restore them to their natural shape and contour by adjusting or tightening the eyelid lifting muscles. This operation often works for children as well, but some will require more complex surgery that employs the eyebrow lifting muscle to help open the eye. Dr. Fante has performed thousands of ptosis repair operations.
The procedure is performed usually under local anesthesia as an outpatient, except for young children who require general anesthesia. The surgery is painless, takes less than an hour and patients can usually resume their normal activities in about a week. Dr. Fante operates at many of the surgery centers and hospitals in the Denver metro area. He also operates in Goodland, Kansas.
Droopy Eyelids Before and After Surgery
Ptosis Surgery Patient Testimonials
“I was quite nervous about having a procedure to lift drooping eyelids. After meeting with staff and Dr. Fante I felt more confident. The Dr. took time to address all of my concerns and reservations. There was no pressure to have the procedure done. After discussing all of the pros and cons I decided to set a date to have the procedure done. Everyone in the office was very polite and supportive.”
Mary-Jane G. – Google Review
What is the Recovery from Ptosis Repair Surgery?
Most surgical procedures that are performed in an operating room will cause swelling and bruising and will have sutures that require care for the first week or two. During this period, you’ll be able to see, move about, and accomplish a lot, but you will probably have at least one “black” eye.
We ask our patients to avoid strenuous activities for the first week or two. We also give patients more specific instructions on travel, bathing, and post-op care. Your healing will be dependent on which procedure you are having done, your compliance to pre and post-operative instructions, and your overall health. We will do our very best to make sure that you have all the information you and your caregivers will need to provide the best care possible. We are always here to help and available if any questions or concerns arise.
Most people, depending on their surgery, will return to work in 7 – 14 days. Some more, some less. This is very dependent upon the type of surgery you need, your occupation, and your compliance to post operative instructions. For some smaller repairs, you might be able to return to work in 2-3 days, particularly if you can work with bruises on your face.
Will Insurance Cover Ptosis Repair Surgery?
Your eye doctor performs a special test, a visual field test, to determine if the eyelid ptosis is affecting vision. In some cases, where there is vision obstruction, medical insurance may cover some or all of the costs for surgery. Some patients may also elect to have the surgery for cosmetic reasons. Children with ptosis usually need to have the eyelid(s) repaired to permit normal visual development, and for them, surgery is never cosmetic.
Are there Risks to Blepharoptosis Surgery?
Risk factors for the development of eyelid ptosis include trauma, contact lens wear, and some neurological conditions such as myasthenia gravis. In addition, with aging, excess skin and bags around the eyes can also develop, leading to the tired, sleepy look.
Why Choose Dr. Fante To Repair My Droopy Eyelids?
Dr. Fante has tremendous experience in all facets of oculofacial plastic surgery and been in practice for over 20 years He is involved in the educational community and is well aware of the latest technologies. He is open, honest, and always willing to answer any specific questions in your consultation.
What kinds of procedure options are there for Ptosis treatment?
Surgical correction achieves the best results for patients with ptosis. Dr. Fante considers one of three corrective outpatient procedures when treating this condition in one or both eyes. These include the external approach, the internal approach, and the frontalis sling fixation procedure. The most appropriate technique for treating ptosis is identified during a comprehensive consultation and ophthalmic examination that measures the strength of the levator muscle.
Which ptosis treatment is more common?
Oculoplastic surgery has two common methods of treating a drooping eyelid.
The external approach is also referred to as levator advancement. This outpatient procedure may be appropriate for patients with strong levator muscle function. During this approach, Dr. Fante makes an incision in the crease of the eyelid to access the levator muscle. This muscle is repositioned and connected to the tarsus, the connective tissue within the eyelid. It is secured with very fine sutures.
The internal approach may also be appropriate for a patient with strong levator muscle function. Performed with general anesthesia or sedation, this surgical procedure involves shortening one of two eyelid muscles from inside the eyelid. After careful observation, the doctor chooses to tighten the levator muscle or Mueller’s muscle, both of which are involved in lifting the eyelid. Usually, Mueller’s muscle is selected when less elevation is needed. When there is a greater degree of ptosis, the levator muscle is typically selected for shortening.
What are the benefits associated with internal and external ptosis treatment?
The primary objective of ptosis surgery is to achieve the best aesthetic and functional outcome for each patient. Each of these approaches, the internal and the external, can obtain this goal. A potential benefit of the external approach may be that the procedure can be performed without the use of general anesthesia. However, risks and recovery are comparable for each approach. After your consultation and examination, Dr. Fante can discuss his recommendation and reasoning for the approach he believes would be best for you.
What is a frontalis sling and when is it necessary?
Certain cases of ptosis involve drooping and poor levator muscle strength. In these situations, the frontalis sling procedure may be necessary because, even with shortening, the levator muscle does not have the strength to function properly. This surgery is usually performed with general anesthesia, though patients can go home the same day. To correct the drooping eyelid using the frontalis sling, Dr. Fante attaches the upper eyelid to the frontalis muscle, located just above the eyebrows. The attachment is typically achieved via a small silicone rod inserted beneath the skin. This new connection allows the patient to lift the eyelid using the frontalis (forehead) muscle rather than the levator muscle.
Is there a difference in recovery time for internal treatment compared to external ptosis treatment?
The recovery for ptosis surgery is similar regardless of approach. Patients who have internal or external ptosis surgery can expect some degree of activity limitations for a short time after their procedure. Additionally, they may experience some or all of the following:
- Dry eye symptoms. This may occur due to minor post-surgical inflammation or the increase in exposed ocular surface area. Medications or other treatments may be prescribed to support adequate lubrication.
- Bandages are typically not necessary. Patients should take care to avoid touching or rubbing the eye.
- Post-op care may involve carefully cleaning the eye several times a day until sutures are removed.
- Sutures may be removed about one week after surgery.
- Patients may be able to return to work after 10 to 14 days.
- Exercise and strenuous activity should be avoided for approximately 3 weeks.
- Full recovery is generally expected within three months of surgery.
Schedule a Consultation
For more information about eyelid ptosis and other reconstructive procedures visit our office in Denver, CO! Call (303) 839-1616 today to schedule a consultation with top plastic surgeons Dr. Robert Fante & Dr. Tara Goecks.