Our 17 year old daughter had Ptosis surgery on her right upper eyelid 3 months ago. We had her 12 week follow-up visit a couple of days ago. All healed well, and the doctor agreed that the right eyelid still sits about 1mm lower than the left when she looks straight ahead. If she looks up, the both look almost identical, but if she looks down, while reading a book or working on the laptop, the right eyelid is usually lower than the left - as much as 3 mm or so. Is this to be expected at 12 wks?
Has the Eyelid Surgery Worked?
Doctor Answers (11)
The questions you have regarding the procedure performed and the expectations will all be based on how things were prior to the surgery. Consult with your surgeon for additional follow-up. Best wishes!
Asymmetric Upper Eyelid after Ptosis Surgery
Hi Just Curious1394 in Just Curious,
As other eyelid surgeons have stated, eyelid and facial asymmetry is very common. Many may consider 1mm difference between eyelids within range of normal. The eyelids may continue to adjust after ptosis repair, and you could potentially see some improvement gradually over time. Speak with you eyelid plastic surgeon to review options. Best of luck.
Typical for certain types of ptosis
That’s typical for certain types of ptosis. Usually you will have a 12 week follow up, and by that time what you see is what you get, unless the patient has had multiple surgeries or is still having swelling. If she’s under corrected by a millimeter, that’s borderline on whether you want to go back to have it corrected. But if the downward gaze is bothering her, a second surgery to correct it may be a consideration.
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Looks like a good result from your explanation
In general the eyes are not symmetrical and there is some degree of asymmetry in most people. If you have to look at certain direction to see the asymmetry,it is a good result.
This will be an unsatisfactory result for a 17 year old.
The need to re-operate for ptosis surgery is very common. It in no way reflects on your surgeon. Think about the fact that the eyelid has to be corrected even as it blinks continuously during the day. At three months it is very improbable that the right eyelid will change much over time. You did not tell us if the difference between the right upper eyelid position was a significant improvement over her pre-op situation. As she is three month out, it is reasonable to allow the eyelid to heal a full year before it is revised. Reasonable surgeon can have different opinions regarding this time frame. Experienced oculoplatic surgeons routinely operate and correct 1 mm and even 1/2 mm ptosis. It is important that your surgeon lives in this camp. If they tell you this is the best they can do, please respect that and don't compell them to operate on something they are not comfortable with. Not all ptosis surgeon are created equal and at a minimum other opinions would be appropriate.
Has the Eyelid Surgery Worked?
Hard to say over the internet without an examination. Seek second opinion. From MIAMI Dr. Darryl j. Blinski
Ptosis surgery success depends on muscle function
The success of ptosis surgery is very dependent on the function of the levator muscle which raises the eyelid. At least 8mm or more of eyelid excursion is needed for the most natural result. In most repairs the muscle or its connection to the lid is shorten so that in forward gaze the lids are symmetric and fall just over the edge of the iris. If the muscle can't move well the lid becomes 'static' and lagopthalmos occurs, where the lid can no longer close completely. It is all about trades offs in the pursuit of symmetry, improved vision, and corneal protection and moisture. Lid balance can improve over time, so be patient.
Best of luck,
The result will get even better with time and she should not need any further surgery. It sounds like she had a good surgeon,
Unilateral ptosis repair
1mm difference is within the range of normal so I would not worry about it. Enjoy the successful surgery!
Early Eyelid Asymmetry after Ptosis Surgery
A 1 mm difference in the appearance of the eyes after ptosis surgery was performed 3 months ago is not bad. There are natural healing events going on and I would definitely give at least 9 to 12 months before considering anything more. In addition, there is a natural adjustment phase due to differences in muscle strength for the eye opening muscles, usually one side is slightly stronger than the other.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.