I'm 17 and I have had a slightly droopier right eyelid all my life. I visited my doctor about it today and I'm scheduled to visit a Oculoplastic Surgeon in two weeks. What is the surgeon most likely going to recommend? What are my options that I'll most likely be given? I'd like to receive the minor surgery to attempt to fix my drooping lid. The skin flap is just covering the crease and my doctor said that minor surgery should fix it. Also, will it be covered through health insurance?
Cogenital Ptosis, What Are my Options?
Doctor Answers 7
Ptosis vs Dermatochalasis [excess skin]
From your photos it is difficult to say whether you truly have ptosis [droopy eyelid] or dermatochalasis [excess skin that's hanging over] or possibly both.
An examination will help tease out those subtleties. Those conditions require different surgical techniques.
If it is ptosis, then an internal approach would be the least invasive. It is called conjunctivomullerectomy and not all surgeons are comfortable with this technique. Ask your surgeon whether he is comfortable with this technique. He will need to do an eyedrop test to see if you are a good candidate.
If there is skin hanging over, then skin will need to be removed. If you already have a crease, then the incision will hide very well. If you don't have a crease, one will need to be created [double eyelid surgery] to hid the incision. Of course this will change the shape of your eyelid.
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Congenital ptosis in the Asian Eyelid
I see this so often in my practice. You're Oculoplastic surgeon can best answer your questions but what I see in your photo is some moderate ptosis and likely insurance will cover it but you will have to complete visual field evaluations and so forth before that can be pre-certified. You're crease would need to be recreated at the same time as the ptosis repair and that takes special skill and experience. I recommend a few consults before moving forward with surgery. I think this video will best answer your questions.
Best of luck
Chase Lay, MD
Cogenital Ptosis, What Are my Options?
These are all good questions but are not really answerable without an actual examination. Congenital ptosis varies in its presentation and findings. Therefore, the treatment varies as well. An Oculoplastic surgeon is the right person to help you with this.
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You pose excellent questions for any reconstructive, corrective and Cosmetic Surgeon! Upon evaluation by at least three Facial Surgeons over the next two weeks, you will begin to understand the answer to your questions. Bon Chance!
You are correct in seeing an oculoplastic surgeon for this problem. The type of surgical intervention depends on the anatomy and function of your eyelid.
What is Ptosis
Ptosis is a condition where the eyelid rests lower on the eyeball than it should. This is not the same thing as extra skin which is referred to as dermatochelasis. Looking at your photo, it is hard to tell if you have ptosis or asymmetry in your upper eyelid skin.
Ptosis is a result of a deficient connection between the muscle that you use to open your eye and the eyelid itself. It is most easily identified by looking straight ahead and measuring the distance between the pupil and where the eyelid touches the eyeball.
Ptosis can be fixed a couple of ways. One way is to go through the inside of the eyelid and shorten a section of the muscle. This is a minimal surgery with minimal recovery but is usually only effective for mild cases and has a higher recurrence rate. The other way to fix it is to make an incision in the skin and specifically identify all of the anatomy and reconnect the muscle to the eyelid. This is more work, leaves a scar, but rarely has recurrence of the problem.
Issues with the skin almost always require a skin incision. Also in Asian eyelids there is consideration of the eyelid crease (or lack thereof) and whether you would like to create one.
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.