My teenage daughter has ptosis of the left eyelid. It is not interfering with her vision but it is definitely noticeable. I did not want her to have the "cosmetic" surgery as a child under general anesthesia. The doc said it was best to wait until she was older and growth has stopped and the surgery can be done under local anesthetic. My daughter does not want the surgery now and the docs say it is not interfering with her vision. Should I force her to have the surgery?
I Believe My Daughter Needs Ptosis Surgery, But She Doesn't. Should I Force It?
Doctor Answers 2
Ptosis Eyelid Surgery for Children and Teenagers
As a Cosmetic Oculofacial Plastic Surgeon who specializes in eyelid surgery in New York, I think it is ideal to wait. There are social issues that you may want to do ptosis surgery for a drooping eyelid sooner; however, if there isn't a basis to do surgery for vision affected by ptosis, it is best to hold off on doing the eyelid surgery. It is easier to do this type of eyelid surgery with patient cooperation as the muscles in eyelid are very sensitive. With children, surgery is done using very objective measurements and we anticipate the results from ptosis surgery will be close to ideal. On older patients, we get the cooperation of the patients, thus we are able to have the patient open and close eyes in order to do precise measurements and ensure the eyes will match as much as possible after ptosis eyelid surgery. In my practice and 20 years of experience, it is best to perform the eyelid surgery safely under local anesthesia with light IV sedation.
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When should a child be compelled to have eyelid surgery?
This isn't uncommon. I have seen several families where the parents are adamant the child have surgery, but the child is not bothered by the problem and it isn't a medical necessity. In these cases, I have to side with the child. They aren't putting their health in danger and forcing them to do something that alters their appearance could affect their trust and confidence in your decisions. We parents don't need our children to feel we are forcing our will on them unnecessarily. Plus, all surgery has risks and no one wants to see a complication occur in a patient who didn't want to have surgery in the first place. Chances are she'll change her mind in the future and it will then be her decision. The good news is a mild congenital ptosis can be fairly easily corrected by a oculoplastic surgeon through an internal incision at any age.
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