Ptosis Revision on Left Eyelid? (photo)

I had ptosis revision in may on my left eyelid. I'm two months post op and my eyelid looks more droopy than before my first two surgeries. My surgeon wants to make adjustments to the eyelid but i'm afraid of another failed surgery. My surgeon said he would have to overcorrect my eyelid in order for it not to droop. Should I get another procedure done or wait a few more months before considering an adjustment? I attach a few pictures of how my eyelid looks as of today. This is very depressing:(

Doctor Answers (4)

Ptosis Revision on Left Eyelid?

+2

Yes thanks for the series of posted photos showing the defect in different phases of gaze. Maybe obtain additional in person opinions in the course you should choose. 


Miami Plastic Surgeon
4.5 out of 5 stars 64 reviews

Ptosis

+1

Lots of different clinical photos will aid in the future care of your eyelid ptosis.  Best to see a Facial Cosmetic Surgeon who performs a lot of eyelid surgery.

Robert Shumway, MD
San Diego Facial Plastic Surgeon
5.0 out of 5 stars 8 reviews

Some oculoplastic surgeons are more gifted at ptosis surgery than others.

+1

I would recommend getting several opinions regarding your upper eyelid.  Unfortunately, the eyelid is not like a car engine.  The more you work on the car engine the better it runs. With eyelids, the more you tinker with the tissues, the worse things get.  The American Society for Ophthalmic Plastic and Reconstructive Surgery maintains a geographic directory on its website that can help you a highly qualified surgeon in your area. 

Kenneth D. Steinsapir, MD
Los Angeles Oculoplastic Surgeon
5.0 out of 5 stars 17 reviews

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Congenital Ptosis

+1

Based on your photos, it seems that you have congenital ptosis. This occurs because of malformation of the levator palpebrae muscle, the more effective of the two eyelid muscle elevators). If the  level of the function of this muscle is very low, the surgery can be quite difficult to achieve good eyelid symmetry, without causing potential eyelid closure problems.

Your last photo illustrates this issue: on downgaze, the left eyelid does not lower as well as the normal right eye. Raising the eyelid higher, will accentuate this problem. Although further improvement of your eyelid may be possible, you have to accept this compromise that sometimes needs to be made, and alter you expectation level. Initial overcorrection may be necessary, but you should also recognize the risk that closure of the eyelid and subsequent dry eye symptoms may be the outcome.

As Oculoplastic surgeons, we often see the most difficult eyelid cases, and more often than not, perfection is not possible, and this was likely one of those cases.

Having said that, sometimes getting a second opinion is of value. Different surgeons sometimes have different approaches. Or sometimes, hearing the same opinion will give the patient the peace of mind that the initial surgery was done properly, and accept our limitations, both as surgeons and patients.

 

I would not jump in quickly and re-operate. In fact I would urge patience to allow scarring to soften for up to a year before re-attempting surgery.

If you decide to explore this further, I would recommend consultation with an ASOPRS trained Oculoplastics surgeon. You can find one close to you on the ASOPRS dot org website.

A.J. Amadi, MD
Seattle Oculoplastic Surgeon
5.0 out of 5 stars 24 reviews

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.