I went to a plastic surgeon yesterday about how my ptosis was affecting my eyesight. I was born with ptosis in both eyes.My right eye is worse than my left. He told me, I would need surgery on both the upper and lower eyelids because my eyes don't fully shut and it might be worse post-surgery. My right eye also swells in the morning. I'm not sure if I should get the surgery and knowing its risky and if it will be a significant improvement to my appearance and eyesight.
Is Getting Ptosis Surgery Worth It?
Doctor Answers (8)
I suggest that you consider seeing a specialist for this issue not a general plastic surgeon.
Unless your general plastic surgeon is also a board certified ophthalmologist, they are just shooting from the hip here. Yes, you have very prominent eyes. Yes your lower eyelids rest low on the eye surface. Raising your upper eyelids may very well increase the corneal exposure and drying. The real question is what is your dry eye status now. This includes symptoms that you are currently experiencing, and signs including dry spots on the corneal surface. WIthout a slit lamp examination, it is impossible to assess the cornea surface. This specialized biomicroscope allows the oculoplastic surgeon to examine the eye surfaces to precisely assess your dry eye status. If you have good tear production and a healthy corneal surface, it is likely that you could have a conservative upper eyelid ptosis surgery that will improve the position of the upper eyelid margin and give you a brighter look without the need to also reconstruct the lower eyelids. I suggest that if you are motivated to learn if your are a candidate for ptosis surgery, that you find yourself a well qualified oculoplastic surgeon or two. The American Society for Ophthalmic Plastic and Reconstructive Surgery maintains a geographic directory at their website to help you identify highly qualified oculoplastic surgeons near you: asoprs.org.
Is Getting Ptosis Surgery Worth It?
RE: "I went to a plastic surgeon yesterday about how my ptosis was affecting my eyesight. I was born with ptosis in both eyes.My right eye is worse than my left. He told me, I would need surgery on both the upper and lower eyelids because my eyes don't fully shut and it might be worse post-surgery. My right eye also swells in the morning. I'm not sure if I should get the surgery and knowing its risky and if it will be a significant improvement to my appearance and eyesight"
Your surgeon is right. You have prominent eyes with Scleral Show (we see the white of your eyes under the iris in neutral forward gaze) - normally, in young people the lower lid covers the white (sclera) and lower portion of the (brown pigmented) iris. If you carefully look at your middle picture, the upper lid DOES its job of covering the eye ball but the lower lid literally falls short. Before, lifting and shortening your sagging upper lids, the lower lids need to be tightened (if the are lax) and a graft needs to be placed inside the lower lid in the midline to prop it upright so it can cover a higher portion of the eyeball.
Is looking less sleepy worth all this surgery? the ONLY person who should be answering this question is you.
Dr. Peter A Aldea
You should seek more than one opinion and include an oculoplastic surgeon in your search and Board Certified Plastic Surgeon. There will be risks, so you will have to evaluate them and decide if the risks are worth the possible improvement.
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Ptosis repair would help
Is ptosis surgery worth it
congenital ptosis is different than senile ptosis commonly fixed by plastic surgeons. as a plastic surgeon with excellent training in oculoplastic surgery I have always been very comfortable with senile ptosis surgery among other oculoplastic procedures, but even I would not tackle your congenital ptosis because the motor (levator muscle) is usually the problem and unless your visual field is affected the procedure is essentially cosmetic. symmetry will be very hard to achieve and you may be unhappy with result as well as exacerbate a subclinical dry eye. in short, a second opinion is in order (see an oculoplastics surgeon who only does these, you live in NYC there is no shortage of specialists) and the procedure should not be done casually.
Is getting ptosis surgery worth it?
Lower eyelid surgery would not have any impact on your eyesight ,nor does improve your ptosis. It is a good idea to address swelling in your R upper eyelid before you go about fixing your ptosis . Ptosis surgery ,however, would help your visual field and relief your forhead muscles from constant work ( contracion) to hold your upper eyelids up to improve your vision. This is a very meticolous surgery and should be done by an expert surgeon , othervise you may need to have additional corrective surgeries to achive a symmetrical result.
A simple frontal photo can be deceiving but it certainly looks like you have ptosis. But ptosis can be caused by more than one anatomical issue. You will need a dynamic exam testing the strength and movement of your upper eyelid muscles as well as lateral photos to see the position of your eyelid relative to your orbital bones, your eyeball and cheek pads. You will also need to have a test of the tightness and mobility of your lower eyelid in the upward direction to see how this shortening can be corrected.
Robin T.W. Yuan, M.D.
Just ptosis repair. High risk of under- or overcorrection.
Ptosis surgery can correct the sleepy look. It is not an easy procedure and demands precision on the part of the surgeon. Over or undercorrection is common even in experienced hands, in the range of 50%. My preferred technique is a levator advancement because it preserves your anatomy and can be adjusted.
You also have excess scleral (the white part) show of you lower eyes. This is not easy to correct either, and sometimes the lower blepharoplasty can backfire in patients who have a negative vector (you may be one) and actually make the problem worse.
I would recommend keeping it simple, treating just the problem that you presented with (the ptosis) with no skin removal from any eyelid. That way you should not have trouble closing your eyes even with the ptosis correction. You are best advised to see an experienced surgeon and it is not asking too much to request examples of his or her work to look at.
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.