3rd Time Ptosis Repair if There is Any Peeking of my Eye Lid or the Contour is Destroyed? (photo)

3RD time for revision of Tarso frontal Sling for marcus gunn jaw winking ptosis after it snapped, 1st SURGERY DEC 5th , 3rd surgery 6 days ago [pics attached] 1 I want to know if the surgery is done right 2 will there be any peaking /abnormal contour of eye due to repeated surgery ? 3 if this fails again cant the tf sling be taken out completely 4 any precaution that should be taken so that the sling doesnt snap again ? thank you

Doctor Answers 2

Forehead slings

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Often times the wisest course is not to undergo any additional surgery but simply to allow time to pass and the healing process to continue.

Sling ptosis repairs are challenging and often times require revisions for height and contour.

New York Oculoplastic Surgeon

Congenital ptosis is challenging.

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As you have experience, congenital ptosis, is one of the more challenging scenarios that we have to deal with. It is not unusual to need revision surgery. Having three surgeries in a 2 month window is enough. Your eyelid position with the eyes open is excellent, though as you can see from the second photo, this leaves eye closure compromised.

Since you are young, your cornea can likely tolerate this with some lubrication, especially at bedtime. This tolerance will diminish as you age, but the eyelid position will also drop with time as the sling becomes less effective. It is important for you to have realistic expectations when you get older, as opening they eyelid this widely will not be tolerated.

As far as the sling "snapping"... what type of sling did your surgeon use? Was it silicone, prolene suture,  goretex, or fascia lata? The first three are synthetic material and have a higher possiblity of slipping or snapping. I would resist the temptation to rub your eye, especially when you develop itching. To combat the itching, use ice compresses.

A sling can be removed [much easier with silicone than the others.

A.J. Amadi, MD
Seattle Oculoplastic Surgeon
5.0 out of 5 stars 42 reviews

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