abnormal/peaked eyelid contour after ptosis surgery (photos)

Generally this needs to be dealt with as soon as it is noticed.  We try to detect this on the operating room table and this is one of the reasons oculoplastic surgeon favor intravenous sedation over general anesthesia to reduce the risk of developing this type of a peaked eyelid.  The sooner in time this is addressed, the easier it is to deal with.  When it develops within a week of surgery, it is usually helpful to open the eyelid stitches and remove the levator suture that is causing the eyelid to be peaked.  Some advocate for aggressive massage of the eyelid and this can be remarkably helpful.  At three weeks, this might respond to massage but you might also need to have the eyelid explored to reduce the peak.  I really encourage you to let your surgeon know what is going on and see if they recommend corrective action.  The sooner the better, in my opinion.

Sutures used to correct ptosis are usually permanent and will not dissolve.  Therefore, any irregularity in your eyelid position will likely need to be fixed via a revision. 

A peaked eyelid can occur after ptosis repair where one of the sutures may be pulling too much.  Early on massage inferiorly over this area may help.  You are still in the early healing phase, so your surgeon may wish to open the wound in that area to release the suture which will help to drop the lid.  This is easier to do at this stage than waiting for full healing, so go see your surgeon and discuss this.

Has your surgeon seen this?  Does he think it is more due to swelling and you should wait or is he recommending revision?  If he recommends revision, then you should listen to him.  If he says it is swelling, then you should see a pattern of the contour improving as the swelling subsides.  It never hurts to get a second opinion if you are concerned. An accurate opinion can only be given with a full examination.

Still VERY early in healing/swelling phases. What does your surgeon say??? If there is a possibility to release one suture at the "peak" than maybe that could be done???  

this is a somewhat common issue after ptosis surgery.  You want to deal with this as soon as possible.  In some cases if it is not to noticeable massage works just fine.  Return to your ptosis surgeon as soon as possible.  He may need to release the suture or revise the surgery.  Don't be to discouraged and the patient because ptosis surgery can be a difficult one for both the surgeon and the patient.Chase Lay, MDDouble board-certified facial plastic surgeon

You should definitely return to your ptosis repair surgeon. It appears that one suture on each side is likely over-correcting the margin of your eyelid. The offending sutures can be released and you should be able to massage the eyelid downward. I would followup ASAP. This can and does occur despite performing the procedure properly. It is a risk of the procedure but these issues can typically be resolved. I hope this information is helpful for you.Stephen Weber MD, FACSDenver Facial Plastic Surgeon

With ptosis surgery, eyelid malposition is not too infrequent an issue postoperatively, and internal sutures may need additional adjusting. This could be done through manual massage or additional surgery, but frequent visits to your surgeon postoperatively are a must. In your particular case, based on the limited views in your pictures, the need for surgical revision is very likely. 

I suggest you see your surgeon as soon as possible for all of the reasons discussed by the surgeons below. The sooner this is addressed the better. If you feel your surgeon is not giving you the answers you want then you may want to consult for a second opinion asap. Best regards, Michael V. Elam, M.D.

You have a suture that is too tight on each side and it needs to be released as soon as possible. The longer you wait the more difficult it will be to get the look you want.