First ptosis repair outcomes; trajectory of plan of care?

Question

I am a 21 yo Asian male; 5’ 11”; 155 lbs. Negative phenylephrine test and external approach on right lid. During op, surgeon advanced levator maximally when lift increase was initially absent. Post-op outcomes: (1) More prominent lid platform; (2) Minimal lift; (3) Contour change. Was the op unsuccessful and outcomes avoidable? Is revision warranted? Which type? I’m nervous for a 2nd op, yet I want to manage this due to its psychosocial impact. Is my goal of lid symmetry unrealistic? Thoughts?

Kenneth D. Steinsapir, MD · Answer

I am skeptical that you had "maximal" advancement of the anterior levator. Meaning you likely have a real probability that revisional surgery would be beneficial. It appears that more could have been done to control the eyelid platform which appears to still contain redundant skin and muscle with a crease that is too high. If you are early from this surgery, more healing is definitely warranted. An in person assessment is really essential to provide more information. Please be aware that the accuracy you need is really beyond the scope of most ptosis surgeons. You also need someone experience with double fold surgery.

Soheila Rostami, MD, FAAO, FAACS · Answer

If the number 2 is after the surgical correction photo, I believe you have a great outcome. there is no better outcome is a reasonable expectation for this type of surgery.

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