Alternative to Ptosis Correction/tightening Levitator Muscles?

I am a 27 yr old female with a 2mm difference between my eyelids. When i was young my eyebrow was split open in an accident. i got stitches,resulting in a "railroad track" like scar. could the ptosis be a result of scar tissue bringing my lid down? i feel like my right eyebrow is "heavier" than the left & may be weighing down my eye? could i benefit more from a surgery that removes excess eyebrow skin to essentially lift the lid? Im very worried of overcorrection from ptosis surgery.

Doctor Answers 5

Ptosis may be due to injured levator obicularis

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The cause of your ptosis is less likely to be due to your injured eyelid being "heavier" and more likely to do with an injured muscle called the levator obicularis. There are other possibilities such as internal scarring. The bottom line is  that you should consult consult with a plastic surgeon or oculoplastic surgeon skilled in ptosis surgery to determine the cause of and solution to your ptosis. Most likely it can be corrected and made to look more symmetric.

Photos would be helpful

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Photos would be very helpful for us to give you a better recommendation. But there may be a variety of issues to consider here:  the movement of the eyelid, the extent of the scar, the position of the eyelid with regards to the your pupil [is it affecting your vision]. So there is no substitute for an in-person consultation with an Oculoplastics surgeon. The ASOPRS website can direct you to someone close to you.

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

There is no substitute for a personal consultation.

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Ptosis after trauma is fairly common.  The possible presence of scar tissue may complicate ptosis repair.  It is essential to understand that the overwhelming preponderance of this type of surgical work is done by fellowship trained oculoplastic surgeons rather than facial or general plastic surgeons.  The American Society for Ophthalmic Plastic and Reconstructive Surgery maintains a geographic directory of highly qualified oculoplastic surgeons on their website (asoprs dot org).  Two millimeters of ptosis after trauma is generally considered reconstructive surgery and may be covered by your health insurance.  It is appropriate to inquire if your potential surgeon accepts your health insurance coverage.

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Droppy Eyelid and Brow

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Your concerns are certainly possible.  2mm of ptosis certainly can have other causes such as a small abnormality in another muscle as an example.  The best advice I can give you is to seek a consult and thorough exam to determine the cause of you ptosis and then develop strategies to correct the issue if necessary.

Good Luck.

Dr. ES

Depends whether there is brow ptosis or only eyelid ptosis

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This sounds like a complex situation, and the only way to give the correct advice is to do a thorough exam and determine the correct cause of the difference in the two eyelids.  If the accident injured the frontalis muscle, this could result in compromised ability to raise the brow, a lower brow, and, possibly a lower eyelid.  If brow function and position are normal, and the whole problem is eyelid function, then ptosis correction is indicated.  This can be done one of two ways - 1/ An open approach with advancement and tightening of the levator muscle or 2/ Tightening Mueller's muscle and conjunctiva on the undersurface of the eyelid.  Both are very good procedures.  An office pre-test needs to be done to determine whether you would be a good candidate for the Mueller's muscle procedure.


I wouldn't worry too much about over-correction - this is easily reversed.  Under-correction, however, if it is significant, usually means re-doing the procedure.  Both procedures are good ones and low risk.

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.