Is Ptosis after upper and lower blepharoplasty caused by mistake during surgery? Will it resolve on its own? (photo)

Question

I am 15 days post surgery and my right eye seems to have ptosis. The lid partially covers the iris and the difference is pronounced when looking up. When I look up or laterally, I feel a pulling sensation on the outer side above the right eye. Left eye is normal. I see little visible swelling now. Could it be the result of a mistake during surgery that damaged the levator? If so is there a way to correct it and how serious is it? Not scheduled to see PS for another 2 wks.

Thomas Fiala, MD, FACS, FRCSC · Answer

Hi.  Assuming that this ptosis is a new finding - the most common explanation is related to the swelling of the area post-surgery.  Sometimes this swelling is enough to temporarily stretch the levator aponeurosis, and cause a temporary mild ptosis.  It typically resolves with time, and no surgical intervention.  Naphcon A drops may help.

John J. Martin, Jr., MD · Answer

You have a mild ptosis on the right.  At 15 days you are very early in the healing period.  It is not uncommon for one or both lids to be a little low for several weeks.  Give it more time and see if the lid comes up.  At 6 months it can be lifted if necessary.  Sometimes a ptosis may not be noted pre-op if there is a lot of excess skin.  Removal of the skin may "unmask" the ptosis.  But still need more time to heal.

Kenneth D. Steinsapir, MD · Answer

The tendon that raise the upper eyelid is very thin in some people.  It certainly can be inadvertently damaged during eyelid surgery and this is common but it usually does not cause ptosis.  However, the tendon is really held in the eyelid with very thin tissue and even the swelling associated with the surgery can cause ptosis after eyelid surgery.  Generally you should let this heal a very long time before having a repair.  The rationale for this is that many of these droopy eyelids do get better on their own.  I recommend letting this heal for at least a couple of months.  Generally it is best to let the tissues heal at least 6 months to increase the accuracy of the repair.  I do make an exception to this timing if there is evidence of a tethered ptosis with corneal exposure and irritation of the cornea.

Soheila Rostami, MD, FAAO, FAACS · Answer

It appears that there is some eyelid lag and ptosis of the RUL. This could be thought to scarring of levator muscle to septum. Please, return to your surgeon and explained your problem. Sometime just little injecting of Kenalog-40 can help extensively.

Thomas Trevisani, MD · Answer

Without pre-op photos- it's impossible to give an accurate comment. Also, 15 days post-surgery is far too early to evaluate. Therefore, give it more time- address the issue with your Board Certified Surgeon and hopefully the end result will be in your favor.

Is Ptosis after upper and lower blepharoplasty caused by mistake during surgery? Will it resolve on its own? (photo)

Answers (9)

Answer: It seems there is some scaring of the septum to the levator muscle.

Answer: It seems there is some scaring of the septum to the levator muscle.

Answer: Is Ptosis after upper and lower blepharoplasty caused by mistake during surgery? Will it resolve on its own?

Answer: Is Ptosis after upper and lower blepharoplasty caused by mistake during surgery? Will it resolve on its own?

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Is Ptosis after upper and lower blepharoplasty caused by mistake during surgery? Will it resolve on its own? (photo)

Answers (9)

Answer: It seems there is some scaring of the septum to the levator muscle.

Answer: It seems there is some scaring of the septum to the levator muscle.

Answer: Is Ptosis after upper and lower blepharoplasty caused by mistake during surgery? Will it resolve on its own?

Answer: Is Ptosis after upper and lower blepharoplasty caused by mistake during surgery? Will it resolve on its own?

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Recommended reading

Everything you need to know about Eyelid Surgery

Our mission is to create a world where every investment in modern beauty is Worth It.