Ptosis direct result of Upper Blepharoplasty 5 wks ago. How soon can I correct? This is a follow-up question. (photo)

Sep. 25th (5wks) had upper blepharoplasty. Severe bleeding. Dr. said didn’t see septum during surgery in left eye which now has ptosis. Ultrasound shows no hematoma. Incisions terribly slow to heal - that’s another problem. Some surgeons I spoke with won’t correct the levator muscle with surgery until 3 more months. My job is in public eye. Don't want to wait. Is Ptosis caused by Edema or Levator trauma? Why did this happen? Any solution sooner than 3m - temporary or long-term?
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Doctor Answers 5

Ptosis post bleph

A ptosis can occur during a bleph if the muscle is inadvertently cut.  It can also occur if you had significant bleeding and swelling as this can stretch out the muscle.  In those cases, the muscle action will usually slowly come back, so the ptosis should improve somewhat.  You always want to wait at least 3-4 months.  Rushing this may make the surgery and adjustment of the muscle less accurate, and you don't want to have to revise the revision.  


Coral Gables Oculoplastic Surgeon
5.0 out of 5 stars 25 reviews

I personally think that it is reasonable to consider personal/social concerns in the timing of repair.

Yes, it is ideal to wait but sometimes for a variety of reasons.  That sometimes means additional revisional surgery because of the necessity of being conservative.  In my experience, these are generally mechanical not nerve damage.  You need to find a highly experienced oculoplastic surgeon who also agrees with an early repair.  Most surgeons will want to get you out as long as possible to allow the granulation tissue from the original surgery to settle down more.  I personally will violate that if the corneal surface is compromised at all by what is going on.  

Kenneth D. Steinsapir, MD
Los Angeles Oculoplastic Surgeon
4.9 out of 5 stars 23 reviews

I am so sorry

Do you have diplopia (double vision)? It appears that there is nerve damage rather than the levaotr muscle trauma?

Ptosis after Blepharoplasty

Schedule a consultation with a board certified oculoplastic surgeon to discuss your case.  Usually, it is best to wait at least 3-6 months to see if the condition will improve on its own.  Good luck!

Samuel Baharestani, MD
Long Island Oculoplastic Surgeon
4.8 out of 5 stars 24 reviews

Ptosis after Blepharoplasty

I think that it is quite clear that a ptosis of this magnitude is a result of mechanical damage to the lavatory muscle. I have seen this happen many times. When the skin and muscle are removed, it is possible to damage important underlying structures, particularly when the lid tissue is quite thin. This is not due to nerve damage. I don't think that a ptosis of this magnitude will resolve with time.

If you see an experienced oculoplastic surgeon, he/she would be able to correct this for you, but I fear that you may well need to wait as early surgery at this point may make the outcome more predictable. 

Daniel Ezra, MD, FRCS
London Oculoplastic Surgeon
5.0 out of 5 stars 1 review

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.