What technique and which success rate after 2 failed Ptosis surgeries? (photo)

Question

I have had 2 Ptosis Surgeries already I started noticing ptosis first time in 2014-15 and I decided to correct it in 2016 The doctor at that time performed muellerectomy The good results didn;t last and I had to do another revision with levator resection in 2019 The uneven eyelid runs in my family so I am sure it's just an aesthetic problem but I would like to really fix this Would you recommend a 3rd surgery and which technique this time? Is there a success probability ?

Kenneth D. Steinsapir, MD · Answer

Muellerectomy is very popular with surgeons because it is a very anatomically easy to perform surgery and can provide a very nice correction of a small amount of ptosis. The rub is that it is so simple a surgery that surgeons often accept failed results and try to tell you that surgery was successful when it is not. The Mullerectomy removes a pinch of tissue behind the eyelid. Studies suggest that it works by plicating and shortening the main levator tendon. To be effective, the levator aponeurosis needs to insert into the tarsus-the hard platform of the upper eyelid. When the central levator aponeurosis does not insert into the tarsus, it is also not in position to benefit from the Mullerectomy. How often is there a central levator aponeurosis disinsertion? Good question. The answer is more than 50% of the time. That means Muellectomy surgery often fails. An anterior levator aponeurosis resection ptosis surgery is the answer. However these are fussy and it is easy to see an under or over correction or a countour abnormality. We call that a peak or an A-frame. It can be corrected by repeating the surgery and fixing the contour. You really need to find very specialized are for the fix for this. I do not think you will find this work in Europe. I am attaching a video regarding this work and a website reference. Your eyes can be your best feature.

Katrinka L. Heher, MD · Answer

Ptosis can be tricky to fix so having already had two surgeries, I think you could consider having another procedure with a different surgeon. Unfortunately some types of ptosis can’t be significantly improved so you take this risk, but at least you’ve given it a shot. As to which procedure is best it depends on the surgeon’s training and experience.   Just try to find the surgeon with the most expertise. Hope this helps and best of luck!

What technique and which success rate after 2 failed Ptosis surgeries? (photo)

Answers (2)

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