Cant Blink after Congenital Sling Surgery, Can This Be Fixed?

Question

I was born with droopy eyelids and had to get surgery when i was a small child (between 1-4). They took a muscle out of my leg just above my knee and put it in my forehead to help correct my eye movements. Along with this, the surgeon also stitched my eyelid open so that i cannot blink at all. I am 19 now you can imagine that my biggest concern is how i look when i stare down and my upper eye isnt covered by an eyelid. That is how people know whats wrong with me. Can this be fixed?

Mehryar (Ray) Taban, MD, FACS · Answer

The problem you are describing can be improved but only at expense of worsening droopy eyelid.  There can be a happy medium where there is some droopiness but the can blink and close the eye. See an oculoplastic surgeon.

Kenneth D. Steinsapir, MD · Answer

This is the story of congential ptosis.  Your original surgeon did not remove a leg muscle.  What that did was harvest fascia lata from the leg.  This tissue is used to make a facial connection between the eyelid margin and the brow muscles.  The surgery does make it possible to open the eyes.  The down side is that the appearance is never quite right.  fixing this to make it better may be possible but it is not realistic to expect that it will be normal.  You really need to find an oculoplastic surgoen who does a lot of work with frontalis suspension.  I would recommend finding an oculoplastic surgeon who runs an ASOPRS fellowship.  The ASOPRS website has this information.

Matheson A. Harris, MD · Answer

Frontalis sling surgery is making the best of a difficult situation.  Your levator muscle that opens the eyelid did not develop normally and the sling is the best, although imperfect, way to fix it.  I agree with Dr. Steinsapir below.  One thing I'd add is that many new materials have been used in recent years for frontalis sling, such as silicone and Gore-tex. I prefer silicone and find that it has some stretch, which allows the eyes to close better with forced blinking.  I recently revised bilateral slings on a 70 year old man with fascia lata slings placed when he was young. We used silicone and his eyelid movement was much improved.  Find an ASOPRS member near you to discuss your options.

Cant Blink after Congenital Sling Surgery, Can This Be Fixed?

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Cant Blink after Congenital Sling Surgery, Can This Be Fixed?

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