What is conjunctivo-mullerectomy ptosis surgery and what does it entail?

Question

My oculoplastic surgeon said my creased upper eyelids may benefit from.. "conjunctivomullerectomy ptosis surgery" What exactly is conjunctivomullerectomy ptosis surgery? What does it entail?. Thanks :)

Vivek Bansal, MD · Answer

Have your Oculoplastic surgeon what he/she is going to include in this procedure with regard to fat removal, skin removal, etc.

Kenneth D. Steinsapir, MD · Answer

The upper eyelids commonly droop due to relative weakness of the tendon that raises the upper eyelid. There can be weakness in the muscle also. Testing done by the oculoplastic surgeon evaluates the relative contribution of these factors. The muellers muscle is a thin muscle in the upper eyelid that helps to create that surprised look when we are frightened. It turns out that removal of a strip of this muscle together with the overlying conjunctiva can help lift up the eyelid. Testing with drops before surgery predicts the potential response to this surgery with reasonable accuracy. This is an excellent procedure, and can be comfortably performed for many individuals under local anesthesia with or without light intravenous sedation. Recovery takes about two weeks. Persistent swelling in the eyelid means that it is often 6-8 weeks before you see the full effects of surgery.

Mark J. Lucarelli, MD · Answer

Conjuntivo-muellerectomy is an effective and popular type of ptosis surgery used to elevate a drooping upper eyelid. 

	Conjunctivo-muellerectomy is performed by removing a precise length of 2 of the layers from the back of the upper eyelid.  No skin incision is necessary. It is usually done under a light sedation in as outpatient surgery.  Some oculoplastic surgeons may perform this in the office with local anesthetic.

	Your oculoplastic surgeon will be able to help you decide whether this surgery of a different type (such as external levator repair)  is a better option in your case.

	Best of Luck,

	 

	Mark Lucarelli, MD, FACS

	Madison, WI

Robert Schwarcz, MD · Answer

A mullerectomy is a great way to address upper eyelid ptosis.  Although not all ptosis can be addressed with this technique it is very effective in achieving consistent results.  The upper eyelid is everted (like many a thrid grade boy did to get attention) and a clamp is placed over the undersurface of the eyelid and the contents of the clamp (mullers muscle and conjunctiva) are cut and a suture is placed.  This avoids a skin incision although very often it is combined with a blepharoplasty that would involve a skin incision.

	All the best

	Rob Schwarcz, MD

	NYC

Michael McCracken, MD · Answer

Diana22x,

	Conjunctivomuellerectomy (or "muellerectomy" for short) is a procedure for tightening the muscle that lifts the eyelid.  It has a number of advantages over the traditional method for lifting the eyelid.  First and foremost, muellerectomy provides more predictable outcomes than traditional eyelid lifting procedures.  Also, this procedure does not require you to open your eyes during surgery to titrate the surgery and it does not require a skin incision.  Muellerectomy is my surgery of choice to lift the eyelid in patients who are candidates.

	However, if you are truly seeking to change your eyelid creases rather than to lift low eyelids, a blepharoplasty may better address your concerns.

What is conjunctivo-mullerectomy ptosis surgery and what does it entail?

Answers (5)

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