Should I repeat internal method of ptosis surgery? Would the same method work?

Question

I had the internal method of ptosis surgery almost a year ago. It lasted for about 7 months. Would this same method of ptosis correction possibly work if repeated and if the muscle were tightened more? I found this procedure very easy to go through.

A.J. Amadi, MD · Answer

The internal ptosis repair method involves shortening the conjunctiva and muller's muscle. If you still have enough redundant tissue, it may be possible to repeat the procedure, but if there is not enough tissue and it is attempted, it could lead to scarring of the eyelid to the eyeball and possible cause poor eyelid closure or even double vision. 
Choose a surgeon that has done this previously and is experienced enough with the required examination to identify if you are a good candidate.

Kenneth D. Steinsapir, MD · Answer

Generally, when you say internal method, presumably you are referring to the Muller's Muscle Conjunctival Resection ptosis surgery. This is a very popular surgical approach among oculoplastic surgeons. I have colleagues who would use this same method again. I would not recommend this. I fix many failed ptosis surgeries. It is my opinion that this surgery does not work well when there is central levator or partial levator disinsertion. Assuming levator function is good or better, I would recommend an anterior levator resection ptosis surgery performed through a crease incision. A photograph would be helpful but it is no substitute for a detailed in person assessment.

Mark L. Mazow, MD, FACS · Answer

Thank you for your question. There are several variations of an internal ptosis repair. Most commonly it involves removal of some of the lining of the upper eyelid along with some of the minor muscle that raises the upper eyelid. While tihs can be repeated one has to e careful to avoid dry eye if too much of the lining of the upper lid is removed as it contains cells that make some of the baseline tears. It is best to be evaluated by a fellowship trained ASOPRS affiliated surgeon who is well versed in all types of ptosis repair. Good luck

Should I repeat internal method of ptosis surgery? Would the same method work?

Answers (3)

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