Failed Ptosis Surgery - what are my next steps? I would like to have another surgery done ASAP (Photo)

Question

I had a mullerectomy done to correct the ptosis in my left eyelid 10 months ago. I am less than pleased with the result and was wondering if anyone had any recommendations for next steps, as I would like to have another surgery done ASAP. I understand perfect symmetry is impossible to achieve...but this result is less than satisfactory and there is still noticeable drooping. I also want to mention that I use Upneeq, and have been using it since before my surgery. The result I get from using that is what I would like to see from a surgical procedure. I have included a picture of that as well for reference. Any feedback or advice is greatly appreciated.

Kenneth D. Steinsapir, MD · Answer

My approach is anterior levator resection ptosis surgery performed through a crease incision. Please be aware that the success of surgery is not simply determined by the type of ptosis surgery performed. The excursion of the eyelid is critically important. It is a measure of the function of the levator palpebrae superioris muscle. In some cases, there is an abnormality in the function of the muscle that limits the potential of ptosis surgery to satisfactorily fix the ptosis. Generally thought the most common cause for an unsatisfactory ptosis repair is that the tendon was not advanced enough to correct the ptosis. The most common cause of this is posterior approach ptosis surgery (Müllerectomy ) in the setting of a disinserted or partially disinserted levator aponeurosis. For this reason, the eyelids need to be physically examined to determine what surgery you need which will also inform the conversation that will take place at the time of the consultation between the patient and surgeon. I recommend being very skeptical of a "zoom" consultation. One simply can not gather the information needed to determine what you need from what is really a meet and greet. The other issue that needs to be assessed is why your right upper eyelid is as high as it is. Generally once you have healed 6 months, it is possible to revise the eyelid. It all starts with a detailed personal assessment.

Mehryar (Ray) Taban, MD, FACS · Answer

Revision ptosis surgery may be possible. It is complex. You need more detailed evaluation to determine. See an expert.

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