What's the difference between ptosis surgery and a bleph?

Question

Does ptosus surgery change the eyeballs or just the muscle? Will it make your brows pull down. Confused.

Scott Trimas, MD · Answer

Both procedures are done through an incision in the upper eyelid crease. The blepharoplasty is done to remove excess skin to make the eyelid crease and space between the bottom of the brow and the upper eyelid more visible. The ptosis repair is done to correct a hanging eyelid that hangs too much over the iris or the colored part above the pupil. This will result in a more open eyelid. Some patients need both procedures to be done at the same time. Others need one or the other.

John J. Martin, Jr., MD · Answer

A ptosis surgery is done to elevate an eyelid which is too low. The lid is usually in front of the pupil and can restrict vision.  The muscle which elevates the lid is often weak or stretched, and in the surgery the muscle is tightened to elevate the lid.  A blepharoplasty is a surgery where excess upper eyelid skin and fat are removed.  A person having a ptosis repair can also have the blepharoplasty if they have excess skin.  If a patient has a ptosis, they may use their brow to help elevate the lid.  When the lid is elevated surgically, the brow may then relax, and will appear to fall.  You should see an oculoplastic surgeon who can evaluate your eyelid muscles and decide what type of surgery would be best for you.

Soheila Rostami, MD, FAAO, FAACS · Answer

They are two different surgeries. Blepharoplasty only correct the excess skin over the eyelids and it may even correct the fullness over the eyelid with removal of fat from the eyelids. Ptosis is correction of droopy upper eyelids and opening of the eyelids. It has to do with the eye muscles and we correct the ptosis with muscle surgery. this could be with levator advancement or Muller muscle resection.

Erik Miles, MD, FACS · Answer

Great question!  This is a question that confuses many patients.  Blepharoplasty is a general term that is used to describe eyelid surgery, whether it be on the upper or lower eyelid. An upper blepharoplasty procedure is designed to address the excess skin and sometimes fat of the upper eyelids.  This surgery is done on patients with normal (or close to normal) eyelid position.  In other words they do not have ptosis where the eyelid droops down towards the pupil and the eyes appear more closed.  A ptosis operation can reposition the low hanging eyelid as well as remove excess skin when necessary.  It is best to seek an experienced eyelid surgeon, because the treatments for these conditions are vastly different, An accurate assessment needs to be made prior to surgery. Best wishes!

Ronald J. Edelson, MD · Answer

Ptosis surgery is done to correct an eyelid that doesn't open wide enough.  The standard eyelid lift removes excess skin and fat which causes puffiness.  The eyelid lift, or blepharoplasty is by far the more common procedure and is done for facial aging.

F. True Lansden, MD · Answer

Levator repair consists of tightening of the levator muscle that raises the eyelid and is often performed through the same incision, and often at the same time as an upper lid blepharoplasty.  Tightening of the levator will not pull down the brow but removing too much skin during the upper lid blepharoplasty may.  Consult a board certified plastic surgeon who specializes in eyelid surgery and levator repair.

Barry L. Eppley, MD, DMD · Answer

While both use eyelid incisions, a blepharoplasty removes eyelid skin and fat while ptosis surgery adjusts the level (height) of the eyelid. Ptosis surgery works on the eyelid muscles, blepharoplasty does not. Both a blepharoplasty and ptosis repair can be done during the same surgery for simulaneous eyelid correction

William Marshall Guy, MD · Answer

Hello browliftedbut,A blepharoplasty is designed to improve the appearance of the eye by removing excess skin and either removing or repositioning bulging fat.  With ptosis this means that the eyelid or lids are not raising as much as they should.  There are multiple causes of this.  With ptosis repair the goal is to get both eyelids to be at the same position at rest so one eye does not appear droopy compared to the other.  Neither surgery changes the eyeballs but ptosis surgery may change the muscle that helps the eyelid raise up.  When done properly and for the right indication, neither technique should pull the eyebrow down.  This usually occurs when the brow is already low, weighing down on the upper eyelid, and someone tries to remove the "excess skin" of the upper eyelid.  Since the real culprit was the eyebrow pushing downwards removing that "excess" only serves to pull the eyebrow farther down.I hope this helps and good luck.

Ven Erella, MD · Answer

Thank you for your question. In bleph excess skin and fat will be removed and make it look more youthful. In ptosis the muscle responsible for lifting the upper eyelid levator will be repaired so that the lower edge of your upper eye lid high enough not to obstruction to the vision. These two procedures can be done same time with the same incision.  Often they may have both conditions together. It will not pull your bow. Pl consult a board certified PS for evaluation.

Samuel Baharestani, MD, FACS · Answer

Great question.  Ptosis is a condition where the edge of the eyelid (where the eyelashes come out) is droopy, blocking the pupil.  Ptosis repair strengthens the weak muscle that is causing the lid to droop.  Blepharoplasty is a procedure that removes excess skin, muscle, and fatty tissue from the eyelids.  Both can be done for cosmetic and/or functional purposes.  Your best bet would be to schedule a consultation with a board certified oculoplastic surgeon to discuss your specific condition and how best to treat it.  Good luck!

What's the difference between ptosis surgery and a bleph?

Answers (10)

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