Not sure I should get another ptosis surgery or the distance between lids. Told there was 1mm after levator resection. (Photos)

Its been about 4 and a half years since I had the levator resection. From this surgery I gained strength in the muscle witch I didn't previous. From gaining strength in my eyelid would that increase the chances of getting an even better result from a second surgery? Lifting my lid doesn't engage my eyebrow muscle. I added 6 photos to hopefully aid in your answer. Thank you.

Doctor Answers 3

Persistent ptosis on the left

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If your levator function is normal on the left, then there is an excellent chance of improvement with repeat surgery by an Oculoplastic surgeon who is experienced with ptosis repair. An external/skin approach is optimal. There is no need to accept this degree of asymmetry! Best wishes for a successful second procedure.

Revision eyelid ptosis surgery is possible

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You do have left upper lid ptosis and revision ptosis surgery sounds reasonable looking the photos. See an oculoplastic specialist. See link and video below too.

Revising a prior upper eyelid anterior levator resection ptosis surgery is challenging.

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Your current result is not acceptable.  Revisional upper eyelid ptosis surgery is an advanced skill and not well performed by the average eyelid surgeon.  You really need to identify a surgeon with a great deal of experience addressing issues like this.  The likelihood that revisional surgery will be successful very much depends on how much levator function you have in the eyelid.  That is the excursion of the upper eyelid from extreme down gaze to extreme up gaze with the eyebrow position held fixed.  When this exclusion is more than 12 mm the likelihood is that surgery can be beneficial.  Below 10 mm the changes are much lower.  From the pictures, it suggest that the levator function may be adequate but this needs to be confirmed with an actual examination.  The left upper eyelid also has lash ptosis and the suggestion that the sulcus is hollow.  This makes me wonder if the levator slipped from position after you had surgery.  I suspect the best approach for you will be an anterior levator resection ptosis surgery with an anchor blepharoplasty.

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

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