Almost 2 years post upper bleph, which needs revision for raised lumpy scarring, high crease etc. Had consultations with 3 oculoplastic surgeons, with different opinions. I also have ptosis in both eyes. I see the advantage of (scarless) posterior ptosis repair alone. However, if the surgeon is making the eyelid incision anyway for the revision upper bleph, why not do the anterior ptosis repair through the same incision? Preferred surgeon wants to do posterior repair. I'm a contact lens wearer.
August 25, 2016
Answer: Ant vs post approach ptosis correction surgery Hi Peta. Most of my oculoplastic colleagues in the UK still go for an anterior approach as that is how most of us have been trained. Increasingly there's a vogue though for a posterior approach as the recovery time is quicker, there's reduced risk of scarring of the skin and theoretically it makes more anatomical sense. Quite a few of my colleagues do report good results for contact lens related aponeurotic ptosis (with high creases) via a posterior approach (e.g. white line advancement surgery). I personally still prefer an anterior approach as I like to reform a skin crease properly and it's just an approach I'm most happy with. As you say it makes sense to go for an anterior approach if you need a revisional blepharoplasty anyway and seems illogical to cut through the skin and then again through the back conjunctiva. If the ptosis is very mild though then some surgeons prefer a posterior approach as they feel their results are more predictable plus they can offer adjustability post op. Either way the most important thing is find a surgeon whom you're most comfortable with. Both approaches have their pros and cons
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August 25, 2016
Answer: Ant vs post approach ptosis correction surgery Hi Peta. Most of my oculoplastic colleagues in the UK still go for an anterior approach as that is how most of us have been trained. Increasingly there's a vogue though for a posterior approach as the recovery time is quicker, there's reduced risk of scarring of the skin and theoretically it makes more anatomical sense. Quite a few of my colleagues do report good results for contact lens related aponeurotic ptosis (with high creases) via a posterior approach (e.g. white line advancement surgery). I personally still prefer an anterior approach as I like to reform a skin crease properly and it's just an approach I'm most happy with. As you say it makes sense to go for an anterior approach if you need a revisional blepharoplasty anyway and seems illogical to cut through the skin and then again through the back conjunctiva. If the ptosis is very mild though then some surgeons prefer a posterior approach as they feel their results are more predictable plus they can offer adjustability post op. Either way the most important thing is find a surgeon whom you're most comfortable with. Both approaches have their pros and cons
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