Can I have my ptosis revised?

Question

Hello. I had ptosis surgery. I would like the outer edge to be lower than it was placed. Is this possible to correct? I want the Iid at the edge to be lower

Mehryar (Ray) Taban, MD, FACS · Answer

It is possible to do that although it is not a routine procedure and there are risks and limitations involved. See an oculoplastics expert.

David Samimi, MD · Answer

Thanks for posting this question. The contour of the eyelids are incredibly important for the appearance of the face. What you are noticing is a lateral flare aka relative upper eyelid retraction. In addition to the upper eyelid lateral flare, your photo shows a lateral lower eyelid flare as well. To answer your question, this appearance may be correctable but not without its risks. I would recommend allowing the eyelid to heal for at least 6 months, during which time perform massage and puling maneuvers to help the upper eyelid heal a bit lower. If you are still bothered by the appearance at that time, a revision could be considered where the levator muscle is accessed through an upper eyelid crease incision and relaxed in a graded fashion to lower the eyelid. Given the appearance you like in the photo with your finger, once could also consider doing a lower eyelid elevation or "canthopexy" at the same time or later. But you would have to know that these procedures are unpredictable and there is a significant chance of an under or overcorrection. Of course it would be best to discuss your concerns with your primary surgeon and help find the best way forward. Wish you the best.

A.J. Amadi, MD · Answer

Your photo and outcome illustrate how difficult ptosis surgery really is. Even fractions of a millimeter can make your result unsatisfactory. Your photo does illustrate that the contour of the eyelid is slightly off. The peak of the eyelid curve should be slightly medial (towards the nose) of the pupil, and  yours is slightly on the outside portion. Having said that, its  very subtle and a lot of patients would not have noticed it. Even the best, most meticulous surgeons occasionally will have a result like this. This can be improved surgically if massage doesn't settle it, but it is a challenging surgery that should only be re-vised by an Oculoplastic surgeon who specialize in this type of surgery. Ideally, I wait 12 months before attempting revision, but 6 months may be enough. Discuss this with your surgeon first to make sure that you are on the same page. If not, seek a second opinion.

Kenneth D. Steinsapir, MD · Answer

Generally it should not be addressed surgically for at least 6 months. Have you discussed your concerns with your surgeon? Massage is usually used first to address this type of lateral flare. Assuming you have massaged and 6 to 12 months have passed to let the eyelid heal, a detailed assessment is needed to determine the basis for the flare. It might be simply from over correction laterally or from lateral canthal disinsertion. Fixing this type of flare can be fussy business. However, I would encourage you to talk with your original surgeon regarding the issue. If they don't validate your concerns or are uncomfortable with the repair, you may need to seek a second opinion.

Can I have my ptosis revised?

Answers (4)

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