Will the standard ptosis surgery work for me or do I need a more advanced procedure?

Question

Hello. I want to fix my upper eyelids with ptosis surgery but I want to make sure I get the right surgery. Would the standard surgery be correct for me?

Charles S. Lee, MD, FACS · Answer

I prefer an incision technique on the skin in order better access the muscle that opens the eyelid directly (anterior approach). The eyelid crease can be recreated more precisely this way. The posterior approach is done from the undersurface of the eyelid but in my opinion is not as precise.

Kenneth D. Steinsapir, MD · Answer

There is no substitute for a personal assessment. That assessment should include a neosynephrine test. If you respond to the drop with more open eyes, many eyelid surgeons make the mistake of assuming that you will do well with the Mueller's muscle conjunctival resection ptosis repair. That is not accurate, which accounts for the high failure rate of this surgery. If the central levator tendon is disinserted in the eyelid, the Muellerectomy is likely to fail even if the eyes respond to the neosyephrine test. These eyelids need the anterior levator resection ptosis surgery. Bottom line, there is no substitute for finding a very experienced ptosis surgeon.

John J. Martin, Jr., MD · Answer

There are two standard techniques for correcting ptosis. One is done from the outside, called an external levator advancement or resection.   The other is done from the underside of the eyelid.  This is called a Mullerectomy.  If someone has a true congenital ptosis with poor muscle function then they may need something else.  See an oculoplastic surgeon who can evaluate your eyelid muscles to determine what surgery would be best for you.

Will the standard ptosis surgery work for me or do I need a more advanced procedure?

Answers (3)

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