When getting ptosis surgery for the second time, do you replace the sling?

When I was three, I had ptosis repair with a sling because I have congenital ptosis in my right eye. The eye now looks terrible and very assymetrical. I went to a specialist who said she was going to do all of these procedures when all she really did was tuck some muscle somewhere to try to lift it up more. It was only about a week ago but the swelling on one side is down and there is no difference. So, can the sling be too small now since that was 22 years ago and why didnt she replace it?

Doctor Answers 1

This is a highly specialized situation.

Generally you need a minimum amount of excursion of the upper eyelid.  This is called levator function.  Below about 8 mm of levator function, a sling to the forehead is needed.  Levator ptosis repair is more effective with more levator function.  Presumably the recent surgeon felt there was enough function to warrant this approach.  Honestly, the frontalis slings are rare enough that you should see a University based oculoplastic surgeon and not simply a local specialist.  Without a personal examination, it is not possible to fully answer your question.


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