Eyelid crease is gone after silicone frontalis surgery on congenital Ptosis eye w/ poor levator function....what are my options?

I had my third surgery on my eyelid in order to correct the height and to be honest the outcome is fine with me. I had this surgery about 6-7 months ago. The only issue is that now my eyelid crease is gone...missing. My doctor said there is not much he can do but cut a line and put in stitches and hope it creates a crease after the stitches are removed. Is this my only option? Can't he attach it to the tarsal?

Doctor Answers 2

Congenital ptosis repair

Surgery for congenital ptosis is always harder than for a regular ptosis with good levator function.  You know this since you have had multiple surgeries to try and fix your lid height.  People with congenital ptosis usually have little or no lid crease.   When you do a frontalis sling, there is no way to try and make a crease.  Sometimes an incision where a crease should be can help create a small crease, but this doesn't always work.  Luckily you have a good lid height which is the most important issue here.

Coral Gables Oculoplastic Surgeon
5.0 out of 5 stars 27 reviews

Eyelid Crease After Ptosis Surgery

This is a difficult question.  The first think to understand is why you have ptosis in the first place.  Is it congenital?  acquired from a trauma? You mentioned that you had a silicone sling frontalis surgery...which is often a last resort surgery if all other options are failed.  It may be a good idea to upload some photos.  It is possible to redefine your crease (as your surgeon had mentioned), but not without an incision.  To answer your question, it is very possible to reconstruct the crease by adhering the skin to the tarsal plate.  In these scenarios, I place both an external set of sutures, and an internal set so the skin adheres.

Salvatore Pacella, MD, MBA, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 36 reviews

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