Will ptosis repair surgery help my eyes and give them a better look, especially when smiling?

Question

I can barely see my eyes especially when smiling, will a ptosis repair give me eyes a better look

Joseph L. Daw, Jr., MD, DDS · Answer

Karl,
Based on the single photo that you provided, I appreciate mild ptosis of the upper eyelids that is slightly asymmetric.  What stands out more to me is the heaviness of your brows related to brow ptosis.  The distance between your upper eyelid lashes and the lower edge of the brows is very small, compromising the aesthetics of the eyes.  Optimal improvement would be provided by a brow lift and upper eyelid ptosis repair.

Charles S. Lee, MD, FACS · Answer

You have detachment of the muscle that opens your eyes, causing the eyes to half-way close. typically, patients will raise the forehead to help open the eyes. When you smile, the brows drop and are no longer able to assist in eye opening - at this point you are seeing the true position of the eyelid. Ptosis repair will place your eyelids into the proper position. You may consider combining it with an endoscopic browlift if you want to maximize the appearance around the eyes.

Mehryar (Ray) Taban, MD, FACS · Answer

It appears you have upper eyelid ptosis which can only be effectively improved with ptosis surgery. See an oculoplastic surgeon for evaluation and treatment.

Kenneth D. Steinsapir, MD · Answer

Botox is nice and all but it really does not address ptosis. Surgery is necessary to improve ptosis. Ptosis surgery strengthens the opening effect of the levator palepebrae superioris muscle. This muscle inserts with a tendon into the upper eyelid. By shortening the tendon, the eye opens more effectively. Generally surgery is performed under light intravenous sedations in an accredited surgery center. Oculoplastic surgeons perform these surgeries. While other subspecialties my dabble in ptosis surgery, you should seek a true specialist for this. The American Society for Ophthalmic Plastic and Reconstructive Surgery maintains a regional directory on their website that can help you find a highly qualified surgeon.

Jeffrey Joseph, MD, FACS · Answer

Thanks for the question and photo.   It would be best to see multiple photos of your eyes to better evaluate your condition.   I’d recommend seeing what Botox would do before any surgery.

Paul E. Goco, MD · Answer

Thanks for your question and photo.  Based on our photos, it does not appear that ptosis surgery would be beneficial.  Have your tried botox yet??? Botox can lessen crowsfeet and squinting activity and provide a browlift that may open your eyes and make you look more youthful.  Best!

Katrinka L. Heher, MD · Answer

If there is any drooping of the eyes, it’s worse when smiling. We unconsciously use our brows to elevate our eyes, and this shuts off when we smile.   You should see an oculoplastic surgeon who can evaluate you and recommend options.   I believe your ptosis could be significantly improved. Wishing you the best of luck!

Johnson C. Lee, MD · Answer

Thank you for your photo. Ptosis repair surgery can help tighten the muscle which controls the upper eye and give you a more open and brighter look both at rest and when smiling. It is best to have an in-office evaluation to determine the degree of ptosis you have and the best type of ptosis repair technique for your specific case. Hope this helps!

Johnson C. Lee, MD
Board-Certified Plastic Surgeon

Johnson C. Lee, MD 
Board-Certified Plastic Surgeon

Reginald Rice, MD, FACS · Answer

Ptosis is when the lid hangs down and covers a part of the pupil affecting vision. It also does make the eye look tired. However, from the single photo, it does not appear that your lid covers any of the pupil, therefore blepharoptosis may not be a significant contributor. Have your doctor apply a small amount of ophthalmic phenylephrine to your eyes. This medicine causes the muscle that is weak in ptosis to contract just a little more--if ptosis is present the eye will open up and the amount of ptosis can be assessed. If present it certainly should be repaired as does make the eye more open.

Hardeep Dhaliwal, MD, DMD · Answer

Thanks for the great question.
Looking at your photos you have mild ptosis in your right upper eyelid. This can be seen by where the edge of the eyelid rests compared to the edge of the pupil.
Although surgery will open the eye slightly, it will only be for the right eye and will only be subtle to the average observer.
As other Doctors have already suggested, Botulinum Toxin (Botox or equivilant) will help. I would ask your injector to also deposit a little botox to help achive a brow lift. You likely will need at least 20-30 units of toxin (botox, xeomin, jeaveau) to achieve an appreciable result. However, you could always start at a lower dose and then reinject more toxin after 2 weeks.
Warm Regards,HD

Will ptosis repair surgery help my eyes and give them a better look, especially when smiling?

Answers (10)

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