Should I Have a Third Ptosis Surgery? (photo)

Question

I have unilateral, congenital ptosis of the right lid. I had two surgeries on the levator muscle at 3 and 25. Each surgery was initially successful, but the lid dropped back down. I am 31, and my surgeon wishes to perform a frontalis suspension. I am undecided about the effectiveness of a third surgery. I am not optimistic about the results after having two "failed" surgeries and am worried about possible complications due to this being my third surgery. I can currently close my lid completely.

A.J. Amadi, MD · Answer

Frontalis sling is the classic method, and if you haven't had that performed before then it would be a good option for you.

	The other option of maximal levator resection or full thickness lid resection may give you a better result when you have your eyes open, but it will be more risky in terms of dry eye problems and eyelid closure.

Mehryar (Ray) Taban, MD, FACS · Answer

Congenital ptosis with poor levator muscle strength doesn't leave many options. The classic technique would be frontalis sling, however you might benefit from another technique called full thickness lid resection ptosis surgery which takes advantage of the existing scar.  No matter which technique you do, you have to understand that you have a difficult problem and your eyelid will never be normal.

Kenneth D. Steinsapir, MD · Answer

We do them on children because even though the kids have trouble closing their eyelids, they adapt.  Adults do not adapt well to these situations.  If I were  an adult in your situation, I would get multiple opinions from recognized leaders in oculoplastics.  Generally these will be university based surgeons who run their own fellowship.  These will be the individuals with the greatest experience with the surgery that is being discussed.  These are very difficult situations especially if you have less that 8 mm of levator function.  Look on the ASOPRS website and use the geographic directory.  Don't have surgery until you have had at least 3 consults with university based oculoplastic surgeons.

Mitesh Kapadia, MD, PhD · Answer

Hi Michelle,

	Unfortunately, there is no real "cure" for congenital ptosis. The main muscle that lifts the eyelid doesnt function normally and there is no way to make it function better. That being said, if you have already had multiple levator muscle surgeries, a frontalis sling procedure would probably give you best chance of a longer-term lift in the eyelid position. The procedure is far from ideal - the curvature of the eyelid is sometimes suboptimal after this procedure and the eye may not close completely. Only you can decide if it worth going through another surgery. Best wishes.

Lawrence Kass, MD · Answer

Only you can answer whether you should have a third procedure.  Does the drooping bother you sufficiently to warrant this?  If you are bothered by the ptosis than the sling is a viable answer.  However, if the lid is brought up, you may have more difficulty achieving full closure and greater dry eye symptoms.

Should I Have a Third Ptosis Surgery? (photo)

Answers (7)

Answer: Congenital ptosis surgery

Answer: Congenital ptosis surgery

Answer: Third ptosis surgery?

Answer: Third ptosis surgery?

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Should I Have a Third Ptosis Surgery? (photo)

Answers (7)

Answer: Congenital ptosis surgery

Answer: Congenital ptosis surgery

Answer: Third ptosis surgery?

Answer: Third ptosis surgery?

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Recommended reading

Everything you need to know about Eyelid Surgery

Our mission is to create a world where every investment in modern beauty is Worth It.