Ptosis - has my surgery failed?

Question

Hi, I had ptosis blepharoplasty surgery 11 days ago and I’m not seeing an improvement in my right eye lid level. My doctor said the muscle was fatty which can limit the result. Will I be able to improve my eye level any more? Has the surgery failed? I’ve attached a before photo, the day after operation swelling and my eye lid level now.

Kenneth D. Steinsapir, MD · Answer

You are so early from your ptosis surgery that I would be patient. Will surgery be satisfactory? I think your surgeon is already preparing you for potential failure by telling you that your levator is "fatty." You need a couple of months of healing here.  One key thing here is how much levator function did you have before surgery. Levator function (measure of upper eyelid excursion) is less than 8 mm, the likelihood is that leavtor resection surgery will be unsuccessful. Levator function greater than 12 mm is favorable for ptosis surgery. If this surgery is not successful, I strongly do not endorse trying to make it better Mullerectomy.  That is highly unlikely to be successful. I have much greater success with revisional anterior levator resection ptosis surgery.  At the moment I advise patience. Let this eyelid heal and stay away from sites like this for the next two months.

John J. Martin, Jr., MD · Answer

You are still early in the healing phase, so you may get some more elevation in the lid as all the swelling and inflammation resolve.  If you still have ptosis after a few months, you may benefit from doing an internal ptosis repair - this is done on the inside of the lid, also called a mullerectomy.   But let things heal from the previous surgery first.

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