Is It Normal to Have a Triple Eyelid After Ptosis Surgery?

Question

Three weeks ago I had ptosis surgery (levator resection, no skin removal) on my right eye. There doesn't seem to be any swelling anymore, but I've noticed that a few hours after I get up, a layer of skin forms right above my eyelid, which looks like an extra fold. It looks like there's a little hollow with a fold underneath. What could have caused this and is the crease likely to improve with time?

A.J. Amadi, MD · Answer

A change in the position of the eyelid height  by ptosis surgery can change the eyelid fold [skin overhang]. In addition the eyelid crease can be altered surgically, depending of the goals of the patient/surgeon.

	In addition, eyelid fat atrophy can potentially change the draping of the overlying eyelid skin. Furthermore, in the postoperative healing process, scarring takes place and takes months to evolve and soften.

	So I would recommend waiting for things to settle down further before considering anymore surgery. Three months is a safte amount of time to wait to be able to assess final results, although scarring can soften even more, though subtley.

John Pak, MD, PhD · Answer

Based on your photos, your right eyelid is lower or ptotic. The multiple folds of the skin represent different attachments of the levator to the subdermal upper eyelid skin. This phenomenon can be seen in individuals with dehiscence of the levator complex. Creating a single fold of the upper lid can be difficult but usually requires ptosis surgery and creation of a single crease.

Francis R. Palmer, III, MD (retired) · Answer

It appears as if some fat, or orbicularis muscle was taken form that upper eyelid creating a skin retraction or indentation.  I'd ask the surgeon the next time you're there for a post op visit.

Is It Normal to Have a Triple Eyelid After Ptosis Surgery?

Answers (3)