I had a mullerectomy on my left eye about three weeks ago for congenital potsis and I don't see any improvements. Will just have accept the asymmetry in my face? I thought that my left eyebrow might be trying to pull up the left eyelid up due to the ptosis, so it was more arched, bit maybe my eye structures are just asymmetrical? Would other surgery be too risky for slight ptosis in one eye?
January 21, 2017
Answer: Failed Congenital Ptosis Repair Sorry your eyelid is still drooping. I tell patients undergoing muellerectomy (internal ptosis repair) that there is about a 10% reoperation rate. There can be many factors that can be unpredictable in terms of the healing and the result obtained, and I have done well over a 1500 ptosis surgery repairs. Also, some patients with congenital ptosis the internal approach just doesn't work. I will only use it on patients that respond well to what we call the phenylephrine test. Since you are only 3 weeks out, it still may improve. I've seen in rare circumstances the repair improve over a few months. It doesn't appear that you have much swelling left, so this is hard to say. An external incision approach could be done, and should work well. The external approach can be tougher sometimes to obtain the desired symmetry in terms of contour and elevation, but carries a high satisfaction rate. Best regards.
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January 21, 2017
Answer: Failed Congenital Ptosis Repair Sorry your eyelid is still drooping. I tell patients undergoing muellerectomy (internal ptosis repair) that there is about a 10% reoperation rate. There can be many factors that can be unpredictable in terms of the healing and the result obtained, and I have done well over a 1500 ptosis surgery repairs. Also, some patients with congenital ptosis the internal approach just doesn't work. I will only use it on patients that respond well to what we call the phenylephrine test. Since you are only 3 weeks out, it still may improve. I've seen in rare circumstances the repair improve over a few months. It doesn't appear that you have much swelling left, so this is hard to say. An external incision approach could be done, and should work well. The external approach can be tougher sometimes to obtain the desired symmetry in terms of contour and elevation, but carries a high satisfaction rate. Best regards.
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Answer: Healing after Mullerectomy Experienced oculoplastic surgeons have differing opinions on the use of mullerectomy. Some surgeons never use it because it removes normal lining of the posterior lid and may remove some accessory glands. Often patients who have this procedure notice slipping of the lid level over time. Muller's muscle may be the physiologic source of the ptosis in a small minority of cases. When it is used for levator dehiscence, congenital, or myogenic ptosis, it does not directly address the source of the problem - the levator muscle. After any kind of ptosis surgery, it is best to wait several months before considering another procedure. You may find that the lid elevates as the edema resolves. Best wishes.
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Answer: Healing after Mullerectomy Experienced oculoplastic surgeons have differing opinions on the use of mullerectomy. Some surgeons never use it because it removes normal lining of the posterior lid and may remove some accessory glands. Often patients who have this procedure notice slipping of the lid level over time. Muller's muscle may be the physiologic source of the ptosis in a small minority of cases. When it is used for levator dehiscence, congenital, or myogenic ptosis, it does not directly address the source of the problem - the levator muscle. After any kind of ptosis surgery, it is best to wait several months before considering another procedure. You may find that the lid elevates as the edema resolves. Best wishes.
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