Can the Attachments That Form the Upper Eyelid Crease Loosen from Surgery?

If “The upper eyelid crease is formed by attachments of the levator aponeurosis to the skin" Is it possible that these attachments could be disturbed (and cause the upper eyelid crease to droop) by a upper bleph and / or ptosis repair surgery? I am 1 yr. post op from bilateral upper bleph, and left eye only mueller's muscle resection for mild congenital ptosis. about 4mm of skin was removed, no muscle or fat. Following surgery my naturally high / deep creases are drooping. Can this be fixed?

Doctor Answers 5

Can the Attachments That Form the Upper Eyelid Crease Loosen from Surgery?

 Yes, the attachments can be cut and weakened with upper eyelid surgery (Blepharoplasty), especially when a large portion of the eyelid muscle is removed which increases the depth at which the tissues are dissected...and the attachments weakened.

Beverly Hills Facial Plastic Surgeon
4.6 out of 5 stars 25 reviews

Upper eyelid crease

There could be various factors in play here.  The crease can be changed by prior surgery including blepharoplasty. The crease is affected by eyelid skin, orbicularis muscle, fat, and levator muscle. See an oculoplastic surgeon for evaluation.

Mehryar (Ray) Taban, MD, FACS
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 73 reviews

Cosmetic Surgery is an Art and a Science

The levator muscle attatchment to the skin creates a natural crease in the eyelid. Most patients do not have symmetrical lids and that is what makes us unique. Without photos, it is hard to completely answer your dilemma. Revising the muscle attatchment may help. Thomas Narsete, M.D.

Thomas A. Narsete, MD
Denver Plastic Surgeon
5.0 out of 5 stars 10 reviews

Upper eyelid crease

Upper eyelid crease can be disrupted by lid surgery, with resultant drooping of the crease.  This crease can be re-created with corrective surgery. There  might be some residual asymmetry, depending on the degree of existing pre-operative asymmetry and ptosis.

Boris M. Ackerman, MD
Newport Beach Plastic Surgeon
4.7 out of 5 stars 57 reviews

Ptosis Repair Affects Lid Crease Position

Your naturally high deep creases were a consequence of your eyelid ptosis or drooping.  The retracted levator muscle causes a high deep crease...which is not normal.  Once the lid position is corrected, the lid crease is naturally lowered. Ideally in women, the lid crease should be 8-10 mm above the lid margin.  Discuss your concerns further with your surgeon. All the best.

Robert F. Centeno, MD, FACS
Columbus Plastic Surgeon
4.9 out of 5 stars 77 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.