I had upper/ lower blepharoplasty about 6 years ago. Ptosis was present, but the doctor did not mention the ptosis as a problem separate from the other eye work. I thought my droopy lid would be addressed by the surgery. For a couple of years it was. Now it's back to drooping to the point where I look "off". I consulted a surgeon that does excellent ptosis work, but he said the ptosis isn't enough (yet) that he could work on. I've read about eyedrops. Are they a viable solution for now?
What to Do for Ptosis of the Eyelid?
Doctor Answers 4
Eye drops for ptosis
Eye drops can only work for mild ptosis and are temporary. Follow your surgeon's advice or seek another opinion.
Communication between Surgeon and patient is extremely important. From your description it is not clear if your surgeon recognized the ptosis before surgery and obtained your permission to address it OR you assumed he would "I thought my droopy lid would be addressed by the surgery".
As to the second surgeon's reluctance to correct your ptosis, I suspect either he was not comfortable performing such a repair or you may have insisted he petition your insurance company to pay for a repair of a degree of ptosis he knew would be be approved.
I am certain that if the insurance company was not a part of your request and you were paying for the surgery, regardless of its complexity, your ptosis repair would be performed quickly.
If you have ptosis of the actual eyelid, then there are drops that can help lift the lid in some circumstances. If you have ptosis of the skin on the eyelid (the actual lid position is normal but the skin is hanging over) then you may need surgery to remove the extra skin. There are criteria for insurance to cover such a surgery. The doctor may mean that you do not meet that criteria yet. Good luck.
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A photograph would be very helpful
Ptosis is very common. There is a sharp distinction between cosmetic eyelid surgery and ptosis surgery for a simple reason. The vast majority of eyelid surgeon performing cosmetic eyelid surgery are only vaguely familiar with the anatomy of the eyelid. Removing skin and fat from an eyelid is not too technically challenging.
Repairing eyelid ptosis is a whole other matter. The surgeon has to have mastery of the deeper eyelid anatomy to identify the tendon that raises the upper eyelid. The surgeon needs a great deal of experience resetting this tendon to cosmetically control the upper eyelid contour. These are skills that almost don't exist with general plastic surgeons and facial plastic surgeons, even ones who perform great cosmetic blepharoplasty. I suspect that the surgeon you consulted in to a fellowship trained oculoplastic surgeon. We operate on both large and small amounts of ptosis all the time.
When the ptosis is small, it is generally deemed cosmetic and not covered by health insurance. When it is severe, the eyelid actually blocks or partially blocks the field of view. Under these circumstances, the repair is often covered by health insurance. I would encourage you to visit the American Society for Ophthalmic Plastic and Reconstructive Surgery website: ASOPRS.org. This site has a directory that will help you find a well qualified surgeon in your area.