Ptosis Repair - Over Corrected?

The eyelid usually appears undercorrected a week after ptosis surgery because of swelling.  Your eyelid most likely will go higher as the swelling goes away. So you should see your doctor (or an oculoplastic surgeon) now, rather than later.

Dr Taban

If the eyelid is mildly over-corrected, stretching the eyelid will help settle this overcorrection. If it is overcorrected significant, then a revision will likely be necessary. In either case, your surgeon will need to evaluate. If revision is needed, the earlier the better, as the tissues have not yet healed fully and scar formation is minimal.

If it looks high 1 week after surgery, it likely is.  Go see your surgeon- depending on the way he/she did the correction, sometimes you can have a small procedure done now to lower it without having to go through surgery. Good luck!

Rose

The upper eyelid should be under-corrected not over-correct at just a week out from surgery.  Swelling weighs the corrected eyelid down at this point (like gluing a dime to the eyelid).  As the swelling resolves the lid gradually comes to its final position.  If the eyelid is all ready over-corrected, it will be even worse as the swelling goes down.

There are typically two options here and it very much depends on what was done at surgery.  One option is to physically finger wink the eyelid.  This has the effect of stretching out the eyelid tissues.  This can be effective for small over-corrections.  However, if the eyelid is more than a little over-correct, I generally surgically adjust the eyelid in the office in my procedure room.  At this early date it is possible to inject a little local anesthesia and gently pull the healing tissues apart.  The sutures that are holding the eyelid up are cut and a new suture is placed to position the eyelid in a lower resting position and the eyelid is sutured closed.  This type of adjustment can be done up to 2 weeks after the surgery but the sooner the better. 

If your surgeon was not a fellowship trained oculoplastic surgeon but a general ophthalmologist, general plastic surgeon, or facial plastic surgeon, please be aware that they may or may not have enough training and experience to properly address this situation.  This type of over correct occurs and is not always avoidable.  My consents detail this possibility.   Please be open if your surgeon wants you to see a colleague for a second opinion.  Please call your doctor today.  Do not wait three months.  This is not going away on its own.  

the overcorrection may be functional while the frontalis (forehead) muscle spasm that often accompanies ptosis resolves. but waiting three months is the mistake. if your surgeon feels it is overcorrected, simple massage into position is genrally effective. make an appt ASAP. good luck

Rose,

I do agree with the other physicians and that you should see your surgeon now rather than in 3 months.  Patients that undergo ptosis repair usually have an undercorrected look for the first week due to the swelling.  As the swelling subsides, the eyelid rests at a higher position. If you already appear to have an overcorrected look, you should see your surgeon to see what is possibly causing this. Sometimes your unoperated eye (the left eye) can become more droopy which results in your operated eye to appear more overcorrected.  Nevertheless, if there is any adjustment that can be done to the right eye, now is the time to have it done. 

Hope this helps and good luck.

One week after surgery, the eyelid is usually lower due to swelling of the lid so if you are too high you should see your surgeon.  See them as soon as you can - you should not wait until your 3 month appointment especially if you have concerns.  You may also want to see the opinion of an oculoplastic surgeon if a different type of surgeon did the ptosis repair.

Dear Rose,
At one week, over-corrected ptosis that resolves is rare. If a revision to lower the lid needs to be done, then now is the time. You should see your surgeon to get his opinion of what is going on. Perhaps your unoperated eye dropped due to something called Herring's Law making the operated eye seem to open, and that is the problem. Your surgeon will give you your best answer.

If your eye looks a bit over corrected, it probably is. Go back and see your surgeon to review your results.

It is normal to see a little overcorrection one week after surgery. That has a chance to improve as the swelling goes down and the tissues relax. If it was undercorrected at this point, it will not magically jump up and correct itself and would be more of an immediate concern. But I would get an appointment and go back and see your doctor in the next few weeks for your own peace of mind. Your doctor and you need to follow the position of the eyelid to see how it settles and there is always the possibility of adjusting a suture or two early if it remains high for very long.