Persistent Ptosis Repair Swelling (Almost 7 Months)

I had levator resection for 2 mm congenital ptosis(left eye) six months ago but still no lift in eyelid height, instead swelling continues to this day, i don't know is it swelling or not because i just see extra skin over my eye lid. My surgeon told me earlier that it's swelling and wait for six months now as it has been more than six months so he is suggesting me surgery but this time he says to perform surgery awake for correct symmetry & lift with right eye. Please advise me on awake surgery

Doctor Answers 1

If feasible, I would find a new surgeon.

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While it is very common to need revisional surgery for upper eyelid ptosis, you first surgery was not performed correctly.  In adults, this amount of ptosis should be corrected while you are awake to that the effects of surgery can be judged during the procedure.  This is not done for congenital ptosis is infants and young children who have their surgery under general anesthesia, because, well, no 2 year old will cooperate with this type of surgery.  For these situations, a table such as Burke's table is used to guide the amount of levator resection.  However , this method is not ideal.  Once an individual is old enough to cooperate with surgery while awake (local anesthesia is used so it is comfortable) this provides a much more precise surgical result.  The fact that you surgeon did not use this approach with you initially suggest a lack of experience or training in this specialized area of surgery.  You need to find an ophthalmologist who is fellowship trained in oculoplastic surgery.

Beverly Hills Oculoplastic Surgeon
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