How Many Ptosis Surgeries Can 1 Eyelid Safely Handle?

An adjustment is still a surgery.  However, the surgeon takes advantage of the healing tissues to gently reopen the eyelid that has not fully healed.  This is relatively common for ptosis surgery.  Ptosis surgery is complicated by a number of factors.  The big one is the reality that the eyelid must continue to function even as you are healing.  This is not ideal but this is what we have to work with.  Also how much excursion the eyelid has prior to surgery is very indicative of how successful ptosis surgery is likely to be.  When there is ptosis from birth or early childhood and very little excursion, repair of ptosis is very difficult.  This is where the experience of your ptosis surgeon is very important.  The most experience ptosis surgeons will be ophthalmologists who are fellowship trained oculoplastic surgeons and pediatric ophthalmologists.  You might consider seeing Dr. Raf Ghabrial in Sydney or Alan McNab in Melbourne for a second opinion.

Even though you have had 2/3 surgeries on the eyelid, you can safely have another procedure if your results were less than satisfactory. Make sure you choose an experienced surgeon.

Andrew Campbell, M.D.

Board Certified Facial Plastic Surgeon

Your eyelid has had sufficient time to heal, settle,and soften the scar tissue from your previous surgeries. A new surgeon sounds like a good idea, but make sure you have carefully researched his/her credentials and experience. Ptosis surgery is challenging since it's not just a "measure and cut" type of procedure. Muscle stretch, variable healing factors, and effects of swelling and scar contracture are all variables that can yield less-than-perfect symmetry despite any surgeon's best efforts. I'm sure your surgeon told you this, but perhaps you considered this defensive or an "excuse." Trust me, it wasn't. Even superb surgeons cannot guarantee perfect results with ptosis surgery (or any surgery, for that matter); less-skilled or experienced surgeons will find this operation even more unpredictable and with a higher chance of residual asymmetry.

In cases such as yours, I try to emphasize that perfection or exact symmetry is both an unrealistic and impossible goal. Improvement so that you do not feel deformed may be the best that can be achieved, irrespective of the number of surgical attempts.

You can have surgery for ptosis repeated. Obviously, each time it becomes more difficult and there’s more scar tissue. So, the less surgery, the better. But, if you really need to have the surgery, because the ptosis is either very cosmetically bothersome or blocking your vision, you can often have it repeated. There are multiple types of ptosis surgery to try, depending on the reason for the ptosis.

Eyelid ptosis can be a bit tricky and in some cases they need to be fine tuned. It really depends uponnumerous factors including levator excursion and how much ptosis you have.  Go to an expert in your ocmmunity to seek help. Good luck.