Ptosis Surgery Strange Outcome

Hello All Respected Doctors I had ptosis by birth(left eye~2-2.5mm). After 4 months from ptosis surgery of left eye still the height of the eyelid is same as before surgery and strangely my eyelid is now more thicker compared to what it was before surgery. Please tell me by looking at my picture that is it swelling or extra skin that has come out. My surgeon says that it is swelling, but i am confused what actually is it. In 4 months no increase in eyelid height occurred. please help me

Doctor Answers 9

Ptosis Surgery Strange Outcome

From your picture, it does look like there might be swelling.  We usually urge you to wait 6 months to see the final result.  Congenital ptosis repair is difficult and often has undercorrections.  If at 6 months you are not satisfied with your eyelid height, you should discuss the options with your surgeon.

Beverly Hills Oculoplastic Surgeon
4.7 out of 5 stars 16 reviews

Swelling in Eyelid after Ptosis Surgery

I usually don't comment unless I have an idea. This is my opinion on what is likely going on. I think that the approach that was made to correct your ptosis repair has caused some contracture and tissue buildup to create a crease for you that you did not have before. That is why you are seeing more lid on the left side.  The way to correct this would be to assess where the crease is set on the good eye. Approach the revision at the same height as what you measure on the good eye, revise the ptosis repair and then close without recreating your crease.  If you do have a distinct crease on the good side, I would create the crease on the ptotic side at the same height as the good side.  The issue would then be whether the current crease will have the tendency to reform.  This can be prevented with some fat grafting through my techniques.  Although this is my opinion, I'm pretty sure this is what has happened.  You can always write me if you would like some more counsel.

Philip Young, MD
Bellevue Facial Plastic Surgeon
4.2 out of 5 stars 86 reviews

Revision Surgery for Ptosis Surgery

Eyelid swelling can be significant up to 6 months and even 1 year. If the eyelid level remains after the next 2 months, a second procedure may be necessary.

Amiya Prasad, MD
New York Oculoplastic Surgeon
4.3 out of 5 stars 72 reviews

Ptosis after repair

At this point I doubt that swelling alone is responsible for the lack of improvement that you see. I believe that it will likely need a revision.

Mark Preston, MD
Columbus Plastic Surgeon
4.4 out of 5 stars 21 reviews

Ptosis Repair

From this one photograph it is hard to tell exactly what happened. Congenital ptosis is often due to a defect of the lifting muscle of the eyelid. If the muscle doesn't work at all, then operating on the muscle may not work well  and can lead to prolonged swelling.

If operating on the muscle didn't work, you might need a "sling operation". This is where an implant is placed in the eyelid and attached to the lifting muscle of the eyebrow.

David Schlessinger, MD
Long Island Oculoplastic Surgeon
4.8 out of 5 stars 17 reviews

Persistent ptosis after repair

From the picture it does appear that you have some swelling.  There may be a mechanical component to your ptosis secondary to the swelling.  It is unusual to have residual swelling four months out but it is possible.  I would give it a couple of more months.  In addition, it is important that the correct procedure was performed for your repair.  There are different methods of correcting ptosis (sling, levator resection and levator advancement) based on the degree of levator function.  With congenital ptosis, levator function is usually impaired and so a sling or resection is needed for correcting it.  I would seek consultation of an oculoplastics specialist who would be able to assess your levator function and direct revision surgery appropriately.

Keshini Parbhu, MD
Orlando Oculoplastic Surgeon
3.9 out of 5 stars 10 reviews

You will need revision

You ptosis was congenital and you may not have enough levator muscle funtion. You may need revision and sling. The other reason that you need revision is the eyelash sagging in your left eye which I correct during the ptosis repair. Please also send picture while your eyes are closed,open and fully trying to open. That will show you muscle function.

Kamran Khoobehi, MD
New Orleans Plastic Surgeon
4.7 out of 5 stars 124 reviews

Ptosis Surgery Strange Outcome

Sorry looks like the operation did not succeed. seek revision. From MIAMI Dr. darryl j. Blinski

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.6 out of 5 stars 174 reviews

Ptosis surgery problems

I don't consider myself an expert on ptosis repair so it will be interesting to see what our ophthalomlogy doctors say but it looks to me like your repair just didn't work.  A preop photo side by side would help.

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon
4.8 out of 5 stars 67 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.