Do I Need a Revision For My Eyelid Ptosis Surgery? (photo)

I had ptosis surgery performed about 3 1/2 months ago to my right eye, during the whole healing process my eye looked exactly the same as before, the swelling has mostly gone down i cannot tell if the ptosis is gone but I'm positive i need some more more like a blepharoplasty, its almost as if my eyelid has completely disappeared under excess skin, do i have to go back to my oculoplastic surgeon or can i see a normal cosmetic/plastic surgeon? i feel really hesitant about seeing the same Dr.

Doctor Answers 2

Ptosis surgery is very specialized. Let me share the process with you

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As an oculofacial plastic surgeon, I can tell you that ptosis surgery must have a specialization of oculoplastic surgery. Anyone who has difficulty with ptosis, whether it’s a plastic surgeon, a ophthalmologist or anybody who works around the eye area, always refer these types of patients to an oculoplastic surgeon.

After twenty years of practice that includes a lot of ptosis surgeries, I always tell my patients that it is unrealistic to believe that the procedures will always come out perfect. When I perform ptosis surgery in adults, I have the patient open and close their eyes during the surgery. Most of the time, I let the patient sit and I let them open and close their eyes again so that the muscle and the position of the eyelid is adjusted as closely and accurately as possible. The muscle that lifts the eyelid called the levator muscle is so sensitive that a millimeter or more can make the eyelid look low or high after the anesthetic and medicine wear off.

Despite looking great after ptosis surgery, a certain percentage of people will need revision. I don’t think you need to question the competency of your surgeon as it’s not unusual for someone to have swelling or other issues so they don’t see much of a difference after the procedure. In my practice, I usually wait at least a couple of weeks until swelling has resolved. If it’s clear that the person’s eye has dropped and it is not where it should be, then maybe that's the time for a revision. In most cases, I prefer to try to take care of a patient who needs ptosis revision sooner rather than later unless there are other factors such as swelling that lingers and affects the physician.

I think it’s completely reasonable for you to see your original doctor and consider having them perform the revision. If you’re not comfortable with your physician, then finding another oculoplastic surgeon is more advisable. It’s doubtful that other plastic surgeons or cosmetic surgeons who do not have an ophthalmology or oculoplastic surgery background will feel as comfortable about doing this specialized kind of surgery.  I hope this was helpful, and thank you for our question.

Upper eyelid hollowness

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You have some right upper eyelid/brow hollowness which can improve with filler/fat injection. You may still have mild ptosis but not enough to warrant additional ptosis surgery. See an oculoplastic specialist.

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.