Severe Ptosis is Eyelid Surgery an Option for my 74 Year Old Mother? (photo)

Looking for Dr. who can perform surgery on severe ptosis patient.

Doctor Answers 12

Blepharoplasty versus ptosis repair

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  Ptosis  is caused by weakness  in the muscle that opens upper eyelid. The repair can be performed through external or internal incision on the upper lid. Dermatochalasis is  caused by excess skin  and  fat of upper eyelid that is causing droopiness  and is repaired for cosmetic or functional reasons. Both  ptosis repair and  blepharoplasty can be performed at the same time.   Both  surgeries are performed as an outpatient procedure. Ptosis repair is usually performed  by an Oculo-plastic surgeon

Seattle Facial Plastic Surgeon
4.8 out of 5 stars 158 reviews

Correcting eyelid ptosis

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Surgery can be performed on a 74 year old who can pass medical clearance.  Your mother's ptosis is severe and, before planning a procedure, understanding the etiology is extremely important. Knowing how much of the problem is excess skin versus weak musculature is key.

Eyelid Ptosis

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Even with this photo with her sunglasses on, it is obvious that your mom suffers from pretty severe eyelid ptosis. The fact that her eyebrows are maximally arch gives it away: she  is trying to compensate by raising her eyebrows.

In general, however, there are three ways to address this surgically. The techniques differ in the approach and in the muscle that is operated on.

In one method, the incision is made through the skin to tighten the muscle that is closest to the skin [levator muscle].

The second approach is through the underside of the eyelid without any skin incisions. In this technique, the eyelid is flipped and the Mullers muscle is tightened. This elegant approach is my preferred technique, as it is more reliable in producing accurate results, and causes less swelling/bruising without any visible scars/incisions.

The third technique, frontalis sling, is used when the eyelid muscles are very weak, and so a sling is attached to the eyebrow muscles [like your mom is naturally doing] to help elevate the eyelids.

There are many question's that need to be answered here:  how long has this been going on? Is it progressively getting worse? Are there are body weaknesses associated with her problem? Does she have double vision? Did she have droopy eyelids as a child?

You definitely need an evaluation by an Oculoplastics surgeon. I would not recommend seeing a general plastic surgeon. Although some may have experience in this problem, most do not.

I have provide a link below that will help find you an ASOPRS trained oculoplastics surgeon near you.

A.J. Amadi, MD
Seattle Oculoplastic Surgeon
5.0 out of 5 stars 42 reviews

Ptosis surgery is a viable option

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It is difficult to see her eyes in the photo.  Were you told that she had ptosis?  Ptosis is when the upper eyelid margin (where the eye lashes come out) hangs down and beings cover the pupil (black part) of the eye.  Ptosis is usually a muscular problem as opposed to the more common condition of having too much upper eyelid skin.  In older individuals, it is certainly possible to see both conditions together.

Fortunately, ptosis and/or too much excess skin can both be fixed in an office or  outpatient setting.  If she is having difficulty seeing because of her ptosis, it would be very reasonable to perform the surgery.  Keep in mind that if one eye is ptotic and the other is not, fixing the ptotic eye may unmask a ptosis in the other eye.  Therefore, it may be necessary to undergo an additional surgery to correct the second eye.

Michael Ondik, MD
Philadelphia Facial Plastic Surgeon

Eyelid ptosis

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There is no age limit for eyelid surgery.  Consult with a Board Certified Plastic Surgeon to discuss your concerns and expectations.  Best of luck to you!

Robert E. Zaworski, MD
Atlanta Plastic Surgeon
4.9 out of 5 stars 61 reviews

Ptosis Repair for Severe Ptosis

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Thank you for the great question and the picture. It's difficult to make out the details of the upper eyelids in the picture. That said, there is not a limit, in terms of age or severity, for ptosis repair. Depending on the severity, different approaches may be indicated (e.g., internal vs. external levator repair). In most cases of "senile ptosis" (eyelid drooping with age), an external approach is used via an upper eyelid lift incision. Best of luck moving forward!

Severe Ptosis is Eyelid Surgery an Option for my 74 Year Old Mother? (photo)

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Hi and thanks for your question. Despite the sunglasses your mom is wearing it is evident that the eyebrows are raised by the forehead muscle in an attempt to compensate for the Bilateral Ptosis. At 74 it most likely to be age related stretching ( dehiscence) of the levator muscle ( the muscle that elevates and opens the eyelid). This makes it ineffective in the same way as an overstretched rubber band. The operation involves tightening of the stretched Levator aponeurosis that helps the ptosis. The raised eyebrows will settle after 3-6 months if the operation is successful. You need to see a Plastic Surgeon who does Ptosis repairs.

Correction of ptosis

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There is no limitation, as far as age, for correction of ptosis.  The operation can be performed under local anesthesia is is usually well tolerated.  If a thorough medical examination of your mother is okay then she should be a good candidate for the procedure.  

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 20 reviews

Severe Ptosis is Eyelid Surgery an Option for my 74 Year Old Mother? (photo)

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The good daughter takes care of Mom, and you definitely qualify Laura.  If she's in the colorful dress with the sunglasses, looks like she has lots of life left in her.  It's worth the straightforward office procedure to correct and/or improve what is most likely "senile" ptosis, resulting from attenuation or "dehiscence" of the levator palpebrae superioris muscle insertion onto her upper eyelid tarsal plates.  This is a procedure I perform frequently with consistent success, so either plastic surgeon or oculoplastic surgeon should be able to help her.

Steve Laverson, MD
San Diego Plastic Surgeon
4.9 out of 5 stars 50 reviews

Is eyelid surgery an option for mom?

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  Of course, eyelid surgery is an option for your mother.  Please don't take this wrong but the one photo you attached is truly awful because it is impossible to see any details.  Nevertheless, there is a whole organization of doctors who are specially trained to help someone like your mom.  Check out the directory of to find a doctor near your mother who can help her.

Lawrence Kass, MD
Saint Petersburg Oculoplastic Surgeon
4.8 out of 5 stars 140 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.