Young Son w/ Congenital Ptosis - Has Surgery Failed?

It appears there is still ptosis present.  It is possible that the surgery has failed. (If it was originally a frontalis sling procedure, sometimes the sling breaks.)  Recommend consultation with an oculoplastic surgeon.

Dr Taban

It is quite possible that significant improvement occurred from her first surgery despite the fact that a total correction is still not present. Close and continued followups are required with your pediatric plastic surgeon for oculoplastic surgeon. When in doubt seek a secondary consultation. Oftentimes more than one surgery is required for the best results.

It depends on the type of surgery he had, but it looks like he had a frontalis sling procedure based on the immediate post-op photo. With that type of surgery, when your son is not using his eyebrow muscle to open the eyelids, the eyelid will still seem droopy. The goal of the surgery is to set the eyelid slightly above the pupil at baseline so that when he uses his eyebrows as most children with congenital ptosis do, he can see better. The eyelid cannot be opened widely without eyebrow use because there would be risk of damage to the eye itself. Once he raises his eyebrow, you should notice a significant change in the eyelid position. If it still looks the same even if he uses his eyebrow, I would suggest seeing an oculoplastic surgeon as he may need a revision.

It is a normal effect of surgery not to be able to close the eye completely. It often gets better with time but may be a permanent side effect to the surgery. It is not usually dangerous or harmful in children. Usually it is a good trade off for having the lid higher, particularly if the eyelid is blocking vision. But, you should go back to your doctor to make sure there is no problem.. It often gets better with time but may be a permanent side effect to the surgery. It is not usually dangerous or harmful in children. Usually it is a good trade off for having the lid higher, particularly if the eyelid is blocking vision. But, you should go back to your doctor to make sure there is no problem.

   The surgery has absolutely not failed but please realize that this is one of the most complex and sifficult problems in plastic surgery.  Patients with congenital ptosis often undergo many surgeries befor a pleasing reslut is attineed.  Just be confident that a pleasing result is possible and will be attine for your son.  There are many possible procedures and I recommend you see two opthalmic plastic surgeons and two ABPS-FACS surgeons for opinions. Do nt rush. Go to a major University Service.  Do you homework.  Make sure your surgeon does this weekly and make thwem prove it.  If you are not accommodated, walk out.   Your son will be fine.  Ideally at his next surgery, a team of both opthamic surgeon and plastic ABPS surgeon will be in attendance.  This is WHAT I WOULD INSIST ON FOR MY SON!   BOTH WORK TOGETHER.  YOUR HARD RESEARCH AS TO WHO IS THE BEST IN YOUR AREA WILL BE REWARDED.  Do not dispair.   It will take 3 or 4 more surgeries to hit perfection at age 19 but YOU WILL AND CAN GET THERE.   My Best.    Dr Commons.