Ptosis expands with strain. Crease is also pushed up. 4 1/3 months post op. I'm aware revisions can be needed (Photo)

Before my surgery I had mild ptosis, but it used to get worse when my eye was strained. Specially when i was either sleep deprived, very obviously when i was under extreme Sun without any sunglasses or when i was exposed to heat of some sort. But after the surgery this condition has worsened, not only does my eye lid look much larger, but now it droops and the crease is pushed up under strain. It looks like i have a bug bite for an eye lid. Any diagnosis comes to mind here?

Doctor Answers 2

Residual Ptosis

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Hi Zoey_K,

Thanks for your question and photos. I can see from the pictures that you have some residual ptosis of your left upper eyelid. I am not sure I can appreciate the contribution of the "strain" to the condition but I don't think it would affect the recommended treatment anyways. Depending on the type of ptosis repair surgery you had performed the first time and your examination, a different type of repair would likely be recommended. I would discuss this with your surgeon or seek out a second opinion with a skilled oculoplastic surgeon in your area. Good luck!

Many details are missing in your story to be able to provide a precise answer for you.

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You have persistent ptosis after having had ptosis surgery.  Based on your description and previously posted photographs, presumably your surgeon performed a posterior approach ptosis surgery.  This would not be the correct surgery for you even if you responded to the neosynephirine drop test with a more open eyelid.  That is because you demonstrate a profound levator dehiscence ptosis on the left eyelid.  The levator is tendon of the upper eyelid.  When it is disinserted like this, it is my believe that posterior ptosis surgery will be ineffective.  The correct approach is an anterior approach ptosis surgery.  Now that work will be more complicated but not impossible.  The key to the surgery is how much excursion is in the eyelid.  If the upper eyelid can move more that 10 mm it is likely that revisional surgery would be profoundly helpful for you.

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

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