Is posterior vs. anterior levator advancement best for ptosis? (Photo)

Question

I had a mullerectomy to LOWER a slight eyelid retraction in my left eye, following Graves disease. The left lid has dropped too much and I now have ptosis. The surgeon believes there is levator dehiscence. Which levator advancement method is best for correction? Is it possible to evaluate/adjust the lid height during the procedure with posterior approach levator advancement?

C. Blake Perry, MD · Answer

The posterior approach can not be adjusted during surgery. Whether or not a posterior approach will work is determined during a clinic visit. Generally speaking, in my hands, patients who have had previous surgery are generally best treated with an anterior approach. Best to see an eyelid expert.

Mark L. Mazow, MD, FACS · Answer

Thank you for your question and photo. It is unlikely that you had a Muellerectomy or shortening of Mueller's muscle for lid retraction. Ot is ore likely that you had had the mueller's muscle recessed or set back to lower the lid. I agree that it appears you have an elevator dehiscence ptosis on that side now. Once the posterior surface has been dilated I think repair through this route is less predictable. Posterior ptosis repair is not predictably adjustable either. An anterior ptosis repair is much more predictably adjustable  during surgery and would my choice in your particular case. You do need a surgeon who is experienced in this procedure. I would discuss this with your surgeon. Best of luck.

Is posterior vs. anterior levator advancement best for ptosis? (Photo)

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Is posterior vs. anterior levator advancement best for ptosis? (Photo)

Answers (2)

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Everything you need to know about Eyelid Surgery

Our mission is to create a world where every investment in modern beauty is Worth It.