How can you tell if an undercorrection of the eye is permanent after ptosis repair surgery?

Question

I had ptosis repair surgery about a week ago and had my stiches removed recently. Before having the stich removed, the lid on the eye with eye surgery looked higher than my other eye which was a big concern. However, the doctor adjusted my sutures and I was very happy with the result. Now though it looks like the eye with the surgery is drooping and is smaller than my other eye. Could this correct itself?

Kenneth D. Steinsapir, MD · Answer

Susan

	This is very early after surgery.  Generally if an eyelid is too open at this point, the eyelid will heal too open.  On the contrary, if the eyelid is a little heavy right after surgery, very often with time (6-8 weeks) the swelling resolves rising to the appropriate height.  It sounds like your surgeon appropriately adjusted your eyelid.  Now it is a matter of healing.

A.J. Amadi, MD · Answer

Ptosis surgery is as much art as it is science and sometimes the same exact surgey done on two eyelids of the same patient may not turn out the same way.

	In your case, when an early post op adjustment is made [which sounds like it was the case], if the eyelid becomes too low, it is unlikely to raise up again afterwards. However, re-revision is not the answer at this point since operating too early now will increase inflammation/scarring.

	By about 1 month postoperatively, you should have a good idea what the result would be. If it is within 0.5-1 mm of the the other result, it is usually considered a good result. Obviously not all patients have same level of expectation, and you may still be less than satisfied. If you are desiring a reoperation, I would wait at least 6 months to allow scarring to mature to an acceptable level.

	Good luck

Michael McCracken, MD · Answer

Susan,

	Eyelid position can vary after ptosis surgery.  I am not sure if your surgeon performed a revision of your ptosis surgery or simply removed skin sutures.  I think it can take up to a month to see your final result.

Francis R. Palmer, III, MD (retired) · Answer

Most of what your are seeing this soon after the ptosis repair is swelling. The eyelid crease will relax in the next 2-3 months and you'll be able to tell at that time if they are somewhat evenly placed. Most people do not have exactly the same creases on both upper eyelids, so I wouldn't go overboard comparing them as long as the ptosis surgery corrected your eyelid ptosis and the creases are close.

How can you tell if an undercorrection of the eye is permanent after ptosis repair surgery?

Answers (4)

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