Additional options for congenital ptosis after 4 surgeries (last one included cosmetic surgery on both eyes)? (Photos)

I am 39 years old. Recently had my fourth ptosis surgery (each were several years apart) but the left eye is certainly still much lower and I think the last surgery made the right eye appear bigger and brighter, and the left eye even smaller. What are my options from here? A sling surgery? Please advise - thanks in advance. My last surgery was about 9 months ago. I just made a follow up appointment with the surgeon for next week, but wanted to get some additional advise from here as well.

Doctor Answers 2

Congenital Ptosis

Four surgeries is a lot. Yes, the left eye is lower than the right eye. So, I would say the most important thing to talk to your surgeon about is "expectations". Most reasonable oculoplastic surgeons will spend a fair amount of time explaining realistic expectations, especially for congenital ptosis, because the outcomes are very different than for regular ptosis. That being said, it might be worth asking your doctor about a Mullerectomy on the left side. Also, be sure to ask about risks of dryness and incomplete eyelid closure after a 5th surgery.

Ridgewood Oculoplastic Surgeon
5.0 out of 5 stars 34 reviews

The reality is that congenital ptosis is an enormously difficult and complex issue.

To have an upper eyelid crease as you do, you must have more than 8 mm of levator function.  Sling surgery is very unsatisfactory but occasionally necessary when there is less than 8 mm of levator function.  It should not be a serious consideration for you.  The question is could you be improved with additional surgery?  The answer is not necessarily.  I would be extraordinarily careful seeking out more surgery.  It is one thing to promise an outcome and an entirely another to delivery that result.  I would not be in a hurry to have more surgery.

Kenneth D. Steinsapir, MD
Los Angeles Oculoplastic Surgeon
4.9 out of 5 stars 23 reviews

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