Ptosis Repair(s) Gone Wrong

I’ll start this review by saying that it’s one thing to judge a doctor by their actions when things go smoothly— but i think their actions when things do not go smoothly say a lot more.

I went to Dr. Kotlus for my (first) ptosis repair in December of 2020. I’ve had congenital ptosis in my left eye since I was little and after years of it being an insecurity, decided to seek out corrective surgery. After doing research online, Dr. Kotlus seemed like a highly regarded, well-reviewed choice. After a brief consultation, i decided to go ahead with it and he booked me for surgery about a month later.

The first few days my surgery seemed promising. My lid was lifted and i was super excited about it. However, about 4 days later, I woke up and my eyelid had dropped back to it’s pre-surgery height.

I emailed Dr. Kotlus and he responded promptly, agreeing that the lid did look low, and although it’s extremely rare for this to happen, all surgery is unpredictable. (Side note: I was aware ptosis surgery is complicated and sometimes fails, so although I was disappointed, I didn’t fault Dr. Kotlus for this.) He suggested that perhaps we revise it early at my one week follow-up before scar tissue formed. I said okay and we scheduled surgery #2 for later that week.

When i came for my second surgery, i still had residual swelling from the first surgery, so swelling was worse than the first time. It was also harder to gage what the actual eyelid height would be post-surgery due to all the swelling.

After a few weeks, though improved, my eyelid height was still a little low. It was pretty slight, and mostly noticeable in pictures. I communicated this to Dr. Kotlus at my one month follow-up, and he said although it was slight, “we can do better.”

He then scheduled me for a *third* surgery in February, only 10 weeks after my first surgery and 9 weeks from my second.

Honestly, at the time, despite the less than stellar results of the first two surgeries, i was still completely trusting of Dr. Kotlus. I trusted that he knew best, and wouldn’t choose to operate if it was too soon after the first surgeries.

(Side note: after consulting with several other doctors recently, ALL of them said they’d wait *at least* 3 months before considering revision surgery, due to swelling fluctuation and healing time).

For my third surgery, Dr. Kotlus decided to do an posterior ptosis repair (first two were anterior) since the improvement would only need to be slight. When i showed up, i took my prescribed anxiety pill and was handed a piece of paper to sign that basically said “revision surgery is more complicated, less predictable, etc etc.) I remember joking to Dr. Kotlus about it, saying, “Should i be scared?” He laughed it off and said no.

I was told the swelling would likely be less than the first two surgeries, since the scar will be inside the eyelid.

This wasn’t the case. The swelling for this surgery was the worst of all 3. I also had severe bruising that lasted almost two weeks. My eyelid was puffed out in several folds and extremely sore. Even at my one week follow up, it was nearly impossible to tell if my eyelid was successfully lifted due to all the swelling/bruising, though Dr. Kotlus insisted the surgery was successful.

Fast forward seven months:

My eyelid height is essentially the same as it was before the third surgery, only now my skin (probably due to the excessive swelling from the combined 3 surgeries in 2 months) is loose and crepey, making my lashes droop more than before. My skin is thinner, making my upper eye look hollow and dark, especially at night. It makes me look aged and uneven.

In the morning, my eye appears puffier than normal and sometimes sore, but always lower than the other. I’ve had several styes since surgery (which i had no history of before the surgeries, and another doctor told me could be due to prolonged swelling.)

I’m embarrassed to say that even after all of this, I still reached out to Dr. Kotlus to ask about potentially getting dermal fillers to correct the resulting hollowness that I now have. Up until this point I really tried to give him the benefit of the doubt—plus, I still i thought it’d better to get the opinion of someone who knows my exact situation and surgery history, to get the best assessment.

I sent him pictures of the hollowing/loose skin, explained my situation and asked if he thought they would help. I received no response.

Thinking maybe it was accidental and he missed my email (even though email is what he uses to communicate with patients and had always been prompt in the past), i emailed him again a month later regarding the same issue. No response.

I’ll circle back to my first sentence of this length review. I think how a doctor reacts when things go wrong says a lot.

I came into this (and still am) someone who is pretty reasonable as far as expectations go. I realize things don’t always go as planned. But when they don’t, I expect a professional to do the right thing and put my best interest first, even if it means waiting longer for a better result. And when all else fails- i certainly don’t expect them to make me feel like a burden for simply reaching out for answers/solutions.

As someone with zero prior surgeries, I really put all my trust into Dr. Kotlus. Less than a year later (and three surgeries later) I’m left with issues that are more bothersome than before my first surgery, and a surgeon who has abandoned ship.