Here’s a looking at ptosis surgery: correcting droopy upper eyelids
In this article, consultant ophthalmic and ocuplastic surgeon Ms Aoife Naughton explains how to correct droopy upper eyelids with ptosis surgery, also known as an eyelift.
Why do eyelids begin to droop?
Ptosis is the medical term for drooping of the upper eyelid, which can cause obstruction in vision. This can affect one or both eyelids. It can be congenital (that you are born with it) or acquired (that it is developed at a later time). By far the most common cause of ptosis is what we call involutional. This is an age-related slippage of the muscle, called the levator, which lifts the upper eyelid. Other, rarer causes can include neurological issues. Therefore, any sudden onset of ptosis of the upper eyelid requires urgent review.
Who isn’t suitable for ptosis surgery?
Generally, individuals who are healthy and who are bothered by drooping of the upper eyelids are good candidates for surgery. As smoking can impair the healing process after surgery, it's important that patients who smoke stop in the preparation period and run up to surgery. Also, any other active medical conditions can require that the surgery be deferred to a better time; all of this should be discussed during a detailed consultation.
What happens during ptosis surgery?
Ptosis surgery is generally performed under local anaesthesia. It can also be performed with sedation, if that is what the patient's preference is and if they are suitable. There are various surgical approaches that are used to address drooping eyelids, which can be performed using an internal or an external incision of the eyelid.
Via an external approach, the upper eyelid skin crease is used as the incision point for ptosis surgery, meaning that the scar will be hidden in the natural crease line. Through this incision, excess skin can be removed, and if there are protruding fat pads, these can also be removed simultaneously. The levator muscle is identified and advanced, resulting in an elevated position of the eyelid. The lid heights on each side and checked for symmetry of height and contour. The incision is then closed neatly with sutures running along the skin. The sutures are generally taken out one week following the procedure.
Ptosis surgery is a day-case procedure, so patients go home on the same day. Patients can expect upper eyelid swelling and bruising, which typically will last anywhere from a few days up to two weeks following the surgery – icing can really help to reduce the symptoms of swelling. Typically, most patients will return to normal activities within seven to ten days. Patients are recommended to avoid strenuous activity and swimming for several weeks following surgery.
What are the risks of ptosis surgery?
Ptosis surgery is a safe procedure when performed in skilled hands, who will take steps to reduce and minimise any complications. But as with any surgical procedure, there are potential risks, which include swelling, bruising, visible scarring, and asymmetry. Those with pre-existing dry eyes can find that they are exacerbated in the period following surgery.
Ptosis surgery can be transformative; an improvement in visual function can be expected by lifting the eyelid which is causing obstruction in the field of vision, and patients look and feel more refreshed and rejuvenated.
If you are considering upper eyelid blepharoplasty surgery and would like to learn more, schedule a consultation with experienced oculoplastic surgeon Ms Aoife Naughton.