Patients consider ptosis surgery when their upper eyelids are drooping, causing impaired vision due to the covering of the pupil. Additionally, droopy eyelids may not be aesthetically pleasing, and so patients may consider ptosis surgery for cosmetic reasons.
Droopy eyelids occur when there is a gradual stretching of the tissue that supports the lid caused by aging, long-term contact wear, or injury.
After a thorough examination, your ophthalmologist will gauge whether droopy eyelid surgery (ptosis surgery) is appropriate based on the patient’s ocular and medical history. Some patients require the levator muscle (eyelid muscle) to be tightened, while others with weak levator muscles may need frontalis (muscle below the eyebrow) suspension.
The treatment of ptosis can vary based on age and how well the eyelid muscles are functioning.
For adults, surgery will be required to treat most cases based on the type and severity of the symptoms. Typically, a surgeon will perform a procedure to tighten the levator muscle which helps to get the eyelid in the proper position. If the levator muscle is extremely weak, solely tightening it may not be enough. Your surgeon may elect a procedure known as a frontalis suspension to provide additional support for the muscle. During this procedure, small strands will be placed in between the eyelid and eyebrow to help raise the lid. There is also a non-surgical option known as a ptosis crutch where an accessory is used in conjunction with eyeglasses to help hold the eyelid in place so it no longer droops.
Children may experience droopy eyelids (congenital ptosis) due to hereditary factors or developmental issues in the levator muscle. To determine the best course of treatment, physicians will consider the age of the child, the strength of the eyelid muscle, and whether or not it affects one or both eyes. Depending on the severity, surgery may be required. For many children, surgery is performed between the ages of 3-5 to promote proper visual development. Some children who have ptosis may also have a lazy eye. If this is the case, special eyeglasses or an eye patch may be prescribed in addition to eye drops that can help to strengthen the weaker eye.
Ptosis surgery is not typically performed by most plastic surgeons as it is a highly specialized and delicate procedure. These types of surgeries are performed by an oculoplastic surgeon whose training begins after medical school and includes a residency in ophthalmology or eye surgery. This allows the physician to understand the eye and surrounding areas, including muscles, in great detail. Once the physician completes this residency, they continue on to a fellowship that involves fine-tuning their knowledge and expertise in order to perform precise eyelid and facial plastic surgery. This type of training, which requires careful attention to detail, is essential when dealing with the body’s most delicate area.
At Milan Eye Center, we have two board-certified oculofacial plastic surgeons, Dr. Kiran Sajja and Dr. Sagar Patel. Both physicians can treat ptosis and address other concerns related to your vision, eye health, and quality of life.
The vast majority of both unilateral and bilateral ptosis affects predominantly the upper eyelids. However, on rare occasions, ptosis may be associated with significant systemic or intracranial diseases like Horner Syndrome, Oculomotor Nerve Palsy, or Myasthenia Gravis, which can affect the lower lid and result in what we call reverse ptosis. This is a very rare condition where the lower lid will appear higher than normal.
When undergoing ptosis repair, patients and their driver are asked to arrive 30 minutes early. They will meet with a nurse to check their vitals and review their health history and meet with their surgeon and anesthesia provider. Patients are intravenously sedated while receiving local anesthesia and numbing eye drops to maintain optimum comfort levels. It is important for patients to have their eyes relaxed and closed for proper measurements. A small incision is made in the crease of the eyelid to maintain a natural appearance and hide any resultant scarring.
Both of these procedures elevate the droopy lid, giving a symmetrical, aesthetically pleasing appearance while correcting for any vision interferences caused by the lid. If you are experiencing puffy, saggy, or tired-looking eyes, our oculoplastic surgeons can remove excess fat, skin, and muscle from the upper and lower eyelids by performing a blepharoplasty. All of these options take about 45 minutes per eye.
Our team of talented physicians and caring staff want to make you feel at home from the moment you walk into one of our eight clinic locations or six surgery centers across North Atlanta. It is our goal to educate you about the condition so you can feel comfortable and be able to make an informed decision when it comes to surgery. If you notice part of your pupil is covered by drooping eyelids, thus limiting your vision, it is best to meet with a medical professional at one of our 8 locations our Alpharetta, Buford, Canton, Cumming, Dawsonville, Johns Creek, Marietta, or Snellville locations to discuss your concerns and evaluate what treatment options are available.
Here at Milan Eye Center, our surgeons do not seek radical changes to patients’ facial appearance, but rather seek to improve their field of vision and give them a youthful, natural look to their eye area.
Ptosis surgery is an outpatient procedure, but you should not drive the day the surgery was completed. A friend or caregiver will need to drive you home after ptosis surgery. Patients should not drive or partake in strenuous activity for the first couple of days. Eye drops and a lubricant will be given to keep the eyes from becoming dry or sore.
Here’s what you can expect in the weeks and months after ptosis surgery:
Eyelid ptosis is covered by insurance if it is considered medically necessary. If your insurance company denies the procedure as a medical necessity, there are cosmetic options available as well. In order to determine if you qualify for the surgery, we will need to submit the clinical and photos to your insurance company and allow 3-4 weeks for the preauthorization process.
To make quality care accessible to everyone, Milan Eye Center offers zero-down financing options with approved credit through Wells Fargo, CareCredit, and Alphaeon. We also accept all FSA/HSA plans.
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