Getting Rid Of Droopy Eyelids With Ptosis Surgery? Get The Facts First
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Getting Rid Of Droopy Eyelids With Ptosis Surgery? Get The Facts First

Are you tired?’, ‘Haven’t you had a good night’s sleep?’ and ‘Are you stressed out?’ are some of the questions you may have to answer on a regular basis with droopy eyelids.

While droopy eyelids don’t have serious health implication, they can significantly impact your appearance. It may lead you to appear much older than you actually are and much more tired than you actually feel. If this is your case, the chances are that you are looking forward to getting rid of them with ptosis surgery. However, you should get the facts first and know what you are about to undergo. Here’s a comprehensive guide to equip you with the right knowledge about the process.

Causes Of Droopy Eyelids

The upper eyelids comprise several structures: skin, muscles, ligaments, tendons, and the conjunctiva, the eye’s mucous membrane. The levator muscles help in raising the eyelids and opening the eyes.

droopy levator muscles

An abnormality in the levator muscle function leads to ptosis that reflects issues with its neuronal network. The muscle gets flaccid, and its tendon relaxes, leading the upper eyelid to droop.

The primary medical conditions of muscle dysfunction that can cause ptosis can be from the following.

Acquired Ptosis

  • Aging — The levator muscles in your eyelids weaken with age.
  • Trauma— Physical trauma or an injury can affect your levator muscle, damaging your nerves. Chemical damage from neurotoxins such as from venomous snakes or Botox injections can also lead to ptosis.
  • Nerve problems— The eye muscles are controlled by the cerebral nerves. Thus, issues arising due to injury to the brain or its peripheral nerves may cause ptosis.
  • Infections or tumors – ptosis can also occur due to an infection or tumor on the eyelid.

Congenital Ptosis

Drooping eyelids can occur due to genetics. Some congenital conditions can affect the muscular functions of the eyelid. Ptosis can occur as a congenital disability in which the levator muscle has dysfunction and mainly occurs in one eye.

Preexisting Health Conditions

The neuronal network of the eyelid muscles can be damaged because of some underlying medical conditions, including diabetes and neuromuscular disorders such as myasthenia gravis.

You should consult a certified doctor to determine the precise cause of your ptosis to craft a proper treatment plan.

Types Of Droopy Eyelids

types of droopy eyelid

The doctor would typically give a recommendation based on the cause of your ptosis and also the severity of eyelid droop.

The eyelid droop is typically gauged by doctors using Marginal Reflex Distance (MRD), which is actually the distance between your pupil and the upper eyelid. You will be considered to have droopy eyelids with an MRD value of less than 2mm.

Symptoms Of Ptosis

Living with ptosis can often be difficult, especially when it hampers your vision.

symptoms of ptosis

If you find yourself suffering from these symptoms, you may have ptosis:

  • Aesthetic Issues – As discussed earlier, ptosis makes you look tired and older than you really are.
  • Functional Issues – For individuals with severe cases of ptosis, visual fields in the upper and outer parts of the eye may be lost due to the eyelid’s droop. This leads to hindered vision blocked by droopy eyelids. It can cause difficulty walking, reading, driving, and watching TV.

In addition, ptosis can secondarily lead to pain and strain on the forehead muscle and neck as the patients lift their forehead and tilt their neck to see well.

The Surgical Techniques For Ptosis Surgery

At first, you will be anesthetized by the anesthesiologist generally by local anesthesia. You may experience slight pain only at the site of injection. Your doctor can also consider sedation if you have a low pain threshold though you will be woken up to make the final assessment of symmetry.

The main surgical techniques to treat ptosis include the following.

1. Suture Ptosis Eyelid Correction

suture ptosis eyelid correction steps

This procedure is also known as non-incisional ptosis. In this technique, the eyelid tissue is stitched as high as needed to attain the unhindered vision. This is generally recommended for conditions of mild ptosis.

2. Incisional Ptosis Eyelid Correction

incisional ptosis eyelid correction steps

Incisional ptosis involves the placement of an incision for gaining access to the eyelid muscle at the point where a double eyelid crease is intended to be created. If any, including fat and skin, the unnecessary tissues may excise with resection of parts of the eyelid muscle. In patients in whom tissue removal is not needed; the eyelid tissue is sutured at a higher level.

3. Frontalis Suspension Technique

frontalis suspension technique steps

When the muscle in your eyelid is very weak, they can be stitched to the muscles above the eyebrow. The brow muscles then serve as an anchor, just like the suspension cables of a bridge. This method is generally recommended in extremely severe ptosis.

After the technique is complete, you will be asked to sit up and assess the amount of eyelid opening. Any asymmetry between the right and left eye will be evaluated, and minor adjustments made. Finally, the incision is stitched.

Cost Of Ptosis Surgery In Singapore

The cost of ptosis surgery in Singapore can range between $5,000 and $12,000. This is not inclusive of the anesthetist fee and operating facility cost.

The total price of your surgery can vary depending upon:

  • The surgical technique utilized
  • The severity of your case
  • Procedure fee
  • Anesthetist’s fee
  • Operating facilities charges
  • Surgical equipment charges
  • Medication
  • Stitch removal

Can Ptosis Be Fixed Without Surgery?

As of now, ptosis cannot be fixed by non-surgical procedures. The impaired levator eyelid muscle causes drooping eyelids, the tightening of which is only possible surgically.

Are The Results Permanent?

Typically, the outcomes of ptosis correction surgery are mostly permanent. Only 10% of patients may need a revision in the future in case the eyelid droops again or causes asymmetry.

In case your eyelid remains symmetrical for up to 2 months after surgical procedure, this means that the treatment has resulted in a permanent change.

Risks Associated With Ptosis Surgery

Just like any medical procedure, there are risks associated with ptosis surgery. These include:

  • Misdiagnosis of ptosis cause, causing inadequate procedural choice
  • Improper surgical technique
  • Asymmetry – one eye smaller than the other
  • Abnormal scarring – plastic surgeons follow different stitching techniques, which can lead to inadequate scarring. A less skilled operator can leave behind noticeable scars along the eyelid. If the incision is not sutured correctly, keloid scarring can also occur along with the incision site.
  • Suture breakage – improper surgical technique can have a risk of sutures breakage or loosening.
  • Bleeding and infection – if the case is not handled properly, it can lead to excessive bleeding or swelling that can impact your repair and recovery.

However, the risks that can be associated with ptosis surgery can be entirely avoided in the hands of an experienced board-certified plastic surgeon. As the eyelid muscle is subtle, it needs vigilant care to handle it during surgery. Otherwise, the eyelid function can be compromised.

Recovery Period For Ptosis Surgery

Bruising may occur for two weeks after ptosis surgery. In general, you can return to your daily chores about a week post-surgery. It will take about 1 to 3 months for the appearance of your eyes to improve.

Points To Consider For Getting Ptosis Surgery

consultation for ptosis surgery

The essential points to consider when going for ptosis surgery include the following.

Correct Evaluation and Diagnosis

It is imperative to identify the actual cause and severity of ptosis. This will be done in the hands of a board-certified plastic surgeon.

Proper Surgical Procedure

The expert surgeon will be able to tailor the surgical outcomes according to ptosis severity. With each technique, a different level of access can be obtained to the levator muscle. Using the right technique ensures muscle correction and crease formation at the correct level.

Correct Dissection

An experienced plastic surgeon can adjust the technique according to each patient’s individual needs, identify the unique problem areas, and make the right stitch-up incisions.

Minimal Duration Of Surgery

A shorter duration of surgery means that it will be a more comfortable experience for the patient while producing less bruising. This also means faster recovery and superior surgical outcomes.

How To Find The Right Surgeon?

Ask People For Their Experience

you can take detailed information from individuals who have already undergone surgery. They are real living examples that can guide you well.

Ask For Before And After Photos

when visiting your plastic surgeon, ask for pictures of a case recently done by the surgeon to evaluate your skills.

Get A Recommendation From A Doctor

Physicians can better recommend a reputable plastic surgeon with an excellent track record.

Choose An Experienced Plastic Surgeon

A surgeon who is board-certified and experienced will handle your case better both functionally and aesthetically.

After reading this article, you may have other questions in mind. If there are still things you wish to clarify, get your questions answered by a board-certified plastic surgeon to determine if the procedure is right for you.

 

 

References:
1.Christopher I. Zoumalan, MD, Richard D. Lisman, MD, Evaluation and Management of Unilateral Ptosis and Avoiding Contralateral Ptosis, Aesthetic Surgery Journal, Volume 30, Issue 3, May/June 2010, Pages 320–328, https://doi.org/10.1177/1090820X10374108