Ptosis Repair in Westport, CT & Fairfield County

What is ptosis?

Ptosis is a condition in which the upper eyelid droops or closes involuntarily. This problem may develop in childhood or adulthood as a result of a compromised levator muscle. One or both eyes may be affected. In some cases, eyelid droop comes and goes, posing a challenge to an accurate diagnosis.

What causes the eyelids to droop?

Ptosis results from an anatomical or functional abnormality in the levator muscle. Potential causes include:

• Congenital ptosis is caused by natural levator muscle weakness.
• Levator aponeurosis is a common type of acquired ptosis caused by age-related stretching and thinning of the levator muscle in the upper eyelid.
• Nerve damage in the area of the levator muscle.
• Certain medical conditions may affect the levator muscle, including
  • Stroke
  • Horner syndrome
  • Stye on the eyelid
  • Tumor in the eye area
  • Myasthenia gravis
  • Diabetes

Who is a candidate for ptosis repair?

Healthy children and adults may be good candidates for ptosis repair. In some children, ptosis may present a challenge to the vision and physical development such as learning to walk. In this instance, ptosis repair may be considered at an early age. Adults who are interested in improving comfort, vision, and appearance can achieve satisfactory results from ptosis repair when treatment is approached with realistic expectations. During her consultation visit, Dr. Levin provides concise information regarding the expected outcome of ptosis repair.

What is ptosis repair?

Ptosis repair is a term that describes various surgical techniques performed to lift the eyelid into proper position. Two common techniques may be considered; one tightens a weak levator muscle and the other utilizes forehead muscle motion to lift the malfunctioning eyelid.

How is the procedure performed?

Ptosis repair is typically conducted in an outpatient setting. Findings of the diagnostic evaluation performed during the initial consultation visit dictate which surgical approach is taken. Options include:

• External ptosis repair may be suitable for people with adequate levator muscle function. In this technique, local anesthetic with sedation is administered to block pain and calm the nervous system. An incision is then made in the natural crease of the upper eyelid. The attachment of the levator muscle is repositioned to the connective tissue in the eyelid (the tarsus). Throughout the procedure, the patient may be asked to perform certain eye movements. This helps to determine the best eyelid position.
• Internal ptosis repair also focuses on the levator muscle in the upper eyelid, but it does so by turning the eyelid inside out. This technique allows the surgeon to observe both the levator muscle and Mueller’s muscle, which is also involved in lifting the eyelid. When only a mild lift is needed, the Mueller’s muscle may be tightened. The levator muscle is shortened when a more significant lift is needed. General anesthesia or sedation may be selected for internal ptosis repair.
• Frontalis sling fixation is a ptosis repair technique that may be necessary when there is poor levator muscle function. Poor muscle function is often the cause of congenital ptosis. In this procedure, a tiny silicone sling is inserted beneath the skin of the upper eyelid up to the frontalis muscle on the forehead. This allows the eyelid to be raised and lowered by elevating and lowering the eyebrows. Frontalis sling fixation is performed under general anesthesia.

How long does ptosis repair last?

Most of the techniques that may be performed to correct ptosis take about an hour to complete. Once the desired outcome has been achieved with ptosis surgery, the appearance of the eye should remain consistently better than it was before treatment.

What are the risks to ptosis repair?

When surgery is conducted, there is always a risk of complications. It is important to undergo ptosis repair performed by a board-certified plastic surgeon who is familiar with the characteristics of this condition. As an oculofacial plastic surgeon, Dr. Levin has additional training beyond plastic surgery that enables her to successfully address the unique nature of ptosis. While uncommon, there are a few risks associated with ptosis repair, including hematoma, dry eye, scratched cornea, infection, and bleeding.