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
- Horner syndrome
- Stye on the eyelid
- Tumor in the eye area
- Myasthenia gravis
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.
Dr. Levin is an excellent doctor. I received Botox injections and fillers under my eyes, cheeks and temples. She was very thorough and took her time explaining and answering all my questions. The wrinkles were smoothed and my entire face looks much more youthful and rested. I would absolutely without hesitation recommend Dr. Levin to all my friends. The results are amazing.
I had surgery with Dr. Levin for droopy eyelids. From the first to the last appointment I felt as if I was her only patient. She spent as much time with me as needed, answered all my questions and alleviated all my concerns. The surgery went very well, and I’m very happy with the results. Everything you would want from a doctor! Highly recommend.
Saw doctor Flora Levin for a Botox consultation. She took her time explaining everything to me, and was very thorough. I scheduled the procedure, and was very happy with the results! She followed up within a week after the procedure to check, and make sure i got the results that i expected. Would highly recommend!
Dr. Levin is extremely knowledgeable in the field of cosmetic surgery and cosmetic rehabilitation. Her diagnosis is astute and her hands are gentle. She is most generous with her time. It is the patient and not the clock that comes first. I have already recommended Dr. Flora Levin to a great many colleagues.
Dr. Levin is an outstanding surgeon. She somehow takes the time to fully understand a patient's goals and expectations. My procedure was over two years ago and I still cant believe how good I look and feel! I would highly recommend her to anyone!PS I was told I look more like the sister of the bride rather than her mom! Thank you, Dr Levin!!!
“Dr. Levin was amazing! She answered all my concerns and thoroughly explained everything to me prior to the procedure and even though I was awake, Dr. Levin’s calm and reassuring presence made me feel perfectly at ease during the relatively painless procedure. My recovery went quickly and smoothly and I couldn’t be more thrilled with the cosmetic result. The change in my look is subtle and natural looking. I am so pleased I chose Dr. Levin to do my surgery. I look refreshed and awake now and I wish I had it done sooner!”
“Dr. Flora Levin is the most caring, professional doctor I have ever encountered. She preformed eyelid surgery on me, and she is a true perfectionist. I am always told how beautiful my eyes are. Thank you Dr. Levin. I think you are wonderful!!!”
Significant "smoker's lines" (I've never smoked a day in my life!) and "elevens," both from a life of expressiveness now come back to haunt me! Met Dr. Levin at Yale and followed to her office in Bridgeport. She's a "doctor's doctor" in my opinion, with brilliant knowledge, wonderful manner, patience and finesse in her work. Absolutely worth it!
Dr. Levin operated on me. I am an R.N. working with plastic surgeons. I was very picky regarding my choice of cosmetic, oculoplastic surgeons. She was the right choice. I couldn't be happier. The office staff was very helpful as well. The atmosphere was welcoming and professional. I would highly recommend Dr. Levin.
I am in awe of the artistry of her work and am ecstatic with the results of my surgeries. I felt very comfortable during my office visits because she spent the time with me. I also felt very comfortable during my recoveries. My face used to be crooked and now it is symmetrical. My eyes are no longer hooded and she has given me a wider field of vision. An unintended consequence is that I look years younger and the results are very natural. I am a very happy patient and I highly recommend Dr. Flora Levin without reservation.