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Ptosis / Blepharoptosis: Why Is There a Need to Correct It?

Ptosis / Blepharoptosis: Why Is There a Need to Correct It?

With ageing comes a common condition, saggy skin. Saggy skin can affect your entire body including your eyelids and it is completely normal. Our skin is a living organ and its elasticity will not be retained as we grow older. One of the common areas we can see this happening is on our eyelids. 

It is not just the saggy excess skin that makes up a drooping eyelid, although that is the most obvious thing to most patients. The eyelid opening muscle is often affected; most commonly, the aponeurosis (tendon) of the muscle is lax or damaged, resulting in a poor eyelid opening function, given the appearance of a droopy eye.

A drooping eyelid, otherwise known as ptosis or blepharoptosis, is a condition in which the upper eyelid falls to a lower than normal position. In severe cases, this results in the drooping eyelid covering all or part of the eyelid impairing someone’s vision. 

This condition can affect both eyes or just one eye. However, drooping eyelids can happen not just when we’re old but at any stage of our lives across all genders. It can be a condition one is born with but it can also be developed over decades as one age. Ptosis can vary in different people – some may experience impaired vision while others will experience droopy eyelids without any impaired vision. This should not be taken lightly however even if one’s vision isn’t impaired as this could be a sign that a more serious condition could be affecting the muscles, nerves, brain or eye socket. 

Some of the causes of ptosis are:

  • Congenital ptosis
  • Aponeurotic ptosis
  • Myasthenia gravis
  • Muscle diseases
  • Nerve problems
  • Local eye problems

Why Should Someone Correct Ptosis

Why Should Someone Correct Ptosis

Having ptosis could mean that you are also affected by other sorts of medical problems. Even if your vision isn’t impaired, that doesn’t mean that you might not have any other medical conditions. If you think you might have ptosis, we would recommend a visit to your doctor to assess the reasons for it and to check if you might have other underlying health concerns. 

Depending on the cause of ptosis, correcting it could help improve your daily life. Besides the obvious effect of looking younger, other factors come with having ptosis such as excessive pressure on brain nerves which could lead to blacking out or fading sight as well as other nervous system problems in the body.

Some immediate results of ptosis corrective surgery are:

  • Improved vision
  • More youthful eyes
  • Less eye irritation or feeling of heaviness/fatigue
  • No more headaches from the constant lifting of forehead/eyebrows to see

Ptosis Corrective Surgery

The corrective procedure is usually a quick day surgery. It typically takes around 45 to 90 minutes, depending on if the surgery aims to correct just 1 eyelid or 2. 

The type of ptosis correction surgical technique is highly dependent on the severity of the droopy eyelids. This will also enable the adjustment of the height of your eyelid. 

There will be 3 different types of ptosis surgery based on the severity of the ptosis and the impact it has on your vision:

  • Transcutaneous external ptosis surgery: the most common type of treatment, this is done on patients that have a normal levator muscle working. The surgery will help to remove any saggy skin and at. The key step of this procedure is the repair of the aponeurosis (tendon) of the eyelid opening muscle (levator palpable superioris), either by tightening it or by shortening it.
  • Transconjunctival ptosis surgery: for mild forms of ptosis that do not require skin removal, this type of treatment is usually used. This is done via an internal incision and leaves no scar on the eyelid.
  • Use of the forehead (Frontalis) or eye closing muscle (Orbicularis Oculi) to augment the eye opening. This is usually reserved for very severe forms of ptosis, especially if the eye opening muscle function is poor. 

How to Prepare for Ptosis Corrective Surgery

If you’re looking into having the surgery, your surgeon will be able to let you know in detail exactly what you need to do to prepare for it and you must consult your surgeon if you have any questions as they will have the best professional answers for you that are suited for your case. 

However, before any surgery, it is important to minimise the risks for complications during the surgery such as infection and bleeding. Some things you should avoid are blood thinners like aspirin, vitamin E and Ginko Biloba. Before the surgery, make sure to have an honest conversation with your surgeon about what sort of supplements and vitamins you are currently taking so they will be able to advise you on which you can continue taking or should stop taking. 

Since this is eyelid surgery, chronic eye problems like dry eye or allergic conjunctivitis should be communicated to your surgeon. These can be managed with eye drops or other medications prescribed by your doctor. It is very important to let your surgeon know about any and every eye condition you have. 

Post-surgery Recovery

After you’ve had your surgery, you might experience your eyelid(s) swollen and your vision blurred as a result. It is important post-surgery to know this is normal and that you should be lifting your head and using cold compresses as much as you can to reduce the swelling. If swelling is not kept under control, this could stretch sutures and cause eyelids to droop again. 

Another thing to note would also be that your eyelid(s) post-surgery can also be stiffer so using lubricating ointment and drops to prevent dryness will help you with feeling more comfortable. These can be prescribed by your surgeon. How long you have to use these will depend on person to person.

If you already have dry eyes or eye disease, there is a higher chance of having a drying of the eyes post-surgery. If you are having an issue with protecting your eyes, especially in those who have poor movement of the eyes and weak facial muscles, please consult your surgeon and they will be able to suggest the best way to prevent this. 

As with all surgeries, it is important to observe how your body is reacting post-surgery but also before the surgery to make sure the chance of the surgery being successful is high. 

There is still a possibility of complications as well as risks that come with ptosis surgery. These risks include infection, asymmetric eyelid height, need for adjustment or additional surgery, unusual bruising or swelling after surgery, overcorrection or under correction, needing the eyelid to be lowered if the eyelid cannot be fully closed, etc. Your plastic surgeon will be able to communicate the risks involved for your body but like any surgery, we recommend you seriously contemplate it over before going through with it.