Surgical correction of eyelid drooping and eyelid lift
The edge of the drooping eyelid covers part of the pupil and obscures the upper part of the visual field. In severe cases, the patient has to tilt his head back or lift the eyelid with his finger so that it does not obscure the view.
Eyelid drooping (ptosis) is usually associated with age and occurs when the tendon of the muscle that lifts the eyelid is stretched; as a result the eyelid drops too low. Eyelid drooping often develops after cataract surgery or prolonged use of contact lenses. The eyebrows may droop in the same way; if this happens, the eyebrows move downwards.
The eyelid drooping may also be congenital. In this case, it is often caused by underdevelopment of the muscle that lifts the eyelid. If this defect is not corrected and there is a violation of the visual axis, this can interfere with the normal development of vision; in this case, the child gets used to the wrong position of his head thrown back with chin lift.
Surgery for the drooping eyelids’ correction can be performed in conjunction with other procedures such as eyelid stretching or eyebrow lift. Dr. Avisar will discuss with you all the available options in detail so that you can make a well-considered decision.
In most cases, eyelid droop surgery is covered by health insurance.
Before and after surgical correction of eyelid drooping
Course of the surgery procedure
During the surgical correction of eyelid drooping the stretched tendon is shortened or pulled towards the eyelid. The muscle itself usually retains its strength and does not require surgical intervention.
This surgery is usually performed under local anesthesia, sometimes with a little intravenous sedation, on an outpatient basis and without the need for an overnight stay in the hospital. The surgery takes about an hour, and as a result, the symmetrical height and contours of the upper eyelids are restored.
In most cases, Dr. Avisar performs eyelid prolapse correction through an incision under the eyelid (posterior approach); with this technique there is no need to make a skin incision and therefore no external scar is left. Sometimes during a procedure similar to an upper eyelid lift, a thin incision is made in the eyelid crease to mask the scar. In addition to shortening the tendon, excess skin and muscle and, in rare cases, fat can be removed in a single surgical procedure. Then the incision is closed with thin sutures; they are usually removed within a week or dissolve on their own.
Very seldom, especially with congenital drooping of the eyelid and a problem with muscle strength, it is necessary to connect the eyelid to the forehead muscle with silicone or nylon suture or tissue from the upper thigh (fascia lata), thus allowing the forehead muscles to lift the eyelid.
What to expect after surgical correction of eyelid drooping
After the surgery, you may experience swelling and bruising; cold compresses and keeping the head elevated will help reduce discomfort.
• Eyes may feel dry because they are more open than before, especially if the eyelids were heavily lowered prior to surgery; you should use artificial tears – drops prescribed by Dr. Avisar.
• It is important to avoid physical activity during the first week after surgery, but you can return to work if you wish.
• You will be able to go for a walk during the first week and fly in several days, but you should avoid lifting heavy weights, strenuous fitness training and running for four weeks due to the increased risk of bruising and swelling.
• Use antibiotic eye creams for a few days after surgery.
• Avoid using contact lenses for at least 4 weeks after surgery because the eyelids may be stiff and the eyes may be dry.
• Some patients complain on blurred vision for several days; this sensation appears mainly because of the dry eyes.
• In rare cases, tiny dots may appear along the suture line; they can be easily removed in the clinic with a needle.
• In rare cases, there may be some difference between the eyes after healing; this can be easily corrected with a little additional surgery.
All pre-surgery procedures begin with Dr. Avisar’s consultation.