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Droopy Eyelid Surgery: Eyelid Ptosis Procedure, and Recovery

Ptosis is a medical term that means “droop”, so we call it eyelid ptosis when the eyelid droops. Ptosis, or drooping eyelids, is also known as a “lazy eye.” If you or someone you know has one or both eyes partially closed, it may be ptosis. In most cases, ptosis correction surgery can improve both appearance, and vision. I’ll explain what causes the most common types of ptosis, as well as how I work with my patients to develop a strategy that has the best chance of success.

When I meet a patient with ptosis, I begin by reviewing their history to determine whether they were born with ptosis or if it developed ptosis later in life. Ptosis is referred to as congenital ptosis when it is present at birth, and acquired ptosis if it develops later in life. In either case, I first rule out any neurologic causes of ptosis before discussing surgical options. Ptosis is caused by a condition that affects the levator muscle.

female eyelid ptosis surgery before and after
drooping eyelid surgery before and after

What is the best procedure for droopy eyelids?

The type of surgery I recommend is determined by the cause of the droopy eyelids, as well as the strength and function of the levator muscle. Surgical correction usually entails either levator muscle advancement, or shortening. If the levator muscle is too weak, surgery is performed to connect the brow-lifting muscle to the eyelid.

During Consultation

When patients who are considering droopy eyelid surgery visit our office, they express a desire for their eyes to be as open and symmetric as possible. Patients frequently seek cosmetic upper eyelid surgery for sagging skin and are unaware that they also have ptosis.
ptosis repair and upper eyelid blepharoplasty before and after
ptosis repair and upper blepharoplasty before and after

During my examination, I explain how excess skin over the eyelids known as dermatochalasis, differs from eyelid drooping caused by the levator muscle, which is known as ptosis. People who have had cosmetic eyelid surgery or upper eyelid blepharoplasty elsewhere frequently come in concerned that they still look tired. This is because they had the upper eyelid skin removed, but nothing was done to address the underlying muscle causing the eyelid droop.

The majority of ptosis surgeries are for acquired ptosis caused by progressive stretching or thinning of the levator muscle. Some patients come in saying they’ve always had low upper eyelids, also known as “bedroom eyes,” and that as time passed, the eyelids became lower and made them look tired.

droopy eyelids surgery before and after
ptosis correction surgery before and after

Objective of the Procedure

The goal of surgery is to position the eyelid lifting muscles, which include the levator and another muscle called Mueller’s muscle to correct the position of the eyelids. I explain to my patients that these muscles are extremely sensitive, and achieving the desired result can be difficult.

How is the procedure performed?

The operation is carried out under local anesthesia with LITE intravenous sedation. In most cases, I ask the patient to open their eyes so that I can measure the height and shape of their eyelids. In fact, during surgery, I routinely sit the patient up and evaluate the appearance of the eyes in a way that more accurately reflects being vertical in real life. This aspect of the surgery allows me to more accurately predict the outcome we’re aiming for. With my patients, I qualify the procedure’s predictability by explaining that 95% of the time, the eyes look fine and the outcome is satisfactory. Enhancements are performed approximately 5% of the time when swelling has significantly decreased, which is usually after 3 months.
droopy eyelid surgery before and after
before and after ptosis surgery female patient

Droopy Eyelid Surgery Recovery

Swelling of the eyelids is a normal part of the healing process. The amount of post-surgical swelling is determined by the extent of the surgery, and the physiology of the individual patient. Cold compresses help reduce the initial swelling after surgery in the first two days. The clearance of swelling after the first two days is dependent on the amount of swelling and circulation. I encourage my patients to get up and move around by walking, talking, and smiling, and if they intend to be more sedentary, warm compresses can help.

droopy eyelid surgery before and after 1 week recovery
droopy eyelid surgery on the left eye before and after 1 week recovery time

After one week, the majority of people return to work. I see our patients more frequently in the first two months after surgery, and then at approximately three-month intervals for the next year.

In general, I anticipate a close to final appearance at around 6 months. Swelling may last longer than usual if a patient has a history of allergies, sinus problems, smoking, or other circulation issues.

droopy eyelid surgery before and after 1 month recovery time
droopy eyelid surgery procedure done at Prasad Cosmetic Surgery New York

Is droopy eyelid surgery risky?

Droopy eyelid surgery can improve your appearance and confidence significantly. Functionally, eyelid ptosis can impair vision and visual development in children between  birth to age six. If you’re unsure whether you have ptosis and whether you should have surgery, consult with a Fellowship-trained oculofacial plastic surgeon to learn more about your situation and options.

what is healing like after ptosis repair before and after 1 week
healing after ptosis repair surgery 1 week after

Droopy Eyelid Surgery in NYC and Long Island, New York

Dr Amiya Prasad is a Board-certified cosmetic Surgeon and Fellowship-trained oculoplastic surgeon. He’s been in practice in Manhattan and Long Island for over 25 years. He routinely treats a wide range of ptosis patients in his practice. Many of his patients are patients who’ve undergone previous eyelid surgery done elsewhere. To schedule a consultation, fill out the form below, or contact any of our offices at (212) 265-8877 for the Manhattan, New York City office; (516) 742-4636 for the Garden City, Long Island office; or (703) 356-1336 for the Vienna, Virginia office.

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