Cosmetic Ptosis Surgery

Ptosis is the medical name for drooping of the upper eyelid. It usually occurs in either or both eyes. Aside from the obvious cosmetic effect, the ptosis might also obstruct vision causing a great reduction in field of vision by obstructing the pupil.

Ptosis and changes in facial structure

While ptosis as a condition affects eyelids and vision, people compensate for the falling eyelids by raising their eyebrows, making permanent changes in the facial structure including the upper eyelid and forehead area. In some cases of ptosis, patients even tend to hold up their eyelids forcibly using fingers to be able to see better, indirectly harming the vision permanently. Children with ptosis often develop amblyopia (aka the lazy eye) due to the limitation in vision.

Blepharoptosis (ptosis) types

Involutional ptosis is caused by the gradual stretching of the tissue that supports the upper eyelid. This occurs with aging or due to long term contact lens usage that may weaken the tissue of the upper eyelid.

Muscular ptosis is caused by a weak levator muscle. The levator is the muscle that is used to raise the eyelid. The muscular ptosis can occur in early childhood or adulthood or might be acquired later on as the muscle weakens or due to other neurological problems.

Ptosis – causes and factors

The most common factors casing ptosis are

Congenital weakness – acquired by birth and visible in early childhood, sometimes even genetic

Aging muscle weakness – as people age, the constantly moving eyelid muscles get tired and may start to droop. The tendon that attaches the levator muscle (the major muscle useful for lifting the eyelid even for every blink) might stretch and cause the eyelid to fall

Trauma – some direct trauma around the eyes

Neurologic diseases – any neurological disease that causes twitching and drooping eyelids

Surgery and after effects – surgery options like lasik or cataract surgery might stretch the muscle and tendon, causing ptosis.

How is ptosis corrected?

Ptosis correction is often done surgically by practiced surgeons. The surgery / treatment for ptosis involves tightening the levator muscle to elevate the eyelid. If the muscle is too weak to even be lifted (severe ptosis) a ‘sling’ operation that uses forehead muscles to elevate the eyelids, is performed. If the levels of ptosis are small, a surgery of a muscle on the inside of the eyelid is performed.

What is the most optimal surgery method?

When a surgeon performs ptosis surgery, he or she determines the level and severity of ptosis and choose the intensity of surgery or treatment based on that. The surgeon also performs tests as part of the treatment to determine the best form of correction. The end goal of surgery is to clear the field of vision by elevating the eyelid and achieve symmetry with the opposite eyelid.

Ptosis Symptoms

Ptosis as a condition is the drooping upper eyelid. But there are other auxiliary symptoms that include increased heaviness of eyelid, impaired vision and constant raising of eyebrow to lift the eyelid. People sometimes tilt or twist their faces to see better. The constant movement in the forehead muscles and excess strain on the muscle of the other eye might create repeated headaches that also significantly affect vision and clarity.

Individuals have also reported realising that they had ptosis by comparing recent photographs with old ones where the droopy eyelid was visible and obvious.

Cosmetic concerns of ptosis

In addition to the medical effects, ptosis itself also creates cosmetic concerns. If either or both of the eyelids are droopy, it can create a constant effect of tiredness and also affect the overall face by making it look permanently exhausted. Continuously raising eyebrows might also lead to strain lines in the forehead and asymmetric levels of both the eyes might give a sad look to the face. To relieve themselves of this problem, people reach towards cosmetic surgeons for surgery and ptosis treatment.

Blepharoptosis

Blepharoptosis is a very common oculoplastic problem. The goal of any ptosis surgery is to create a good anatomical result by elevating the eyelids or creating a lid fold if necessary. For a pleasing cosmetic effect, the eyelids need to be symmetrical and the facial contour should be even.

Limitations of ptosis surgery

Though the goal of a blephartoptosis surgery is to lift eyelids to even positions, certain difficulties arise particularly in congenital ptosis, because there are anatomically limiting factors. A defective levator muscle which does not perform its normal functions prior to surgery cannot be corrected by the surgeon with a simple surgery or treatment.

Choosing the right surgeon

Be it in any medical case, choosing the right surgeon is important and is the first and most important step of treatment. A cosmetic and reconstructive facial surgeon who specialises in eyelids, orbit and lacrimal duct systems  is the right choice of a surgeon to perform ptosis surgery. The right ophthalmologist who knows the anatomy of the eyelids and can look at the cosmetic perspective can make all the difference in ptosis surgery.

Dr. Debraj Shome is one of the leading surgeons who specialises in blepharoptosis surgery and also has extensive knowledge about other such ailments that affect the area around the eyes. His experience in the field of cosmetic surgery makes him the best choice for a surgeon.


About Dr. Debraj Shome

Debraj Shome-2
Debraj Shome, MD, DO, DNB, FRCS (Glasgow), FICO (USA), MNAMS, MBA (Healthcare Management, Vanderbilt University, USA), is Consultant Facial Plastic Surgeon, Oculoplastic Surgeon & Cosmetic Surgeon at Nova Specialty Surgery, Mumbai, India..Read more

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