Ptosis Repair
A drooping upper eyelid that hangs too low can block part of the visual field, cause chronic forehead strain from compensating, and make the eyes look heavy or asymmetric. Ptosis repair raises the eyelid to its proper position.
Ptosis is the medical name for a drooping upper eyelid. It is not the same thing as excess eyelid skin: ptosis is a problem with the levator or muellers muscle, which is responsible for actively lifting the lid. People with ptosis often raise their brows constantly to keep the lid out of the way, which can cause forehead tension headaches over time. Children can be born with congenital ptosis; in adults it is usually acquired, from age, contact-lens wear, or prior eye surgery.
Ptosis repair tightens the levator or muellers muscle mechanism so the eyelid sits at its proper height. The approach depends on how much lifting the muscle can still do on its own. As an oculofacial plastic surgeon, Dr. Boxrud is trained to evaluate, diagnose, and treat levator and muellers muscle function precisely and choose between an external or conjunctival (internal) approach based on the individual anatomy. When ptosis is present alongside excess upper-eyelid skin, both can be addressed in the same procedure.
- Procedure
- Outpatient, 45 to 90 minutes depending on approach.
- Anesthesia
- Local anesthesia or mild sedation.
- Recovery
- Return to non-public activities within about a week. Final lid height may take several weeks to settle.
What is ptosis?
Ptosis (pronounced “toe-sis”) is the medical term for a drooping upper eyelid. The lid sits lower than it should, partially covering the pupil and giving a tired or sleepy appearance. It can be congenital (present from birth) or acquired (developing with age or after trauma or surgery).
What causes a drooping eyelid?
The most common cause in adults is gradual stretching or thinning of the levator muscle, the muscle responsible for lifting the upper lid. Other causes include contact lens use over many years, prior eye surgery, trauma, neurologic conditions, and aging.
Is ptosis repair covered by insurance?
Typically yes. Ptosis repair is considered functional when the lid is obstructing vision, which is documented with a visual field test. Coverage is more common than for cosmetic blepharoplasty.
How is ptosis repair different from upper blepharoplasty?
Upper blepharoplasty removes excess skin and fat. Ptosis repair tightens or repositions the levator muscle to lift the lid itself. They are different operations addressing different problems, and they are sometimes performed together when both are needed.
How long do ptosis repair results last?
Results are generally long-lasting, often a decade or more. As the rest of the face continues to age, some patients eventually choose touch-up procedures.
What is the recovery time for ptosis surgery?
Most patients return to non-strenuous activity within 5 to 7 days. Bruising and swelling settle over two weeks. Fine-tuning of the result continues for three months.
Will both eyelids be the same height afterward?
That is the goal. Symmetry is the technical challenge of ptosis surgery; small adjustments can be made post-operatively in the office if needed. Choosing a surgeon with focused oculofacial training matters here more than almost anywhere else in eyelid surgery.