Diagnosis and treatment

What does ptosis surgery involve? 

Ptosis surgery usually involves shortening the muscles or tendons that raise the lid. The muscle or tendon is reattached to your eyelid using sutures, which are buried under the skin. The sutures might be visible on the skin of your eyelids, but are removed around one week after surgery.

Occasionally, the lid is suspended from the brow in order to raise it. This is done using either tendon from your thigh taken via an incision just above the knee, or using an artificial material. Brow lift surgery is often done on both sides at the same time in order to achieve a better cosmetic result. The number of stitches in your leg can vary but this is usually removed after ten to fourteen days. This can be done by your own GP.

Does ptosis surgery have any complications?

There is no absolute guarantee of success with any operation and ptosis surgery is no different.

Facts and figures

• About 80- 85% of patients are corrected satisfactorily after the first operation, with asymmetry of 1mm or less.
• Approximately 15 – 20 % could require a further operation.
• Complications after ptosis surgery include the eyelid being too high or too low, the curve of the lid being irregular or the upper lid fold of skin being asymmetric. The droopy eyelid can also reoccur at any time in the future and might require a further operation. Repeat surgery such as this can be more complicated to carry out.
• Bruising of the eyelids and surrounding face is common after ptosis surgery.
• Bleeding and infection are also potential risks, but are less common.
• Inability to close the eye after surgery (lagophthalmos) can occur, particularly after large ptosis corrections. This usually corrects itself with time as the muscles relax.
• Correcting the droopy eyelid on one side can reveal a previously unnoticed droopy eyelid on the other side.

Recovery

Generally, after surgery your eye is padded shut for 24 hours, in order to reduce any swelling. You can remove this eye pad at home the following day.

When both eyes have been operated on, or when the vision in your non-operated eye is poor, we might remove the pad a few hours after surgery, before discharging you home. In these cases, you can use icepacks to help reduce the swelling. Before you go home, the nurse will clean around your eye and instil drops. Usually, drops and ointment will be prescribed for use at home; the nursing staff will show you how and when to use them.

A follow-up appointment is made for one to two weeks after surgery, with a second appointment between two and 12 weeks after that. The swelling in your lid should have gone down and a more accurate assessment of the result of the surgery can be made. Stitches are sometimes left to dissolve or are removed at about one to two weeks
after surgery.

Ice packs can help to reduce the swelling, as can sleeping at a 45-degree incline and avoiding sleeping on the operated side. It is often advisable to keep the operated area relatively dry for between two and 10 days. You can shower as normal, but ensure you dry your eyelid with a clean cotton pad after.

Other information

• Swimming, contact lens wear and eye make-up are not advised for approximately two weeks or longer if your eye remains red.
• If your child has had a brow suspension lift “sling” operation, they should avoid playing contact sports like football, and he/she must not 'head' the ball for six months.