Droopy eyelid or ptosis surgery

Ptosis (droopy eyelids) is always treated with surgery. When and how to operate will depend on the causing aetiology, the severity of the affection and age of the patient.

In terms of treatment, ptoses are classified into those that cause visual alteration and those that do not. In the first case, it is a surgery necessary to conserve the eyesight. In the second case, treatment is for patients who consult a specialist seeking a better appearance.

Aside from that, we have the case of small children with significant congenital ptosis, as the risk of amblyopia must be evaluated at a very early stage. 

Children in whom ptosis is found to be the cause of the development of visual impairment must be operated on early and immediately, as soon as possible to avoid permanent visual issues in the future. It is, perhaps, the only case of ptosis where early surgery is essential.

The different surgical techniques for palpebral ptosis are based on the status of the levator muscle function. If the condition of the levator muscle is good even though it creates drooping, the techniques will focus on strengthening it and the objectives can be reached in a more natural, predictable and simple way. 

These procedures involve manipulating and strengthening the aponeurosis of the muscle. They are simple, predictable procedures with an excellent prognosis. 

If the function is very poor, the surgery cannot be aimed at strenghthening it, which is why treatment will involve addressing the function of that muscle with substitution techniques, mainly based on the frontal muscle.

In patients who respond to stimulation of the drooping eye using Phenylephrine at 10%, surgery may be performed in a more straightforward and predictable way and even without having to make any incisions in the eyelid skin.

Eyelid ptosis surgery is very safe and predictable in the majority of occasions. Except in the case of children, it is performed under local anaesthesia, so that the patient cooperates during the procedure, and the result is as exact and predictable as possible.

It is a very regulated and predictable surgical procedure. The most common risk is some uncomfortable bruising for the first few days, which disappears quickly. In some cases, the eyelid level reached is not the desired level, therefore, subsequent correction should be assessed.