Ptosis surgery is an operation that lifts a droopy upper eyelid. Ptosis happens when the muscle that raises the eyelid becomes weak or its attachment becomes loose. This can make the eyelid sit lower than normal and may block part of your vision. It can also make the eyes look uneven and cause tiredness in the forehead from constantly lifting the brows to see better. Surgery aims to lift the eyelid to a more natural height and improve both function and appearance.
You may benefit if you have:
A droopy eyelid affecting vision.
Tired forehead muscles from constantly raising your brows.
Difficulty reading or driving because the eyelid blocks your sight.
A tired or uneven appearance.
Congenital ptosis present since birth.
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It is important to note that ptosis surgery does not treat excess eyelid skin. If loose skin is also present, a combined blepharoplasty may be advised.
There are several surgical techniques to perform ptosis surgery:
Anterior approach - going from the front of the eyelid.
Posterior approach - it is a scarless surgery since the incision is hidden in the inner surface of the eyelid).
Brow suspension - usually reserved for severe droopy lids secondary to congenital ptosis.
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The procedure usually takes 30-45 minutes.
Performed under local anaesthetic, similar to dental anaesthesia.
The surgeon uses either an anterior approach (through the eyelid crease) or a posterior approach (from the inner surface of the eyelid).
The muscle that lifts the eyelid is tightened or reattached.
If needed, the eyelid crease is reformed with fine stitches.
In congenital or severe cases, the eyelid may be suspended to the forehead muscle.
Stitches are usually hidden within the natural crease.
The procedure usually takes 30-45 minutes.
The anaesthetic injections may sting briefly, but once numb you should not feel pain. Afterwards, most patients only need simple pain relief such as paracetamol.
Bruising and swelling are expected for 1–2 weeks.
Stitches are usually removed after 7-14 days.
Swelling gradually improves but can take up to 3 months to fully settle.
Most people return to work and social activities within 1–2 weeks.
Results are long lasting but the eyelid can change again over time due to ageing or muscle changes. Some patients may need further surgery later in life.
Doing nothing. In adults, ptosis does not harm the eye and surgery is optional. In young children, a droopy eyelid can lead to a lazy eye if it covers the line of sight. In these cases, surgery may be needed urgently to protect vision.
A ptosis prop attached to glasses. This lifts the eyelid mechanically but is usually used when surgery is not appropriate.
There are no non-nurgical treatments that reliably lift a droopy eyelid.
Complications are uncommon but can include:
Bruising and swelling.
Infection.
Temporary irritation or dryness.
Asymmetry. The eyelids may not match perfectly.
Under correction or over correction.
Need for further surgery.
Visible scars in anterior approaches.
Small lumps from sutures.
Temporary blurred vision.
Dry eyes.
Rare eyelid retraction.
Extremely rare risk of bleeding behind the eye which may affect vision.
Allergic reactions to anaesthetic or dressings.
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Your surgeon will discuss these with you in detail.
Apply cold compresses for the first 24–48 hours.
Sleep with your head elevated for 2 nights.
Use antibiotic ointment on the wound for 2 weeks.
Clean the area with cooled boiled water and cotton wool for 10 days
Avoid bending, heavy lifting and strenuous exercise for 2 weeks.
Avoid eye make-up for 3 week.s
Avoid contact lenses for 2 weeks.
Protect scars from sunlight with sunglasses and SPF for several months.
You should get in touch with us if you experience:
Severe pain not controlled by painkillers.
Sudden drop in vision.
Increasing redness, swelling or discharge from the wound.