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Droopy Eyelid Repair

Eyelid Ptosis is drooping or falling of the upper eyelid. It occurs when the muscle that raises the
eyelid ( levator aponeurosis) is not strong enough to do so properly. It can affect one eye or both
eyes and is more common in the elderly, as muscles in the eyelids may begin to deteriorate. One
can, however, be born with ptosis. If severe enough and left untreated, the drooping eyelid can
interfere with vision development. That is why it is especially important for this disorder to be
treated in children at a young age, before permanent visual changes occur. Other causes of ptosis
may include damage/trauma to the muscle which raises the eyelid, or damage to the nerves
supplying this muscle. Such damage could be a sign or symptom of an underlying disease such
as diabetes mellitus, a brain tumor, a lung tumor and diseases which may cause weakness in
muscles or nerve damage, such as myasthenia gravis. A careful history and examination help to
rule out unusual causes of ptosis. Most common form of ptosis occurs as a result of dehiscence
or disinsertion of the levator aponeurosis from the eyelid. Aponeurotic and congenital ptosis
may require surgical correction if severe enough to interfere with vision or if cosmetics is a
concern.

Surgical procedures include:

  • Levator resection – incision is made in the skin of the upper eyelid and the muscle is
    tightened with sutures. Resulting scar is well hidden and is usually not visible.
  • Müller muscle resection – incision is made on the inside of the eyelid, leaving no visible
    scar.
  • Frontalis sling operation – if the eyelid muscle is weak or damaged, a sling procedure
    using a silicone rod to connect the forehead muscle to the eyelid muscle is performed to
    help elevate the upper eyelid.

  • Upper eyelid ptosis is often seen in conjunction with dermatochalasis (extra upper eyelid skin
    hanging over the eyelashes). In this case, both a blepharoplasty and ptosis repair would be
    performed to achieve a better functional and cosmetic result.

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    Combined Ptosis repair and Upper eyelid Blepharoplasty

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    Combined Upper eyelid Blepharoplasty and Lateral Brow lift

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