PTOSIS REPAIR
NEWPORT BEACH

Orange County’s Best Eyelid Surgery Center

Eyelid ptosis (or blepharoptosis) refers to an upper eyelid which is drooping below its normal position. Ptosis can affect one or both eyes. Ptosis can block our vision, and is often considered a medical issue if the edge of the eyelid is covering any part of the pupil (black circle at the center of the eye). Dermatochalasis, or excess skin of the upper eyelid, may also contribute to blockage of the superior visual field.
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There are several causes of ptosis. The most common cause is known as aponeurotic ptosis. This is a result of the muscle which normally elevates the eyelid slipping or becoming detached from its normal attachment to the structural portion of the eyelid known as the tarsus. This can be a result of aging (involutional ptosis), contact lens use, previous surgery or trauma. Another type of ptosis is known as congenital ptosis. Congenital ptosis is typically present since birth. It results from poor development of the levator muscle of the upper eyelid. Other causes include muscular and neurogenic problems.

Ptosis generally occurs as a result of stretching of the eyelid muscles. This is usually due to age but can also result from previous eyelid surgery or simply the long-term use of contact lenses. That being the case, children can also have ptosis if they are born with weak eyelid muscles.

Although ptosis typically does not affect visual acuity (except in children), it can block the superior portion of the visual field. Other symptoms include fatigue of the forehead and eyebrows, which is most notable when reading. Some patients must maintain a chin-up position to be able to perform their normal activities.

Ptosis Treatments

Ptosis treatment is based on the severity of the droopiness and function of the levator muscle (muscle which elevates the eyelid). Common ptosis (aponeurotic ptosis) can be treated from the inside surface of the eyelid (internal approach- conjunctival/ Mueller’s muscle resection) or from the outside surface of the eyelid (external approach- levator aponeurosis advancement).
  • A conjunctival/ Mueller’s muscle resection is performed on the internal surface of the upper eyelid and avoids a skin incision. This is a good option for some patients, depending on what Dr. Joseph learns during the testing period performed as part of the consultation.
  • A levator advancement is a longer procedure in which the levator muscle is advanced to a stronger position in the eyelid, giving it a better grip to elevate the eyelid.
  • Congenital ptosis and certain types of paralytic or myogenic ptosis typically have very poor muscle function. These types of ptosis are usually treated with a frontalis sling procedure in which the eyelid is directly attached to the eyebrow.
In adults, surgery is usually performed while the patient is awake. Repair may be performed with either local anesthesia, local anesthesia with sedation or general anesthesia, depending on the approach. Dr. Joseph will discuss these options and details during your consultation.
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The average surgery usually requires between 30 to 60 minutes. However, this time will vary depending on the specific goals that you and Dr. Joseph set forth. Every surgery is unique and to achieve the absolute best result, no surgery is ever rushed.
Recovery varies by individual. The eyes are usually swollen and bruised for 1 to 2 weeks. There can be some pain after surgery, but it is usually well controlled with ice compresses and over-the-counter medications.

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