Ptosis Surgery in London for Droopy Eyelid
What is ptosis surgery?
Ptosis surgery is the procedure used to correct ptosis and is performed normally under local anesthesia in adults and general anesthesia in children. It is performed by eye plastic surgeons, not plastic surgeons. Eye plastic surgeons are part of the British Society for eye plastic surgery and specialize in the eyelids and the area around the eyes.
What is ptosis?
Ptosis is the medical name given to when the eyelid falls. Eyelid ptosis can occur for one or both eyes. Ptosis that occurs at birth is known as congenital ptosis. Ptosis that develops later in life is known as acquired.
Congenital ptosis
Congenital ptosis can affect the visual development of a child if it impairs vision.That is why children with drooping eyelids are closely followed by a pediatric ophthalmologist.If the child’s vision is affected, surgery is performed under general anesthesia to lift the eyelid and allow vision to develop.Ptosis can also be treated in children if the child is socially withdrawn, lacks confidence, or suffers bullying because of this. In general, if there is a slight prolapse that does not affect the child visually or socially, it is better to wait for the surgery to be delayed so that it can be performed under local anesthesia with a chance of getting a better result.
Aquired ptosis
Aquired ptosis develops later in life and commonly develops from:
- Long-term use of contact lenses
- eyelid trauma,
- having had cataract surgery or other operations to the eye.
- rubbing your eye there may be a risk of it developing.
- Less common causes include problems with the nerves that go to the upper eyelid such as Marcus Gunn or Jaw Winking ptosis which occurs on opening the mouth or chewing.
- Other medical problems that can affect the eyelid muscle such as myotonic dystrophy and myasthenia gravis
How much does ptosis surgery cost in the UK?
You can expect ptosis surgery to cost between 2,000 and 5,000 pounds depending on whether the surgical procedure is performed under local anesthesia alone or requires an anesthesiologist, the surgical technique used, the number of eyelids treated and whether previous surgery has been performed.
Can you get ptosis surgery on the NHS?
The National Health Service (NHS) provides ptosis surgery for medical reasons but not for cosmetic purposes. If your ptosis is severe enough to affect your vision, your doctor can refer you to an oculoplastic surgeon. The surgeon will evaluate your eyelids and medical history, take photos and conduct a visual field test to determine if you are eligible for eyelid surgery through the NHS.
How long is the recovery from ptosis surgery?
Complete recovery from ptosis surgery may take up to 3 months. In the first 2 weeks we expect some eyelid swelling and bruising that will settle down during the healing process. To speed up your recovery try the following:
- Place ice on your eyelids for the first 3 days following the ptosis correction
- Sleep on 2-3 pillow at night to allow the swelling to drain
- Use your ointment as instructed by your consultant ophthalmologist
- Take 1 week off work unless you can work from home
- Wear sunglasses when outdoors to protect the wounds from sunlight.
- Make sure not to miss you follow up consultations during the recovery period.
Are you awake during ptosis surgery?
Ptosis surgery in adults is usually done while they are awake, under local anaesthesia. The procedure usually takes around one hour, but may take longer, as the surgeon needs to be able to adjust the eyelid height and curvature while the patient is awake. However, even with this precision, around 10% of patients may require a follow-up procedure.
For children, the procedure is done under general anaesthesia, as they are not able to tolerate surgery with local anaesthesia alone. This means that the eyelid cannot be fine tuned in the same way as for adults, but the surgery is still necessary if the ptosis is affecting the child’s visual development.
What are the risks of ptosis surgery?
- Infection to the wounds and the eyelids
- Bleeding from the incisions
- Eyelids are not perfectly symmetrical
- Recurrence of ptosis
- Reduced eyelid muscle movement
- Inability to close the eyes completely
- Worse vision
Can ptosis be corrected without surgery?
Ptosis Phenylepherine Test
For some people, the ptosis in their eye may temporarily improve without surgery for up to an hour when phenylephrine drops are used. This stimulates Müller’s muscle, which is responsible for lifting the eyelid, and causes it to rise. However, the effect is only temporary and will eventually drop back down again. This test is used to determine if a conjunctival Mullers resection is a suitable treatment option for small amounts of ptosis.
Ptosis props
Ptosis props are small crutches that are typically attached to glasses frames and can correct ptosis without surgery. While many people find this solution to be effective, the discomfort caused by the props often makes them difficult to tolerate, and few people are able to use them for extended periods of time.
Does insurance pay for ptosis surgery?
Your insurance may pay for ptosis surgery if your vision is blocked and it is not considered cosmetic surgery. At the initial consultation, your ophthalmologist will evaluate you and arrange visual field tests and photographs to provide your insurance with the necessary data to consider eye plastic surgery to lift the eyelids.
What is the procedure for ptosis surgery?
Many patients are satisfied with the results of ptosis surgery and benefit from a more youthful appearance, better vision if the peripheral sphere is obstructed and more self-confidence. The results of surgery can last a lifetime but for others drooping may recur over time.
There are 3 main procedures for ptosis surgery:
Anterior approach
To access the levator muscle responsible for lifting the eyelid, an incision is made in the skin crease of the eyelid. This muscle tendon is then reattached to the eyelid, and the height and contour are assessed and adjusted if necessary. The incision is then closed with small stitches, and the resulting scar is usually concealed within the skin crease.
Posterior approach
To access the levator muscle without leaving a visible scar, an incision is made on the underside of the eyelid. This muscle is then attached to the eyelid. While the benefit of this approach is that it does not leave a visible scar, there is less room for fine-tuning compared to the anterior approach. Additionally, those who wear contact lenses may want to avoid this approach, as reintroducing the lenses after the surgery can be uncomfortable and take time.
Brow suspension
In cases of poor levator function, where the eyelid muscle is not providing enough lift, a brow suspension may be used. This involves using a synthetic material or tendon known as the fascia lata from the leg to lift the eyelid and secure it in place with the help of the eye brow muscles, which causes a brow lift and thus a lift of the eyelid. As soon as the brow relaxes, the eyelid will drop again. This procedure should not be confused with brow lift surgery.
What is the difference between blepharoplasty and ptosis repair?
Many patients are satisfied with the results of ptosis surgery and benefit from a more youthful appearance, better vision if the peripheral sphere is obstructed and more self-confidence. The results of surgery can last a lifetime but for others drooping may recur over time.
Blepharoplasty treats any excess skin or eye bags in the eyelids. Ptosis repair treats the elevation of the upper eyelid. Blepharoplasty can also be performed on the lower eyelid.
What should I do after ptosis surgery?
- Follow all the instructions given by your eye surgeon
- Use ice packs to calm the swelling
- Get plenty of rest
- Sleep on 2 or 3 pillows
- Avoid smoking
- Refrain from contact lenses for 4 weeks
- Dont do strenuous exercise or heavy listing until the swelling settles
- Try not to rub your eyes
- Wear sunglasses when outdoors
Can ptosis return after surgery?
Ptosis can return after surgery and this is called recurrence. Early recurrence within 3 months of eye operations. The delayed recurrence is years later.
Repetition occurs because the procedure fails, the stitches holding the levator muscle come off or dissolve too early, or because the muscle detaches from the eyelid body again over time due to friction or age, repetition requires a repeated procedure.