Ptosis Surgery (Ptosis correction)

Learn everything about your treatment

Ptosis (pronounced toe-sis) is the medical name for drooping of the eyelid. This is normally caused by weakening of the upper eyelid muscles or the nerves that supply them. These muscles, known as levators, hold the eyelid in place and help to keep the eye open. As a result, weak eyelid muscles will cause the eyelid to sag. This can lead to a number of problems, including problems with vision, discomfort and headaches.

  • Overview
    ptosis

    Ptosis can occur due to a number of reasons, including:

    • Ageing
    • Trauma
    • Complication of another eye surgery
    • Birth defects
    • Medical problems such as myasthenia gravis or muscular dystrophy

    Ptosis can be treated using a number of different surgical techniques and is normally performed under local anaesthetic. Several factors influence the choice of technique used. This includes the cause of ptosis, whether you were born with it or it developed in later life and the degree of eyelid drooping. The surgical procedures work by shortening the muscles and tendons that raise the eyelid. This helps to hold the eyelid up and prevents it from drooping. Your surgeon will discuss the different treatment options during your consultation.

    Reasons for ptosis surgery

    Overall, ptosis can cause a number of issues and can be difficult to live with. A low eyelid may reduce your visual field. In addition, it can make everyday tasks such as reading increasingly difficult. This can cause the eyebrows to become painful and make the eyes tired. Although these are functional issues, ptosis can also make some people unhappy with their appearance. As a result, they may want ptosis surgery for cosmetic reasons.

    You may want to consider ptosis surgery if:

    • Drooping of the eyelid is affecting your vision
    • Your ptosis is causing discomfort and headaches
    • You want to change the appearance of your eyelid
    • You want to improve the symmetry of your face

  • Candidates

    Why choose to have ptosis surgery?

    Ptosis is the medical term for drooping of the eyelid. This happens when the muscles holding the eyelid are weak or the nerves that supply those muscles don’t work properly. This can cause the eyelid to droop downwards. Ptosis can cause a number of problems including cosmetic issues, headaches, tiredness and visual field problems. Each person's ptosis will cause different problems. As a result, there are many reasons why someone may have ptosis surgery. This page highlights which patients make ideal ptosis surgery candidates.

    Who are the ideal ptosis surgery candidates?

    This depends on many factors, including the degree of ptosis, cause of ptosis and when it developed. In addition, ideal candidates for ptosis correction surgery will have good general health and be mentally prepared for the procedure. Ideal ptosis surgery candidates may also be:

    • Wanting to improve their confidence
    • Looking to restore their field of vision
    • Aiming to relieve headaches and eye tiredness
    • Well informed about the risks and benefits of the procedure

    What ptosis surgery will not resolve

    Ptosis correction surgery can give many long-lasting benefits. However, there are certain issues that it will not resolve. It is important that you discuss your symptoms in detail with your surgeon. In some cases, they may recommend alternative treatments that are more suitable for your needs. In summary, ptosis surgery will not correct:

    Vision problems

    Ptosis can limit the area that your eyes can see (visual fields) or the amount of light that is let into your eye if part of your eye is covered by the eye lid. This means that you may not be able to see the upper part of your peripheral vision or your vision may be dimmer. However, ptosis is unlikely to make your vision blurry or hard to focus. Instead, you may need to have glasses or surgery to correct a problem with the eye itself. Once this is corrected, it may resolve issues such as headaches caused by eye strain.

    Eyebrow position

    Some people feel that their eyebrows may be too close to their eyes, or that their forehead is too big. As a result, they may benefit from brow-lift surgery rather than ptosis correction. As ptosis surgery involves shortening the eyelid muscles, it will not typically change the position of the eyebrows.

    Wrinkles around the eyes

    Some people develop wrinkles around the eyes as part of the ageing process. These wrinkles, also known as “crows feet”, can make people feel as though they look old or tired. Crows feet can easily be treated with surgical and non-surgical options. Your surgeon can discuss these in more detail if it is appropriate.

    During your consultation, your surgeon will talk to you in detail about the benefits and limitations of ptosis surgery. This will help you to decide which procedure is most suitable for your needs.

    Who is not suitable for ptosis surgery?

    Ptosis surgery is typically straightforward with few complications. However, some patients may not be suitable for certain treatments. You should let your surgeon know if you:

    • Are pregnant
    • Have a bleeding disorder
    • Have any infection or inflammation around the eye

    You will be able to discuss these issues during your consultation. At Medbelle we recommend that you are open and honest with your surgeon. This will help them make sure you are receiving the safest and best treatment for your goals.

  • Procedure

    Performing ptosis surgery

    There are several different methods available for ptosis surgery. The surgery shortens the muscles that attach to the eyelid. Shortening the muscles pulls the eyelid upwards, correcting the ptosis. Several factors influence which method is used. These include the degree of ptosis and how long you have had it for. Your surgeon will discuss the different possible methods in detail during your consultation. This ptosis surgery procedure page provides a general overview of what to expect.

    What to expect

    Consent

    First you will meet with your surgeon to discuss treatment options and the details of the planned procedure. They will also be able to answer any questions that you may have. It is important that you have a full understanding of the procedure and its risks. That way you can be sure you are making the right choice to go ahead with surgery. If you have any concerns, make sure to ask your surgeon. They will be happy to address any questions you may have.

    After this discussion, if you’d like to go ahead with the surgery you will be asked to sign a consent form detailing that you understand the reason for the surgery, the intended benefits and possible risks.

    Anaesthesia

    Patients normally have this treatment under local anaesthetic. Sometimes a small amount of sedation may be used for the procedure alongside the local anaesthetic or very rarely a general anaesthetic is used. Before having your surgery, you will meet an anaesthetist. This specialist doctor focuses on your pain relief, comfort and safety during surgery. They will talk to you about the options available for your operation.

    The procedure

    Surgeons use several different methods to correct ptosis. Which one is used depends on the how much the eyelid has drooped and for how long it has been drooped. The main methods used are discussed below. All of them work to pull the upper eyelid up and correct the drooping. Overall, the treatment takes 45-60 minutes per eye and is normally completed as a day case.

    The possible procedures commonly used are outlined below:

    Levator aponeurosis advancement

    The surgeon makes an incision in the natural crease of the upper eyelid. The levator muscles are identified and reattached or raised. Sutures hold the muscle in place. During the procedure you may be asked to sit up so the surgeon can assess that your eyelids are symmetrical. Excess skin from your eyelid may be removed if necessary. Levator resection is similar procedure. In this procedure, the surgeon removes a piece of muscle to shorten the levator.

    Muller's muscle resection

    In this method, incisions are made inside the eyelid. A layer of muscle called Muller's muscle is located, shortened and tightened using stitches. These are removed up to three weeks later. Fasanella-Servat method works in a similar way, although it is mainly used for mild ptosis.

    Brow suspension

    Brow suspension corrects congenital ptosis or ptosis associated with muscular dystrophies. In these conditions, the levator muscle is typically weak. As a result, brow suspension uses the forehead muscle to help lift the eyelid. The surgeon makes small incisions around the eyelid. Afterwards, they attach a piece of material under the skin, connecting the forehead muscle to the eyelid. The material used can either be a natural material, such as a tendon, or a synthetic material such as silicone cord.

    After the procedure

    Once you have had your surgery you will return to the ward to recover. You may find that your eye area is slightly numb. The sensation will return as the anaesthetic wears off. You may also notice some blurring of the vision. This is will also get better with time. Overall, most patients go home the same day. If you have had a general anaesthetic, the recovery time may take longer. You will be under supervision from the medical team during this time. Although you should be able to go home the same day, you will not be able to drive. Therefore, you may want to ask a friend or family to take you home. We can assist in arranging transport if you wish.

    In summary, this page provides an overview of the ptosis surgery procedure. If you have any questions, or would like extra information, feel free to speak to your Medbelle Patient Care Adviser.

  • Consultation

    What to expect from your consultation

    Before having surgery, you will need to meet your surgeon for a consultation. Your ptosis surgery consultation will typically last up to 1 hour. During this time, there are a number of things that your surgeon will want to discuss with you. This will include your past medical history, any surgery you may have had in the past, your current medications, as well as any allergies.

    In addition, they will want to talk to you about what you hope to achieve from having the operation. It is important that you are honest about your expectations, that way your surgeon can ensure you get the right treatment to help you meet your goals.

    As part of their assessment, your surgeon will also want to examine your eye and may arrange various tests. Furthermore, your surgeon will talk to you about the operation and what it involves. They will also discuss any risks and complications that can occur. This will help you to make an informed decision about whether or not surgery is right for you.

    Questions to consider during your consultation

    Your consultation is a chance for you to find out as much as you want about the operation. Therefore your surgeon will make sure there is plenty of time to answer any questions you may have. At Medbelle, we want to make sure that you are fully informed about any operation or procedure you’re considering. Therefore, we suggest that you think of potential questions before the consultation. It may be a good idea to write them down and take them to the consultation with you. That way, you won't forget to ask during the meeting. There is no such thing as a silly question and your surgeon will be happy to address any concerns you raise.

    Some questions you may like to ask include:

    • Do you think what I want to achieve from surgery is realistic?
    • How can I get the best results?
    • Where will my scars be located?
    • Can I see any before and after pictures of similar operations you have done?
    • What other options are available for me?
    • Are the results permanent?
    • What will the recovery process involve?
    • Will I need to stop any of my other medications before and/or after this procedure?

    In summary, your consultation is a chance to meet your surgeon and talk to them about what you are hoping to achieve from ptosis surgery. It is also an opportunity for you to find out about the operation and address any questions you may have.

  • Ricks & Complications

    Ptosis surgery risks and complications

    What are the main risks and complications?

    When having surgery, it is important to be aware of any risks and complications that can occur. Your surgeon will discuss these with you during your consultation. In addition, we have prepared this ptosis surgery risks and complications page to help highlight the main risks. After your consultation, we recommend a two-week "cooling off" period. This will give you time to think about the risks and benefits and decide if surgery is right for you.

    Eyelid bruising and swelling

    The eyelids can become sore, bruised or swollen. A degree of this is normal after an operation and will resolve over the following days and weeks.

    Dry eyes

    Following the surgery, the eyes can become dry and sore and it can be difficult to close the eye fully. You may develop some blurring of your vision as a result. If you are suffering from this, you can ask your surgeon to prescribe you some eye drops. These eye drops, known as artificial tears, help lubricate the eye and stop it from becoming dry. This normally resolved within 1 month.

    Chemosis

    The eyelid is lined by a thin layer, known as the conjunctiva. After surgery, this layer can become swollen. Your eyes may feel irritated and it can be difficult to open the eyes fully. Generally, chemosis resolves within a few weeks.

    Infection

    Infection is a risk that can happen with any surgical procedure. In the unlikely case that you are affected, it will become apparent over the first two or three weeks when things are not settling down as expected. Antibiotics treat minor infections. You should contact your surgeon if you are concerned that you have an infection. Signs of infection include:

    • Temperature over 38 degrees celsius
    • Redness at the incision site that is spreading
    • Yellow pus-like or foul-smelling fluid from the incision
    • Increased pain or discomfort that is not relieved by painkillers

    Haematoma

    Sudden bleeding around the eyeball can push the eyeball forward, causing reduced vision and pain. Although this is very rare, it is serious and requires urgent treatment as it can lead to vision loss.

    Overcorrection

    Following surgery, you may notice that your eyelid is too high. Massage and gentle traction can resolve this issue. However, in some cases, further surgery is needed.

    Loss of vision

    Catastrophic loss of vision is a rare complication of ptosis surgery. It often occurs due to sudden bleeding around the eye, creating pressure on the back of the eye. This pressure can become severe enough to cut the blood supply to the eye itself. Symptoms include intense pain, double vision and a sudden bulging forward of the eye. You should seek immediate medical attention if you notice these symptoms.

    Ptosis of the opposite eye

    After surgery, you may notice the eyelid of the non-operated eye beginning to droop. This can occur as your brain gets used to the new position of the corrected eyelid. Despite drooping only being apparent in one eye, both eyes can become affected.

    Aesthetic

    As with any procedure, there is always the risk that you may not be happy with the aesthetic results. Therefore, we always advise patients to choose their surgeon carefully and make sure they are aware of your expectations.

    General risks

    During and after any anaesthetic and surgical procedure there are general risks which include airway problems, blood loss, cardiac arrest, scarring, allergic reactions and blood clots. Every effort will be taken to reduce these risks and the likelihood of any of them happening will be discussed during your initial consultation.

    In summary, this page provides an overview of the main ptosis surgery risks and complications. For more information, speak to your surgeon or a Medbelle Patient Care Adviser.

  • Preparation

    How to prepare for ptosis surgery

    Having surgery can be a daunting experience for anyone. As a result, we recommend a number of this you can do to help prepare. This ptosis surgery preparation page highlights how you can prepare for surgery. Your surgeon will also discuss this with you during your consultation.

    Sleep

    In the initial days after surgery, you may find it easier to sleep with your head propped up. This helps to prevent pressure on the face and will be more comfortable. Try to rest and sleep in an inclined position during the first few days. Make sure you have plenty of pillows ready to help do this!

    Grocery shopping

    After you have had surgery, you will want to relax and focus on your recovery. As a result, we suggest doing a big food shop the day before your procedure. That way you won't have to be going to the shops when you should be resting. You may also want to prepare and freeze some meals before having your surgery. This will save you time and effort afterwards.

    Household chores

    You may want to clean the house and do chores like laundry or taking the bins out before the day of the procedure. This will help free up time in the days after your treatment.

    Young children and pets

    You are likely to feel tired after your ptosis surgery procedure. You may therefore find it helpful to ask friends or family to help look after young children and pets for the first few days after the operation. This will help you focus on your recovery.

    Glasses

    After ptosis surgery, you will not be able to wear contact lenses for a while. Make sure you have a pair of glasses to wear after the procedure.

    Eye protection

    Your eyes are likely to be swollen and sore following the surgical procedure. Therefore it is important to have a pair of sunglasses to protect your eyes from the wind, rain and sun. Sunglasses will also conveniently hide any swelling or bruising during your recovery!

    Travel

    You will be unable to drive after your ptosis surgery. As a result, we recommend you speak to friends or family to arrange your journey home. We can help with your travel arrangements, if you wish.

    Food and drink

    Maintaining good general health is an important part of the recovery process. After surgery, eat high-protein, low-sodium foods, including fresh fruits and vegetables. Also, stay well hydrated with water and caffeine-free beverages. You should try to avoid consuming high amounts of salt and sugar during your recovery time.

    This ptosis surgery preparation page provides a general overview of how to prepare for your surgery. If you have any further questions, feel free to contact your surgeon or Medbelle Patient Care Adviser.

  • Aftercare

    Ptosis surgery aftercare

    What to expect after ptosis surgery

    It is useful to know what to expect after ptosis surgery. Your surgeon will provide specific details regarding your aftercare. In addition, this ptosis surgery aftercare page gives general tips on the recovery process.

    We recommend that you closely follow the advice given by your surgeon. This helps to reduce the risk of complications occurring. As a result, you can help ensure you get the best possible outcome from your surgery.

    The recovery from ptosis surgery is generally straightforward. Therefore you should return to normal activities quickly. Below are some general ptosis surgery aftercare tips:

    Directly after surgery

    Once you have had your treatment, you will wait on the ward to recover. During this time the medical team monitors you and checks that you are comfortable. Your eye area may feel numb if you have had local anaesthetic. This is normal and wears off with time. If you have general anaesthetic, you may feel tired, drowsy or sick afterwards. This will also ease with time. If you feel unwell at all, make sure to let the team know. They are there to help make sure your recovery is as safe and easy as possible.

    Returning home

    Most patients return home on the day of their surgery. However, in some exceptional cases, an overnight stay is required. Your surgeon will speak to you about this during your consultation. If you are going home on the day of surgery, you will not be able to drive. Therefore we advise that you ask a friend or family member to take you home. If you need help arranging transport, speak to a member of the Medbelle team. We will be happy to help!

    How will I feel after surgery?

    It is common to feel some discomfort and swelling around the eye in the first days after surgery. Applying cold compresses and over the counter painkillers will help ease any pain. Your eyelids may be sensitive, difficult to shut and appear watery after surgery. This settles with time. It is important to clean the eye area with water and uses any eye drops that your surgeon gives you.

    Returning to work

    After ptosis surgery, it is recommended that you take at least a week off work. Most patients return to work within 7-10 days. However, it will vary depending on the job you do! If your job involves driving, it is important that you do not drive until your vision has returned to normal. For most people this will be the day after your surgery.

    Returning to exercise

    During the recovery period, it is recommended that you take things easy and relax. As a result, you should avoid strenuous activity and exercise for the first week. This can make the swelling and pain worse. Walking and other light activity is encouraged.

    General tips

    During the recovery time, it is likely that your eye will feel itchy and irritated. Therefore it may be tempting to rub the eye area. We recommend that you try not to do this as it can affect the incisions and disturb the healing process. As you progress through the recovery period, this discomfort will get better.

    In addition, you should not wear any contact lenses during the first week or so. Your surgeon will give further information about this during your consultation.

    Final results

    Although ptosis surgery is a short procedure, it can take a while before you will be able to fully appreciate the results. This may be up to 6 months in some cases. The scars will usually be pink and raised for the first few weeks. Eventually they will fade to lighter lines on the skin in the following months. As the incisions are made in the natural folds of the eye, they are hidden as well as possible. However, it is important to keep any scars protected from strong and/or direct sunlight. Following the aftercare advice from your surgeon and keeping good general health will help the wounds heal fully. This will ensure that the cosmetic outcome is as good as possible and that scarring is minimal.

    In summary, this page provides general tips on what to expect from the recovery process. If you have any questions or would like extra information, feel free to contact your surgeon or your Patient Care Adviser.

  • FAQs

    Common frequently asked questions

    At your consultation, you will have an opportunity to ask your surgeon questions about the procedure. On this page, we have provided some common ptosis surgery FAQs that you may find helpful.

    When will I see the final results?

    After surgery, your eye is likely to be red and swollen. However, this will subside in the first 1-2 weeks and you should be able to notice the results around this time. However, it will take some time before you will see the final results. In some cases, this may be up to 6 months.

    Will the NHS pay for my Ptosis procedure?

    Ptosis surgery for cosmetic reasons is not typically available on the NHS.

    Do I need a GP referral for Ptosis Surgery?

    Most surgeons will be happy to see you without a referral from your GP. However, they may ask for your permission to contact your GP if there are any details of your medical history that they would like to discuss.

    Can I wear eye makeup after surgery?

    You are strongly advised not to wear any eye makeup until your eyelids have fully healed after surgery. Generally, this takes around 6 weeks.

    Do I need to wear anything over my eyes?

    It is recommended that you wear dark glasses for the first week after your procedure. This will help protect your eyes from the sun, wind and rain. In addition, wearing glasses will also prevent you from touching your eyes. Dark glasses are also a good way of keeping the treatment area hidden if you are concerned about people seeing it!

    Will I need to stop any medications before or after the surgery?

    This depends on the type of medications that you are taking. It is important to tell your surgeon and anaesthetist about any medications you take, including over the counter, homeopathic and herbal remedies during your initial consultation. It is also important to tell them if you are taking any medications for diabetes or to thin your blood. Some medications will need to be adjusted or stopped before and/or after your surgery. Failure to do this may result in your operation being cancelled or increase the risk of complications.