Ptosis FAQ Videos

Eyelid ptosis is classified into two types: congenital or acquired. People who have congenital ptosis show deviations in the severity of the ptosis, as well as the muscle function. Acquired ptosis, or “mechanical ptosis”, develops due to the interference of a physical factor, such as tissue, which subsequently affects the way the eyelid functions. The weakening of the levator muscle, which is responsible for keep the eyelid open, is also a cause for mechanical ptosis. This is often seen in patients who have undergone cataract or laser vision surgery.

Ptosis refers to a physical condition wherein the orientation of the eyelid margin relative to the pupil is lower than normal. Sometimes, the presence of extra skin above the eyelid can weigh it down and change its position or even affect vision. This condition is called “mechanical ptosis”. During a preliminary check-up, Dr. Amiya Prasad will try to determine where the eyelid margin is positioned by lifting the extra skin. If the margin remains at a low orientation after lifting, it is probable that you have ptosis, and if that is the case, it is recommended that you undergo ptosis surgery to correct it, as this cannot be fixed by blepharoplasty alone.

The orientation of the eyelid in comparison to the pupil is a crucial factor in deciding whether you will need blepharoptosis repair or blepharoplasty.

Blepharoptosis is present when the eyelid margin is lower than it should be, and dermatochalasis refers to extra skin over the eyelids, which gives eyes a hooded appearance. Dermatochalasis can be corrected by undergoing a blepharoplasty procedure. It is not uncommon for ptosis to go unnoticed, especially when a plastic surgeon mistakenly concludes that doing blepharoplasty will automatically fix the problem of drooping eyelids. It is also not unusual to find both dermatochalasis and blepharoptosis in some people, which can occasionally be a bit tricky when formulating a proper diagnosis and surgical plan for.

During the initial checkup, Dr. Amiya Prasad establishes whether a patient has ptosis by lifting up the extra skin to see if it has a positive effect on the eyelid margin or not. If the eyelid margin remains low, then he can assume that the patient has eyelid ptosis, which can be easily addressed with surgery.

If a patient’s baggy eyelids are caused by excess skin over the eyes (dermatochalasis), then a blepharoplasty is performed. If it is caused by ptosis, then ptosis surgery is done. Remember that before anything else, it is always important for a patient to meet with a specialist first, get a thorough diagnosis and discuss which procedure is right for their case.

Dr. Amiya Prasad recommends that patients approach an oculoplastic or oculofacial plastic surgeon to perform their ptosis surgery. It is important to keep in mind that ptosis surgery is a complex procedure that requires the specialized training and experience of a professional who has studied opthalmology and cosmetic and reconstructive surgery. Some of these general surgeons often overuse the term “board-certified surgeon” as their main selling point. However, many of them lack the actual skills needed to perform such procedures properly.

Like other types of surgery, there is always risk of bleeding, swelling and infection. There are also risks posed by the type of anesthesia used—whether it is general, local, or local with sedation. Risks that are specific to ptosis surgery, however, include the following:

(1) Under-correction of ptosis, wherein the eyelid still continues to droop.
(2) Over-correction of ptosis, wherein the eyelid looks too open.
(3) Undesirable cosmetic appearance, scarring, and problems due to infection and swelling.

A surgeon can approach ptosis surgery in different ways, depending on the case. It is therefore essential for the patient to discuss the possible risks with their surgeon in order to determine a procedure that is right for them.

If your eyelid ptosis already gets in the way of your vision and causes concern from a cosmetic perspective, then ptosis surgery ought to be considered to improve it. Dr. Amiya Prasad recommends doing research and meeting with a skilled and high-experienced oculofacial plastic/ oculoplastic surgeon that specializes in this type of surgery.

Ptosis is caused by a physical dysfunction in the levator muscle of the eyelid, and because it is a physical issue, the best way to fully address it would be through surgery. If surgery is not desired, a different type of eye drop can be used to temporarily lift the Mueller’s Muscle (an accessory muscle that measures about 1-2mm). This makes make the eye look more open for a certain amount of time and can be used in the event or a special occasion wherein one needs to pose for photographs. This, however, is not meant for long-term use.

After ptosis surgery, most patients see an instant boost in their vision. Since the eyelid position is improved, patients observe that their surroundings look significantly brighter and note the sudden ease of being able to keep their eyes open.

Eyeglasses may be worn after surgery, however, Dr. Prasad cautions against wearing contact lenses for at least a week after surgery. This is because a prescribed antibiotic ointment will need to be placed over the eyelids and may get in the way of the effectiveness of the contact lenses. In the event that you do start wearing contact lenses, lubricating eye drops must be used regularly to prevent eye dryness. Dr. Prasad also suggests checking contact lens prescriptions several months after the surgery, as ptosis has been known to cause minor astigmatism.

Ptosis surgery is designed to correct the balance and symmetry of one or both eyelids. In order to determine the correct symmetry before the procedure is done, the patient is made to open and close their eyes in a lying down and upright position. This will allow the surgeon to see if the balance of both eyelids is correct, or if any modifications need to be made. After that, the patient is made to lie down again and the surgery can commence. Ptosis surgery is done with the help of Dr. Amiya Prasad’s LITE™ IV sedation technique, which allows patients to emerge from surgery feeling more refreshed. Cold compresses are applied to the areas and patients are usually able to go home without any bandages.

To give a patient a positive experience both surgery-wise and recovery-wise, Dr. Amiya Prasad capitalizes on the following areas: (1) the anesthesia method, (2) the surgical team, (3) the surgical technique, and (4) the post-operative recovery process.

The Anesthesia Method
Dr. Prasad uses his own modified sedation method—LITE™ IV sedation. This method has been proven to have a better effect on patients as it allows them to reemerge from surgery without feeling groggy or nauseated. It also allows them to heal faster than they normally would had they been placed under a general anesthetic.

The Surgical Team
Dr. Prasad understands that longer surgery times can have a negative effect on a patient, which is why he always performs surgeries in his own Joint Commission-accredited operating rooms, with a consistent surgical team made up of highly trained individuals. Working in such a set-up allows surgeries to happen much faster and smoother. It also allows Dr. Prasad and his team to give immediate and attentive aftercare to their patients, which has shown to have a significant effect on how well patients recover after surgery.

The Surgical Technique
When surgeries are performed efficiently and properly, the patient has a better a recovery experience afterwards. With over 20 years of experience under his belt, Dr. Amiya Prasad has developed a mastery of the art and technique needed in his line of work. Like how an experienced pilot is prepared to handle any type of situation when flying a plane, Dr. Prasad is similarly well adept in handling any scenario in the operating room, given his extensive experience and know-how.

The Post-Operative Recovery Process
At hospitals and surgery centers, Dr. Prasad observed that there was often a big mismatch in the number of support staff in the relation to the number of patients, and this usually led to interruptions in essential aftercare procedures. Delays like these directly affect the overall recovery time of the patient, and it was for that reason that Dr. Prasad decided to launch his own surgical and aftercare facilities.

The recovery period from ptosis surgery does not differ much in comparison to the recovery period after a routine upper eyelid blepharoplasty procedure. Although depending on certain issues that happen during or after surgery, swelling may last longer.

The most important factors that can dictate whether additional surgery is needed are the following: (1) the type of ptosis present, (2) the age when you had the procedure, (3) changes related to aging, and (4) the elasticity of your own tissues. For example, a child with congenital ptosis can have revision surgery before they reach six years of age, and then again later on during their teens or young adult years. Those with mechanical ptosis, however, can achieve good, lasting results with ptosis surgery, without needing additional surgery. One may consider having additional surgery if there are any concerns regarding height, symmetry, or contour.

If ptosis is present, correcting the height by raising the eyelids should be enough to improve the overall symmetry of the eyes. If ptosis is present in only one eye (unilateral ptosis), Dr. Amiya Prasad will simply match its shape and symmetry to that of the other eye.

Surgery costs are dictated by the following elements: (1) surgeon’s fee, (2) anesthesia, (3) facility costs, and (4) aftercare. Keep in mind that surgical procedures should not be likened to commercial goods, as these practices are the product of years of experience, meticulous training, research, and technical expertise. Understanding the quality of work that goes into delivering a high level of care and treatment usually gives patients a better grasp of how surgeons arrive at their fees.