blepharoplasty 101 logo2
The Go-To Patient Resource


Topic 15 - 1
Eyelid Ptosis
Repair Basics 

ptosis of upper eyelid

Other names

Droopy eyelid repair, "cosmetic ptosis repair"

Primary goal

Elevation of a drooping (not baggy) upper eyelid that may be interfering with peripheral vision

Secondary goals

(May be performed in conjunction with blepharoplasty, as in this example)

Female with Ptosis
Before and After Photos

Special anatomy

The levator muscle begins in back of the eye and turns into an aponeurosis (similar to a tendon) as it enters the eyelid. Most cases of adult-onset ptosis are the result of thinning or tearing of the levator aponeurosis. Less commonly, neuromuscular diseases such as myasthenia gravis, muscular dystrophy, Horner's syndrome, or multiple sclerosis may cause the muscle itself to become partially paralyzed (requiring far different operations from those discussed here.)


Local anesthesia with minimal sedation is all but mandatory to allow for active patient cooperation during surgery

Operative technique

Through an upper eyelid crease skin incision, the blepharoplasty is carried out as described above to the point through and including the removal of fat. Now on good display, the levator aponeurosis ("tendon") can be inspected by the surgeon (surgery photo). The aponeurosis is "tucked" using non-dissolving sutures. The surgeon must be careful to not only create a smooth lift for the droopy lid, but also match the one upper eyelid to the other upper eyelid and to restore the normal curve to the lid margin (which becomes flattened with ptosis).


Ptosis, especially when mild, may also be repaired by several different operations performed from the back side of the eyelid ("Müller's muscle-conjunctival resection" and "Fasanella-Servat procedure") in conjunction with blepharoplasty from the normal skin approach. While such less invasive "posterior approaches" work well in mild ptosis surgery performed as an isolated procedure, the advantage of using . . .

To finish this article and gain unlimited
full access, log in or upgrade.

There's a lot more here.
Don't miss out.
blepharoplasty 101 enroll

Pure insight, no marketing

premium upgrade

bleph 101 logo
The complete guide to
cosmetic surgery around the eyes

Do Not Copy
© Copyright 2000-2016 Frank Meronk, Jr., M.D.
All Rights Reserved

Disclaimer: Information, observations, and opinions are presented for general reference use only and do not constitute specific medical advice, diagnosis, or treatment. Base all decisions solely upon the recommendations of your own doctors. With each use of this website, you signify your review and full acceptance of our current Terms of Use and Online Privacy Policy.

Home | Blepharoplasty Research