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Topic 15 - 1
Eyelid Ptosis
Repair Basics 
upper blepharoplasty photos Upper Eyelids ptosis aponeurosis dehiscence

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 the example that follows)

Female with Ptosis
Before and After Photos

Special anatomy: Review: 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.)

Anesthesia: 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 . . .

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Next: The Root Cause of
Most Adult Ptosis

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