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   home > Face > Drooping Eyelids
  Drooping Eyelids (Ptosis Surgery)  
  Ptosis is drooping of upper eyelid where patient cannot open the eye completely. This condition could affect one side or both the sides and usually exits since birth. It persists even after the child grows up. The right age for surgery is anytime, after the age of 5 years. If it is affecting only one eye and is severe, the brain learns to see only with the normal eye. This may lead to a condition called ambliopia, in which one develops partial blindness in the affected eye just because it is never used.
The surgery may be indicated to prevent ambliopia, to improve the field of vision or merely for cosmetic reasons.
 
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Soundarya LASER & Cosmetic Surgery Centre, Mumbai
 
 
 
A quick look at your queries...
 

AM I THE RIGHT CANDIDATE FOR PTOSIS SURGERY ?

Any patient with ptosis can undergo the procedure. One needs to be careful if the patient has a jaw winking phenomenon (winking of eyelid as the jaw moves), dryness of eyes, inability for the eyeball to roll upwards, severe refraction error or any other problem related to the eyeball.

 

WHAT ARE THE UNCERTAINTIES AND RISKS ?

When eyelid surgery is performed by a qualified plastic surgeon, complications are infrequent and usually minor. Nevertheless, there is always a possibility of complications, including infection or a reaction to the anesthesia. You can reduce your risks by closely following your surgeon's instructions both before and after surgery.

The surgery is performed only on the eyelid and does not even touch the eyeball. Hence it poses no danger to the eyesight. You would need to use artificial tears to prevent the eyes from drying till they get used to new lid position. Special care is required at night to prevent the drying. Although a better symmetry is usually achieved in bilateral surgery, it may be difficult to achieve a perfect symmetry with a normal eye.

HOW DO I PLAN MY SURGERY ?

The initial consultation with your surgeon is very important. The surgeon will need your complete medical history, so check your own records ahead of time and be ready to provide this information. Be sure to inform your surgeon if you have any allergies; if you're taking any vitamins, medications (prescription or over-the-counter), or other drugs; and if you smoke. You and your surgeon should carefully discuss your goals and expectations for this surgery.

During your first visit,  Dr. Patankar  would examine your eyes and decide on the appropriate surgical technique, most suitable for you. He would discuss the surgery and the post operative care in detail with you. He would give you an idea about the risks and the expenses involved (Note: Most insurance policies don't cover eyelid surgery, unless you can prove that drooping upper lids interfere with your vision. Check with your insurer.)

In this consultation, you should also provide any relevant information from your ophthalmologist or the record of your most recent eye exam. If you wear glasses or contact lenses, be sure to bring them along.

Don't hesitate to ask your doctor any questions you may have, especially those regarding your expectations and concerns about the results.

HOW DO I PREPARE MYSELF FOR SURGERY ?

You would be asked to get certain basic tests done like blood and urine examination. Chest X-ray and E.C.G. may be asked for in certain patients especially above the age of 35 years.

Dr. Patankar will give you specific instructions on how to prepare for surgery, including guidelines on eating and drinking, smoking, and taking or avoiding certain vitamins and medications. Carefully following these instructions will help your surgery go more smoothly.

HOW LONG WOULD I NEED TO STAY IN THE HOSPITAL?

The surgery is usually done on an outpatient basis; rarely does it require an inpatient stay. Most of the patients can leave the hospital within 4 to 6 hours after the surgery.

IS THE SURGERY PAINFUL?

Eyelid surgery is usually performed under local anesthesia--which numbs the area around your eyes--along with oral or intravenous sedatives. You'll be awake during the surgery, but relaxed and insensitive to pain. You can enjoy your favorite music during the surgery or have a chat with the surgeon. General anesthesia may be used for the patients who are very anxious; in that case, you'll sleep through the operation.

WHAT IS THE SURGICAL TECHNIQUE USED ?

The surgery involves a cut in the skin fold of the upper lid. The muscle responsible for lifting of the upper lid is tightened with stitches. This elevates the lid. If the muscle is very weak, the surgeon may use a fascia (thin layer under the skin of the thigh), and fix it in the eyelid and foreheads though tiny 2 mm cuts. These cuts are so placed that they are completely hidden and are not visible.

WHAT CARE DO I NEED TO TAKE AFTER THE SURGERY ?

After surgery, the surgeon will lubricate your eyes with ointment and may apply a bandage for a few hours. Your eyelids may feel slightly tight and sore as the anesthesia wears off, but any discomfort can easily be controlled with medication prescribed by your surgeon.

Your surgeon will instruct you to keep your head elevated and to use cold compresses to reduce swelling and bruising. Bruising varies from person to person: it reaches its peak during the first week, and generally lasts anywhere from two weeks to a month. You'll be shown how to clean your eyes and apply eye drops and ointment.

Your surgeon will follow your progress very closely for the first week or two. The stitches will be removed two days to a week after surgery. Once they're out, the swelling and discoloration around your eyes will gradually subside, and you'll start to look and feel much better.

Healing is a gradual process, and your scars may remain slightly pink for six months or more after surgery. Eventually, though, they'll fade to a thin, nearly invisible white line.

WHEN CAN I RESUME MY DAILY ACTIVITIES AND JOIN MY DUTIES ?

You should be able to read or watch television shortly after surgery. However, you would be advised to blink your eyes intermittently. You would use artificial tears to lubricate your eyes at regular intervals as per your doctor's advice. This would gradually be reduced and finally stopped. You won't be able to wear contact lenses for about two weeks, and even then they may feel uncomfortable for a while.

You may resume normal daily life the very next day; however there would be some swelling and bruising. Most people feel ready to go out in public (and back to work) in a week to 10 days. By then, depending on your rate of healing and your doctor's instructions, you'll probably be able to wear makeup to hide the bruising that remains. If you are sensitive to sunlight, you should wear sunglasses and a special sun block made for eyelids when you go out.

Your surgeon will probably tell you to keep your activities to a minimum for three to five days, and to avoid more strenuous activities for about three weeks. It's especially important to avoid activities that raise your blood pressure, including bending, lifting, and rigorous sports. You may also be told to avoid alcohol, since it causes fluid retention.

YOUR NEW LOOK

You would appreciate the improved balance between the eyelids of the two eyes. The positive results of your eyelid surgery, the more alert and youthful look, will last permanently.

 

 
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