When does eyelid ptosis require surgery?

Not all eyelid ptosis requires surgery. If the ptosis is mild and stable and does not cause a problem for the patient, in these cases, observation and follow-up may be sufficient.

However, when the ptosis is noticeable or persistent, and treatment is required to improve the function or appearance of the eyelid, surgical intervention may be the most suitable option.

When do we decide to perform surgery?

There is no single degree of ptosis at which we can say that surgery is necessary for everyone, as the decision depends on the specific case and the patient's needs.

For example, a mild degree of ptosis may cause a noticeable problem for one person, while the same degree may not require intervention for another person.

Therefore, when making the decision to undergo surgery, we consider the overall picture of the case, taking into account the cause of the ptosis, the degree of eyelid drooping, its impact on the patient's daily life and needs, and the outcome the patient wishes to achieve.

Is there one surgery that suits all cases?

There are several surgical methods for treating eyelid ptosis, and the appropriate procedure is chosen based on the nature of the case, the degree of ptosis, and the desired outcome.

Tightening or repairing the levator muscle tendon (Levator Advancement / Aponeurosis Repair)

In this procedure, the levator muscle and its tendon, which are responsible for lifting the upper eyelid, are worked on. Access is gained through a surgical incision in the upper eyelid skin, usually within the natural eyelid crease, and then the tendon is adjusted to improve the height of the eyelid.

One of the advantages of this method is that it allows for more extensive and precise adjustments to the eyelid, making it suitable for cases where the ptosis is more pronounced or when there is a need for greater eyelid elevation.

Since access is through the skin, swelling or bruising may appear in the initial period, and the wound needs time to heal and for the eyelid shape to stabilize.

Müller's muscle surgery (Müller Muscle Surgery / Müllerectomy)

In this procedure, Müller's muscle located on the inner side of the upper eyelid is worked on, and access is gained from inside the eyelid, so there is no visible skin incision on the eyelid.

This method is used in selected cases, especially when the degree of ptosis is limited, and it can be suitable when we want to make a correction without the need for a skin incision on the eyelid.

Due to the lack of an external wound, swelling and bruising on the eyelid skin are usually less, and the initial recovery is often faster and simpler in many cases.

In some patients, the problem may not be limited to the eyelid alone, and it may be appropriate to combine more than one surgical procedure at the same time to address more than one factor and achieve the best possible outcome in terms of function and appearance.

What do we aim for with surgery?

The goal of surgery is not just to lift the eyelid higher, but to achieve an appropriate position for the eyelid that maintains its function, helps improve vision when needed, and achieves a natural and balanced appearance as much as possible.