Ptosis, or commonly called a droopy eyelid is a condition where the levator muscle or the muscle that enables you to lift your eyelids isn’t strong enough to lift the upper lid. It can appear in both eyelids at the same time and can develop at any age. It can be mild, where vision is not obstructed and can also be severe where the eyelid completely covers the pupil.
Droopy eyelids can pose a lot of issues in both the function and cosmetic aspects of the eye. They don’t only obscure vision but also make you look older and more tired than you are. Ptosis can also occur early in childhood and when left untreated, can lead to irreversible vision problems like amblyopia (lazy eye), astigmatism (blurred vision) and even permanent poor vision.
This is why many patients always ask for the best treatment for ptosis and doctors always answer them the same thing: ptosis surgery. However, it cannot be helped that some patients tend to shy away from surgical and invasive procedures and always ask if there are alternatives to surgery to treat their ptosis or drooping eyelid. They come to their doctor’s clinic and ask: “Is ptosis surgery really necessary?”.
Alternatives to ptosis surgery
Although ptosis surgery is the most recommended procedure that can safely and effectively treat drooping eyelids, some patients aren’t lining up to go under the knife because of the associated risks with surgical procedures that include:
- risk to anaesthesia
- the risk for under or over-correction (aesthetic purposes)
- long recovery time
- risk of infection, bleeding and swelling
With today’s technology, there are now available non-surgical alternatives to treat ptosis. These methods are usually called non-surgical eyelifts and can include the use of radiofrequency and laser technologies. These devices work by tightening the skin around the eyelid to improve its appearance and give a lifting effect. While these devices are non-surgical in nature, many patients feel that they are safer options. The major downside of these advanced technologies, however, is that the doctor may not be able to properly fine-tune the drooping and result in a high chance or over or under-correction.
This usually results to patients not being satisfied with the results and prompt them to re-do the procedure, costing them more money in the long run and the results aren’t even as effective like surgery as these devices cannot remove the fat and fluid build-up on the upper eyelid that can cause the levator muscle to weaken and droop.
Special eye drops and eyelid tapes can also be prescribed for patients with mild ptosis to maintain the elevation of the upper eyelid but these methods are not long-lasting and need a great amount of compliance and care.
These non-surgical alternatives are rarely recommended by doctors. Usually, these are only used for patients who are not open to surgical procedures or very mild cases where there’s a minimal amount of drooping skin that needs to be tightened.
Surgery is still the primary thought in response to ptosis
The weakening of the levator eyelid muscle is the main cause of drooping eyelids. To effectively lift and tighten this muscle, surgery is required. Other than ptosis surgery, there is currently no other effective way to treat ptosis and help the eyes open up again, especially with patients with severe ptosis. If you are still having doubts about the safety and effectiveness of ptosis surgery, in this article, Health Ascent attempts to provide full, accurate and up to date information about ptosis surgery in Singapore based on current medical evidence and opinions from trusted doctors.
After a thorough consultation and assessment with your eye or plastic surgeon, ptosis surgery is performed in this order:
- Eyelids (or eyelid) is injected with local anaesthetics to ensure a painless procedure.
- Your doctor makes an incision along the crease of your upper eyelid so that the muscles, tissues, fat and fluid deposits are exposed.
- Depending on your doctor’s technique, some parts of the eyelid (fat, tissue and fluid build-up) will be removed or repositioned to tighten the eyelid. In some cases, the eyelid muscles and skin can be sutured to give the eyelid a more defined crease and lifted appearance.
- After giving the eyelid more definition and the assessment of eyelid opening, the cut is then stitched up along the existing eyelid crease.
The whole ptosis surgery procedure can be done in 1-2 hours depending on the severity of eyelid drooping.
Swelling and some bruising on the treated area can be expected. These are normal side-effects and do not cause for alarm as they eventually heal up on their own and can last for 1-2 weeks. After this period, most wounds and side-effects should have healed and subsided and patients can return to their normal activities. To help you manage discomfort while recovering, your doctor may prescribe painkillers. During the recovery period, patients are typically advised to stay away from the sun, avoid heavy physical activities and they are recommended to get enough rest and eat healthily to speed up the recovery process and ensure that there are no complications.
For best results, it usually takes about 1-3 months for the eyelids to be properly repositioned and have a defined and lifted appearance. For most, outcomes from ptosis surgery are long-lasting and there’s no need for repeat surgery in the future.
However, there are rare cases where the eyelids tend to droop again years after ptosis surgery. They can be caused by various factors such as too much stress (triggers fat and fluid build-up), eye trauma or from a natural process where the eyelids droop and weaken with age.
Children who have had ptosis surgery at a very young age (at least 3 years old) are also at risk for developing ptosis again as they grow up. For these cases, repeat ptosis surgery is required to address the problem. If you notice any recurrence of droopiness in your eyelids, call your doctor right away to schedule a proper eye assessment.