Ptosis of the upper eyelid occurs most commonly due to an issue with the function of the levator palpebrae superioris muscle, the muscle which functions to lift the upper eyelid to allow eye opening. Age, trauma or a congenital issue with this muscle can lead to the muscle attachment or its length of contracture to be effected leading to a weakness in opening of the effected eye.
It is important to diagnose the cause of ptosis prior to attempting correction and to rule out any other neurologic causes for the problem.
Ptosis correction can be performed under local anaesthesia in office and usually involves reattachment of the separated levator musculature or shortening of the attachment to allow an improvement in eye opening. This is a procedure often combined with blepharoplasty surgery.
This patient in her 20s had a long standing issue with asymmetry in her left eye due to congenital weakness of the levator musculature on her left side. Her left eyebrow had a persistant involuntary raised position which was required to assist her eye opening on the left side and the problem was worse when she was tired.
Adjustment of the levator muscle insertion length was performed to shorten the muscle and allow better excursion in eye opening. While the brow remains slightly raised in her post operative photo as this is a habitual behaviour which will need to be unlearned over time, good correction of her pre-existing ptosis can be seen at 6 weeks post surgery
This patient in her 30s had an injury to her levator muscle from a previous eye procedure that left her with a weakened eye opening and scarring un the upper eyelid causing uneven fold formation.
A ptosis correction of the left eye was performed through a blepharoplasty incision to correct the levator muscle length and release the scarring. Her upper eyelid fat pad was mobilised to improve the previous scar tethering with good effect.
Results are seen at 6 weeks post op