Open your eyes
Feel like your eyelids sag, making you look tired and even obstructing your vision? This issue may not only be superficial.
Eyelid ptosis, characterized by drooping of the upper eyelid, is a disorder that Dr. Harvey "Chip" Cole, III, M.D., F.A.C.S. of Atlanta, Georgia, specializes in treating. Dr. Cole is a highly skilled OculoFacial plastic surgeon with experience in various methods to decrease the frequency of ptosis repair surgeries and shorten the duration of their respective recoveries. If you are bothered by eyelid ptosis, give Oculus Plastic Surgery a call or book an appointment online now to find out more.
See the full range of possibilities
Congenital or acquired ptosis (droopy upper eyelids), which can occur at birth or later in life, is generally due to hereditary tendencies, aging changes, or trauma. The main reason for having corrective surgery for droopy upper eyelids is to improve vision in the upper-lateral field of gaze; however, there is a beneficial cosmetic side effect.
Corrective surgery is also necessary for children who have ptosis in both eyes for proper visual development. Surgery is done in adults to improve the visual field. Ptosis is a frequent cause of “fender benders” involving older drivers because of a decreased amount of reaction time when side vision is reduced.
Nationwide, approximately 25 percent of those having a ptosis repair need a secondary adjustment so that the best possible symmetrical results may be obtained; the percentage is only 10 percent in Dr. Cole’s practice. There are two basic surgical procedures to correct ptosis. The strength of the levator muscle in the eyelid determines which operation is performed.
If the opening muscle has some strength and can elevate the eyelid, then the levator muscle can be tightened or resected. This elevates the lid to the desired level.
If a patient has poor strength of the eyelid muscle, tightening the muscle does not work well. This procedure uses the strength of the eyebrow muscle (frontalis muscle) to correct the droopy eyelid. A tiny silicone rod/band is passed inside the eyelid up into the eyebrow muscle, where it is secured. This elevates the lid and allows the patient to use their eyebrow muscle to control the lid height. This is analogous to suspenders holding up baggy pants.
Enhance your vision
Ptosis correction surgery can dramatically enhance your vision by restoring access to areas of the eye previously obscured by a sagging top eyelid. The height, contour, and symmetry of your eyelids will also be enhanced. Your confidence will soar as people comment on how alert, revitalized, and youthful you look. Dr. Cole specializes in endoscopic procedures, leading to scarless results.
Youthful Revitalization
Our expert surgeon and compassionate staff want to make you feel comfortable from the moment you walk into our Atlanta facility. We will educate you about your options to make decisions about your care easier. If you notice part of your pupil is covered by sagging eyelids, reducing your vision, schedule a consultation with Dr. Cole to begin the process of making the change you want to see in yourself.
Contour and Balance
Patients and their drivers are asked to arrive 30 minutes early for ptosis repair. You will meet with a nurse to check your vital signs and review your medical history. You will also meet with Dr. Cole before starting the procedure.
To keep you as comfortable as possible, we will administer sedation through an IV along with local anesthesia and numbing eye drops. Dr. Cole can perform the procedure using his scarless InsideOut™ technique if you have not had prior ptosis repair. If you have had ptosis repair with another surgeon in the past, he will likely use an anterior approach to improve the previous scar. When the levator muscle is addressed to fix a droopy eyelid, Dr. Cole uses temporary stitches to tighten the tendon and dissolving stitches to close the incision. In frontalis suspension, a small rod or band is placed through the eyelid and into the muscle above the eyebrow. Both of these procedures lift the drooping lid, giving it a symmetrical, aesthetically pleasing look and fixing any problems with vision that the lid may have caused. A similar procedure, blepharoplasty, involves repositioning and removing extra fat, skin, and muscle from the upper and lower eyelids to make your eyes look less puffy, saggy, or tired. Dr. Cole can help you decide which procedure will best meet your needs. Most eyelid surgeries take an hour or less to perform.
Years Better
While you will notice some change right away, your final results will take a few months to reveal themselves after your healing is complete. While we cannot stop the aging process, these results should last anywhere from ten to twelve years, depending on the individual. Your range of vision should be dramatically improved, and the appearance of your eyes may be younger and more alert.
Change That Matters
Most people return to work and non-strenuous daily activities within a week after ptosis correction surgery and more strenuous activities after about two weeks. You may initially experience some swelling and bruising in the upper eyelid area, but these symptoms should subside quickly.
The recovery after ptosis surgery is fairly minimal and the good thing is there are some things that you can do to assist in your own recovery. If you just recover, it's typically four to seven days. If you kind of sit upright in a chair, if you use ice for swelling, if you put ointment in your eyes so they don't get irritated, if you do those kinds of things then you can really minimize it to two to even four days if you're only having ptosis surgery.
Ptosis swelling is highly dependent on gravity. I like to say that when we go to sleep at night, gravity stays awake. So if your head is above your heart, you have better venous return and you have less swelling. A lot of people don't like to sleep with their head elevated, but I tell many of my clients that are on film, fashion models and things, even if they haven't had surgery, to sleep in a recliner the night before they do their photo shoot because it takes all the swelling out of their face. That's the secret to minimizing swelling after ptosis surgery.
Ptosis recovery is completely painless if, and there's a big if, you have to keep your eye lubricated. There are more sensory nerves per unit area in the front of the eye than anywhere else on the body. That's the reason when you get an eyelash in your eye it feels like a tree branch because there's so many sensory nerves. So as long as you keep it moist it doesn't get dry and irritated and you don't get a secondary abrasion. It's completely painless.
Ptosis surgery is a type of eyelid surgery that involves the center muscle in the eyelid. So ptosis repair can be done when you're doing eyelid surgery. It can even be done when you're doing blepharoplasty, which is a cosmetic procedure where you're removing skin and fatty tissue and a little muscle. There's a separate muscle that involves ptosis repair.
Ptosis is basically congenital, meaning that you're born with it, or you develop it, it's acquired later in life. When it's congenital, you have a lot of fatty tissue intertwined like a zipper with muscular tissue and fatty tissue, and it's very weak. When it's acquired, you have a healthy muscle, but the muscle has pulled away from the cartilage plate or the backbone of the eyelid. So you advance that muscle onto the cartilage plate and it raises the eyelid for ptosis repair.
Ptosis is a common symptom that we see with several different diseases. You can have something called blepharospasm, where you twitch and you close your eyelids a lot and develop ptosis from that. You can have a weakness of your eyebrow or you could have Bell's palsy and that could cause you to have ptosis. You could have a thyroid disorder and that could cause you to have ptosis. Trauma can cause someone to have swelling and have ptosis. We even see ptosis after other surgical procedures. Like for instance, if a person has cataract surgery and they have a weakness of their eyelid muscle, they're predisposed to developing ptosis later in life. So by having the swelling of the cataract surgery, they'll get ptosis pretty soon within a month after their cataract surgery. So ptosis usually is not related to other systemic conditions, but it certainly can be. So another reason it's very important to see somebody experienced in all the different varieties of ptosis and how to repair it.
If you develop ptosis, which is a droopiness of the eyelid, if it's caused from something like trauma where you have swelling or you have a Bell's seventh nerve palsy and the palsy gets better, then your ptosis will also improve as your swelling goes down and as your nerve recovers. Most people with acquired ptosis or even congenital ptosis, the ptosis will either stay the same or get worse, but it will not improve unless you have a surgical procedure. There is a medicine available now that you can put in as an eye drop and that will temporarily raise your eyelid and lots of people will use that for a picture that don't want to have surgery, but they realize it's only going to last for two, three, maybe four hours.
Ptosis is repaired permanently by a surgical procedure to tighten the muscle to allow it to be in a higher position. Sometimes what we do is we give a medicine that will stimulate that muscle to contract so that a person can get a sneak preview, if you will, of how it will look. But if someone wants a permanent repair, it requires surgery for their ptosis to be alleviated.
The risk of ptosis surgery in experienced hands are very minimal. The national average for a secondary adjustment is about 15 percent. In my practice it's about five to eight percent. And what that means is when a person heals the muscle might be a little stronger, might be a little weaker than anticipated, and as it settles you might need to make a minor adjustment. The way that's done is to unzipper the same incision that you made and either loosen or tighten a stitch to either drop down or raise the eyelid a little bit and that's called a an enhancement or revision of ptosis.
Ptosis surgery is not painful to repair. We have numbing drops and numbing solutions that we can inject just below the skin so that you do not feel the procedure. The good part about ptosis surgery is you can even have it done while you're awake and we can adjust it and talk to you and have you look up and down at a Q-tip as you move your upward and downward to measure the strength of the muscle.
Ptosis surgery is a permanent procedure as long as the muscle is tightened and the eyebrow structure is stable. What can happen is if someone has the eyelid ptosis repair and then over time their eyebrow sinks down a little bit then they will get a little more ptosis because all of the tissues around the eye are drooping some but the eyelid repair is permanent.
Schedule your consultation with Atlanta’s premier facial plastic surgeon
Learn what’s possible with some of the most advanced techniques in the field today. During your consultation, Dr. Cole will use his extensive knowledge and experience to recommend an optimally beneficial treatment plan tailored to you. At Oculus Plastic Surgery, our honest and patient-focused approach ensures that every patient can achieve their best outcome.