Ptosis Correction Surgery

Similar names: Double Eyelid Surgery, SUB, Upper Blepharoplasty, Eye Lift.

For patients with droopy eyelids, the eyes may appear tired, sleepy or small. However, ptosis of the eyelids is more than just a cosmetic problem. In advance cases of eyelid droopiness, the patient’s vision is compromised and can give symptoms such as visual obstruction, fatigue and headaches. For these patients, the surgery may be Medisave- or insurance-claimable.

The key to ptosis correction surgery is to repair the cause of ptosis – detachment of the levator aponeurosis, which are muscles that lift our eyelids. After surgery, the eyes will look bigger and the scars are hidden within the double eyelid folds (which also defines them). In milder ptosis, the scarless technique is possible.

There are two types of ptosis: congenital and acquired ptosis. In some cases, babies are born with ptosis due to underdeveloped muscles or nerves in the eyelid. In cases of acquired ptosis, however, the condition develops later in life and is typically caused by various factors, including:

• Ageing – Over time, muscles supporting the eyelid (levator muscle) weaken, causing sagging.
• Injuries – Trauma to the eyelid or nerves can cause temporary or permanent drooping.
• Medical Conditions – Infections, tumours, diabetes, or stroke can also contribute to ptosis.

While both ptosis correction and double eyelid surgery involve the upper eyelids, their goals and methods differ greatly. Ptosis correction tackles an often-medical concern – a drooping eyelid that sometimes even obstructs vision. Surgeons tighten the muscle responsible for lifting the lid, thereby restoring one’s range of vision. This procedure may be medically necessary and covered by insurance.

On the other hand, a double eyelid surgery is solely an aesthetic procedure to create an additional crease on the upper eyelid, allowing for a more alert and alluring gaze. This is considered an elective procedure and hence is typically not covered by insurance.

• Procedure Time: 1 – 2 hours
• Anaesthesia: Local anaesthesia
• Hospitalisation: Day Surgery
• Recovery Time: 5 – 7 days

There are various ways that an eyelid surgeon can perform a ptosis correction, depending on the severity of the condition. These include:

• External Approach (Levator Advancement) – This method involves surgically tightening the levator muscle, which lifts the eyelid through an incision along the upper eyelid’s natural crease. It is suitable for patients with moderate to severe ptosis and good levator function and allows for precise adjustments to the eyelid height.
• Internal Approach – Also known as Müller’s muscle-conjunctival resection (MMCR), this less invasive technique is performed inside the eyelid. It targets the Müller’s muscle and the conjunctiva to elevate the eyelid. This approach is ideal for patients with milder ptosis and those seeking minimal adjustment with a shorter recovery period.
• Frontalis Sling Fixation – Used primarily for severe ptosis or when levator muscle function is poor, this technique uses various materials to connect the eyelid to the forehead’s frontalis muscle. It enables eyebrow movement to lift the eyelid, which is suitable for cases where other surgical options might not be effective, including congenital ptosis.

Before ptosis correction surgery, you can expect to have a detailed consultation with your surgeon. They will discuss your medical history, goals, as well as examine your eyes and vision. You will also receive pre-operative instructions, including temporarily stopping certain medications and supplements (e.g. blood thinners, fish oils, vitamin E, Ginseng, glucosamine before surgery.) and smoking cessation. In addition, your surgeon may recommend you stop using eyelid tapes and glue for around a week before surgery.

Aside from pre-operative preparations, it is also important to know the estimated costs of the procedure. The cost of droopy eyelid surgery will depend on the doctor’s fees, hospital fees, the technique used, and the severity of the ptosis, among others. Ptosis correction in Singapore may be Medisave- or insurance-claimable depending on whether the surgery corrects vision impairment or is related to a medical condition.

Following surgery, it is normal to experience temporary swelling, bruising, and discomfort that gradually improve within days or weeks. Stitches are typically removed in about a week.

Here is what you can do to promote healing:

• Refrain from wearing contact lenses for at least 5-7 days
• Wait a week before applying makeup around the eyes
• Administer any eyedrops, ointments and medications that have been prescribed to you
• Walking around, consuming a low-salt diet and using a cool compress for the first three days can help reduce swelling
• Using a warm compress from day four can help to reduce bruising
• Attend your scheduled follow-up appointment to ensure you are healing as intended

In general, most activities can be resumed in two weeks, although full recovery takes longer. While uncommon in the hands of an experienced surgeon, potential risks like infection and bleeding do exist. Ensure that you communicate with your surgeon beforehand and follow all post-operative instructions for optimal recovery.

Surgeries are often done together with ptosis correction surgery for more eyelid enhancement:

• Epicanthoplasty
• Brow Lift
• Upper Blepharoplasty
• Lower Blepharoplasty
• Laser Eyelid Rejuvenation
• Bright Eye Treatment