What is an eyelid ptosis?

An eyelid ptosis is a drooping of the upper eyelid. It can affect both eyes, or only one of the eyes. There are a number of different reasons why you might develop ptosis, and we will aim to identify this at your initial assessment. Not all ptosis cases require surgery and sometimes other investigations may be needed. The most common cause of ptosis, however, is age-related stretching of the tendon that lifts the eyelid. This can also happen in younger patients who have worn contact lenses for a long time.

Why would I need an upper lid ptosis repair?

We would consider the procedure for either functional reasons (for example, if the ptosis is affecting your vision) or cosmetic reasons – although it is important to remember that not all cases of ptosis require surgery.

How does an eyelid ptosis repair work?

The surgery is best performed as a day case under local anaesthetic, although in rare cases it can be performed under a general anaesthetic or sedation. The most common technique used to correct a ptosis is with an incision to the front surface of the eyelid (though sometimes the incision can be made on the inside of the eyelid instead). After making the incision, we locate the stretched part of the tendon and return it carefully to its original position. We then check the height and profile of the eyelid position and make adjustments if needed. Once I am happy with the height and profile of the eyelid, the wound is closed. The sutures are removed after one week. The wound runs inside the natural skin crease of the eyelid and often heals with minimal scarring. The upper lid can remain swollen for a few weeks and the final result is not visible until at least 2 months after surgery. For more details on your recovery journey, please see our post-operative advice page.

What are the risks of eyelid ptosis surgery?

As with any form of surgery, there are potential risks involved in ptosis – although serious complications are very rare. The risks include:

  • infection: this is very rare around the eyelids
  • bruising and swelling: this is very common after eyelid surgery but usually settles after a week
  • scarring: the scar from blepharoplasty forms along the natural skin crease of the eyelid and heals very well
  • under- or over-correction: the degree of ‘lift’ required to correct the ptosis is carefully judged, and performing the surgery under local anaesthetic helps with this, but sometimes further surgery is needed
  • reduced vision: any operation performed on the eyelids could potentially cause damage to your eyesight; fortunately the risk of this happening is extremely rare.

for more information on ptosis please visit the BOPSS website.

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