What is Cosmetic Ptosis?

Ptosis (pronounced “toe-sis”) is the medical term for drooping of the upper eyelid(s). This lowering of the upper eyelid margin may cause a reduction in the field of vision when the eyelid either partially or completely obstructs the pupil. Patients with ptosis often have difficulty keeping their eyelids open. To compensate, they will often arch their eyebrows in an effort to raise the drooping eyelids. In severe cases, people with ptosis may need to lift their eyelids with their fingers in order to see. Children with ptosis may develop amblyopia “lazy eye” or developmental delay from limitation of their vision.

What Causes Ptosis?

There are many causes of ptosis including age related weakening of the muscle, congenital weakness, trauma, or sometimes neurologic disease. As we age, the tendon that attaches the levator muscle, the major muscle that lifts the eyelid can stretch and cause the eyelid to fall. This represents the most common cause of a droopy eyelid. Ptosis may also occur following routine LASIK or cataract surgery due to stretching of the muscle or tendon. Children may be born with ptosis or may acquire it due to trauma or neurologic reasons.

Can Ptosis Be Corrected?

Ptosis can be corrected surgically and usually involves tightening the levator muscle to elevate the eyelid. In severe ptosis, when the levator muscle is extremely weak, a “sling” operation may be performed, enabling the forehead muscles to elevate the eyelid(s). Other types of repair may include surgery on the muscle on the inside of the lid in cases of small amounts of ptosis. Dr. Fu will perform testing determine the best form of correction for the individual patient. The goal is to elevate the eyelid to permit a full field of vision and to achieve symmetry with the opposite upper eyelid.

As a board-certified, fellowship trained oculoplastic surgeon with extensive training and experience, Dr. Selena Fu customizes each treatment to reflect each patient’s unique anatomy, skin condition, aesthetic concerns and lifestyle— an approach that consistently delivers excellent results for her patients.

Call for a personal consultation today, Dr. Fu will discuss the surgical and non-surgical options that will provide your best possible outcome. Insurance may cover all or a portion of reconstructive eyelid surgeries such as ptosis.

What to Expect from Cosmetic Ptosis Surgery?

Cosmetic ptosis surgery is a procedure designed to correct drooping upper eyelids (ptosis) and improve both aesthetic appearance and vision. It is commonly performed to restore a youthful, alert look while also enhancing eye function.

Before the Surgery

1. Consultation & Evaluation

Your surgeon will assess the severity of ptosis and determine whether it is caused by muscle weakness, aging, or congenital factors.
You will discuss desired eyelid height, symmetry, and aesthetic goals.
If needed, additional procedures like blepharoplasty (eyelid lift) or brow lift may be recommended.

2. Pre-Surgery Preparations

Stop smoking and alcohol at least 2-4 weeks before surgery to improve healing.
Avoid blood-thinning medications like aspirin, ibuprofen, and certain herbal supplements for at least one week.
Arrange for someone to drive you home after the surgery.
Take pre-operative photos to help plan the surgical outcome.

During the Surgery

1. Anesthesia

Local anesthesia with sedation is commonly used.
In some cases, general anesthesia may be recommended for more complex cases.

2. Surgical Techniques

There are three main surgical approaches, depending on the severity of ptosis:

a) Levator Muscle Resection (Most Common for Moderate Ptosis)

The levator muscle (which lifts the eyelid) is tightened or shortened to improve eyelid position.
Typically performed through an incision in the eyelid crease.
Provides long-lasting, natural results.

b) Müller’s Muscle Resection (For Mild Ptosis)

The Müller’s muscle, which also helps lift the eyelid, is adjusted.
Usually performed internally through the conjunctiva (inside of the eyelid).
No external scars, minimal downtime.

c) Frontalis Sling (For Severe Ptosis or Weak Levator Muscle)

Uses a sling (often made of autologous fascia or synthetic material) to connect the eyelid to the forehead muscle.
Best for patients with severe muscle weakness or congenital ptosis.

3. Duration of Surgery

1-2 hours, depending on the technique and complexity.

Recovery Process

1. First 24-48 Hours

Swelling and bruising will peak within the first two days.
Use cold compresses to minimize swelling.
Keep your head elevated when sleeping to reduce puffiness.
Mild blurred vision or eye irritation may occur due to temporary swelling.

2. First Week

Sutures (if used) are removed in 5-7 days.
You may experience mild tightness or dryness in the eyelid.
Avoid rubbing your eyes, heavy lifting, and strenuous activities.
Most patients can return to light work in 7-10 days.

3. Weeks 2-4

Swelling continues to subside, and the eyelid shape becomes more natural.
Minor asymmetry is normal in the early healing stages.
Avoid wearing contact lenses for at least 2 weeks.

4. 3-6 Months (Final Results)

The eyelid position stabilizes, and scars (if any) fade.
Any residual swelling fully resolves, and results appear more natural.

Possible Risks & Complications

While ptosis surgery is generally safe, some risks include:

Mild asymmetry – One eyelid may heal slightly differently from the other.
Overcorrection or undercorrection – The eyelid may be lifted too much or not enough, requiring revision surgery.
Temporary dry eyes or irritation – Due to changes in eyelid position.
Visible scarring (rare, usually fades over time).

Choosing an experienced oculoplastic surgeon significantly reduces these risks.

Long-Term Results & Maintenance

Results are long-lasting, but natural aging may still affect the eyelids over time.
Good skincare and sun protection help maintain results.
If asymmetry or recurrence occurs, revision surgery may be an option.

When to Contact Your Doctor

Seek medical attention if you experience:

Severe pain or excessive swelling beyond expected levels.
Signs of infection (redness, pus, fever).
Sudden vision changes that do not improve.

Frequently Asked Questions (FAQ) – Cosmetic Ptosis Surgery?

1. What is cosmetic ptosis surgery?

Cosmetic ptosis surgery is a procedure that corrects drooping upper eyelids (ptosis) by tightening the muscles responsible for lifting the eyelid. The goal is to enhance both vision and aesthetics, creating a more youthful, alert appearance.

2. Who is a good candidate for ptosis surgery?

You may be a good candidate if you:

Have drooping upper eyelids that make you look tired or aged.
Experience obstructed vision due to eyelid sagging.
Are in good overall health and do not have serious eye conditions (e.g., severe dry eye, corneal disease).
Have realistic expectations about the outcome.

3. How is ptosis surgery different from a traditional eyelid lift (blepharoplasty)?

Ptosis surgery tightens the levator or Müller’s muscle to raise the eyelid height.
Blepharoplasty removes excess skin, fat, or wrinkles but does not significantly affect eyelid position.
Sometimes, both procedures are performed together for a balanced, youthful look.

4. What causes ptosis (drooping eyelids)?

Ptosis can be caused by:

Aging – Weakening of the levator muscle over time.
Congenital ptosis – A condition present from birth due to muscle underdevelopment.
Previous eye surgery – Such as cataract surgery, which can weaken the eyelid muscle.
Neurological or muscular disorders – Rare conditions affecting eyelid movement.

5. What are the different techniques used in ptosis surgery?

Levator muscle resection – The most common approach, where the levator muscle is tightened to lift the eyelid.
Müller’s muscle resection – A less invasive method, often performed from inside the eyelid, suitable for mild cases.
Frontalis sling procedure – Used for severe ptosis, where the eyelid is connected to the forehead muscle to assist lifting.

6. Is ptosis surgery painful?

Most patients experience minimal pain as the surgery is performed under local anesthesia with sedation.
You may feel mild tightness, swelling, or dryness after the procedure, but discomfort is manageable with pain relievers.

7. How long does the procedure take?

The surgery typically lasts 1-2 hours, depending on the complexity and technique used.

8. Will I have visible scars after ptosis surgery?

If the incision is made in the natural eyelid crease, the scar is barely visible once healed.
If performed from the inside of the eyelid (Müller’s muscle resection), there is no external scar.

9. What is the recovery time for ptosis surgery?

First 24-48 hours – Swelling and bruising peak. Use cold compresses.
First week – Sutures (if used) are removed in 5-7 days. Most patients can return to work.
2-4 weeks – Most swelling resolves, and the eyelid shape begins to stabilize.
3-6 months – Final results appear as residual swelling fades.

10. What are the risks and complications of ptosis surgery?

Although rare, possible complications include:

Asymmetry – One eyelid may heal differently from the other.
Overcorrection or undercorrection – The eyelid may be lifted too much or not enough, requiring a revision procedure.
Dry eyes or irritation – Temporary, but lubricating eye drops help.
Scarring – Uncommon, but scars can fade with time.

Choosing a highly experienced oculoplastic surgeon significantly reduces these risks.

11. Will the results look natural?

Yes, when performed by a skilled surgeon, ptosis correction enhances your natural eyelid contour and improves eye symmetry without looking overdone.

12. Can ptosis surgery be combined with other procedures?

Yes, ptosis surgery is often combined with:

Upper blepharoplasty (eyelid lift) to remove excess skin.
Lower blepharoplasty to reduce under-eye bags.
Brow lift to enhance the upper face.

13. How long do the results of ptosis surgery last?

The results are long-lasting, but aging may gradually weaken the eyelid muscle over time.
Some patients may need minor touch-ups in the future.

14. When can I return to normal activities?

Light activities – After 1 week.
Makeup application – After 2 weeks.
Strenuous exercise – Avoid for at least 3-4 weeks.
Contact lenses – Avoid for 2-3 weeks after surgery.

15. Does insurance cover ptosis surgery?

If ptosis is affecting vision, insurance may cover part or all of the procedure.
If done purely for cosmetic reasons, it is usually not covered.
Your surgeon may conduct a visual field test to determine if it qualifies for insurance coverage.

16. How do I prepare for ptosis surgery?

Stop smoking and alcohol at least 2-4 weeks before surgery.
Avoid blood thinners (aspirin, ibuprofen) 1 week before surgery.
Arrange for someone to drive you home after the procedure.

17. How soon will I see results?

Immediate improvement in eyelid height and openness, but initial swelling may mask the final results.
The final, stable result takes 3-6 months as swelling fully resolves.

18. What if my eyelid position is uneven after surgery?

Minor asymmetry is normal during the healing process and usually improves over a few months.
If significant asymmetry persists, a revision procedure can fine-tune the results.

19. What happens if my ptosis worsens over time?

While recurrence is rare, some patients may need a second procedure years later due to natural aging.
Regular follow-ups with your surgeon help monitor long-term results.

20. How can I schedule a consultation?

If you are considering cosmetic ptosis surgery, book a consultation with a board-certified oculoplastic surgeon to discuss the best treatment options for your specific case.

If you have any additional questions, consult with a qualified specialist to ensure safe and optimal results!