Ptosis surgery CENTER FOR FACIAL PLASTIC SURGERY AT ENT SPECIALISTS
Ptosis surgery
Eyelid ptosis also known as Blepharoptosis or Ptosis is characterized by the drooping of
the upper eyelid margin (not just the skin) and can affect one or both eyes. It occurs
when the muscles responsible for lifting the eyelid are damaged or become weak,
leading to the eyelid covering more of the eye than usual. This can obstruct the upper
field of vision and make it challenging to keep the eye fully open.
In children, the most common cause of ptosis is poor development of the muscle that
lifts the upper eyelid (levator muscle). In adults, the tendon of the muscle that lifts the
eyelid stretches and the eyelid falls, covering part of the eye. Contact lens wear and
allergies (eye rubbing) are the leading causes of ptosis in adults. Ptosis can also be
caused by disease or injury to the nerve or the muscle.
Ptosis surgery usually involves tightening the levator muscle through a small incision in
the eyelid crease in order to elevate the eyelid to the desired position, a procedure
called External Levator Resection. For mild ptosis in adults, a procedure called MMCR
(Müller Muscle Conjunctiva Resection) can be done through the inside of the upper
eyelid without skin incision.
The result of ptosis surgery is usually permanent, unless the mechanism that led to the
droopy eyelid (contact lens wear, rubbing the eyes) persists.
BEFORE THE SURGERY
From the time of your first consultation (whether on-line or in person) till the day of surgery you will have the opportunity to discuss with Dr Georgescu and his staff all your questions and concerns related to the surgical procedure, the preparation and the recovery. Make sure you fulfill all your financial obligations at least 2 weeks prior to surgery. Stop all anticoagulants (Eliquis, Pradaxa, Xarelto, Plavix, Coumadin, Warfarin), anti-inflammatory medication (Aspirin, Ibuprofen, Naproxen, Diclofenac, Indomethacin) and all vitamins and supplements (except for Calcium and Vit. D) two weeks prior to surgery, but only with the approval of your primary care doctor or cardiologist. Make sure you fill your prescriptions before surgery. You need to make arrangements for someone to bring you to the surgery center and take you back home, as you will not be able to drive the day of surgery. You also need someone to stay with you for at least the first night after surgery.
THE DAY OF SURGERY
If your surgery is scheduled in the office, you can have a light meal before coming in.
Take your regular medication as usual. Avoid drinking coffee or alcohol on the day of
surgery.
If the surgery is scheduled in the ambulatory surgery center, do not eat or drink anything
past 10:00 PM the night before! If you need to take your blood pressure or anxiety
medication, do so with a sip of water when you wake up. Make sure you arrive at the
office or the surgery center at the time indicated (our staff will call you the day prior
with the exact time you need to be there). Our surgery center staff will greet you and
make sure all the consent forms have been signed. Your companion can either wait in
our comfortable waiting area, where there is coffee, water and snacks, or can return
back home and we will call as soon as the surgery is over. You will be then taken to your
room where our nurses will place an IV and EKG electrodes. A urine pregnancy test is
performed on all pre-menopausal women. Then, you will meet in person our
anesthesiologist who will explain the anesthesia procedure. Most surgeries are done
under sedation. Dr Georgescu will come and read to you the consent form and answer
any last-minute questions you may have. He will then do the skin markings and may take
some additional photographs. The bed will then be wheeled into the operating room
where the time out will be performed before you go to sleep. The anesthesiologist will
then give you IV medication that will allow you to fall asleep. At the end of surgery, you
will be taken to the recovery room where you will wake up with no pain. We typically
use ice-packs in recovery for 20 minutes to decrease swelling. You and your companion
will be shown in detail how to apply the ointments and ice. After approximately 30
minutes you will be discharged to go home with your companion. We will bring you to
the car in a wheelchair. You will be given Dr Georgescu’s personal cell number to call at
any time if you have any questions or concerns.
RECOVERY & RESULTS
Most patients take between 7 and 10 days off after Ptosis surgery. Stitches dissolve or
are removed at 10 days. Bruising and swelling typically go away in about 2-3 weeks.
Antibiotic and pain medication may be prescribed for a few days. You will need to apply
ice packs 20 min / hour while awake for 2 days. Starting on the 3 rd day you switch to
warm compresses twice a day 10 min each till the bruising is completely gone. You will
need to apply antibiotic ophthalmic ointment on the incisions and inside the eyes 4
times a day for 3 weeks. You will also apply Refresh Relieva PF artificial tears every hour
for 2 weeks followed by every 2 hours for 2 weeks and 6 times a day for 2 more weeks.
Strenuous activity, such as golfing, swimming, tennis and weightlifting should be avoided
for 3 weeks. Walking is allowed the day after surgery. Light running and biking can be
resumed after 1 week. The hair can be dyed after one month. Makeup can be applied as
early as 2 weeks after surgery.
You will need to come back to the office the following day to ensure that your eyes are
not dry and that you are healing well. You will also be seen on days 7 and 14 followed
by 1 month, 3 months and 6 months. However, Dr Georgescu is available to see you at
any time if you have questions or concerns.
Although most patients look really good at 6 weeks, they are only 25% healed at this
time and may still experience dry eyes, tearing and blurry vision, especially when
working on the computer or phone extended periods of time. Full healing normally takes
6 months, at which time the numbness around the incisions is typically resolved.
Seek Dr DAN’s Advice
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2122 NW 62nd ST, Ste 229 Fort Lauderdale, FL 33309
