What to expect from your ptosis surgery
1. Consultation
Initially, you will have a consultation with your surgeon, during which the surgery will be fully explained to you. There will also be a detailed discussion on expected surgical results, risks and benefits of surgery and the care that will be required before and after the surgery. If you have old photos you can bring to your first consultation it helps to give us a baseline.
We will also take photographs during your initial consultation as they are valuable in planning your surgery. A detailed medical history will also be taken and if you have any medication that you take, please bring this with you. Please inform us about any allergies, previous surgery and smoking habits.
A full examination of your face will be carried out to assess your eyes, eyelids and skin and whether you have any conditions like blepharitis or dry eyes which can affect the surgery. It may be necessary to treat an underlying condition first, before carrying out any surgery, to give you the best surgical outcome. If you have excess loose skin on your upper eyelid (dermatochalasis) or droopy eyebrow (brow ptosis), this can usually be corrected during the same procedure and will be discussed with you.
You will also have the opportunity to ask any questions that you may have.
2. Type of Anaesthetic
In adults, ptosis surgery is usually carried under local anaesthesia, with or without sedation. All ptosis surgery in children is performed under general anaesthetic. Brow suspension surgery to treat ptosis is performed under general anaesthesia for both adults and children as this is a longer procedure.
Whichever form of anaesthetic is used, the surgical area will be numbed so that you do not feel any pain. Sedation causes you to be in a calm and relaxed state, but you will be able to respond to instructions – this is beneficial in adults undergoing ptosis surgery as the eyelid position can be adjusted during the surgery to achieve the best result.
3. Before Surgery
You will be given clear instructions when to stop eating and drinking before your ptosis surgery. This is usually 6 hours prior to surgery with sedation or general anaesthesia, although clear fluids (water) can be taken up to 2 hours before surgery. We ask that you do not wear any makeup or face cream on the day of surgery.
Smokers will be asked to stop smoking at least 6 weeks prior to surgery and for 2 weeks following surgery, as smoking delays the healing process and causes a higher risk of complications. If you take any non-steroidal anti-inflammatory drugs like Aspirin or Voltarol, Warfarin or NOACS like Apixaban your consultant will advise on when to stop or reduce the dose of these drugs.
Should you require medication to treat a heart or lung condition, Miss Sarangapani will check with your cardiologist or chest doctor which drugs can be safely stopped temporarily.
4. Immediately after surgery
A dressing will be placed over the surgical area to protect it. This can usually be removed the following day after your ptosis surgery procedure. It is common for your vision to be blurry after the surgery as a thick antibiotic ointment is applied into your eyes to prevent infection and to stop the front surface of your eyes from drying out. This blurred vision will gradually settle. You will be given eye drops and ointment to use in your eyes and on your eyelids after the surgery to help with the healing process.
The majority of people will return home on the same day as their surgery, but if needed an overnight stay can be arranged. One of our experienced nurses will give you clear instructions to manage your postoperative care.
5. Recovery period
Swelling and bruising is normal following eyelid surgery. This should start to settle 2-4 weeks after ptosis surgery. In some people, post-operative swelling and bruising can take longer to settle, but most people should be back to normal by 3 months.
We advise you to use ice packs for the first 10 days following eyelid surgery. Frozen peas placed in a small plastic bag and covered in a thin cloth is an effective icepack. This can then be gently placed on the wound up to 6 times a day, without rubbing or placing any pressure on the wound.
For the first 7 days after surgery, sleeping semi-upright with several pillows placed underneath your head will help the swelling to settle. You will be given eye shields to cover your eyes at night to protect the wounds whilst you are sleeping.
Anything more than gentle exercise (like walking) should be avoided for at least 2 weeks following surgery and swimming should be avoided for at least 6 weeks post-operatively. Makeup can be worn again 3-4 weeks after surgery.
As the eyelid wounds heal, they may become “itchy” – it is important not to rub your eyes or eyelids following ptosis surgery, as this can open the surgical site and cause the ptosis to recur. Contact lens wear should also be avoided for the first 2 weeks after surgery.
6. Returning to work
Recovery time does vary but we advise it is better to rest for the first few days after ptosis surgery. You will be able to work from home on a computer after 2 days, but it is important to keep your eyes well lubricated using the eye drops that you have been given.
Most people who have undergone ptosis surgery can return to work after 7-10 days.
7. Post Surgery Consultation
If sutures have been used in the surgery, these will be removed 10 days after surgery if the wounds are healing well. We like to take photographs to show the results of your surgery at this first post-operative visit and again 3 months later.
Ptosis Surgery Results
80-85% of patients with ptosis only require one operation to improve their eyelid position. In a few cases, ptosis can recur following surgery but this is uncommon.
As the muscles of the eyelids work together as a pair, when one eyelid appears to be droopy or low, the other eyelid may appear to be in a “normal” position. After surgery on the droopy eyelid, the “normal” eyelid can occasionally become droopy. This sometimes settles by itself after a few weeks but ptosis surgery on the second eyelid may sometimes be required.
