Ptosis surgery process, treatment options, and cost

Ptosis Surgery

Ptosis surgery can significantly improve symptoms of blurred vision, reduced superior field of vision, headaches, abnormal head posture and watering eyes caused by droopy eyelid. Better eyelid symmetry also improves self-esteem and can really change the way that you look and feel about yourself.

There are 3 main ways to carry out ptosis surgery – the choice of operation depends on a number of different factors, including how much the eyelid needs to be lifted, the underlying cause of the ptosis and the health of the front surface of the eye. Your surgeon will review your condition in detail and then confirm the option with you to give you the best result.

Ptosis Surgery Options

Anterior Approach

An incision is made in the upper eyelid skin crease to access the muscle that lifts the eyelid so that it can be tightened and reattached to the eyelid in the correct position. This results in a “hidden” scar. Ptosis surgery carried out this way allows the procedure to be combined with a blepharoplasty so any excess eyelid skin can be removed at the same time.

Posterior Approach

Making the incision on the inside of the upper eyelid means that there is no visible scar and gives a natural-looking eyelid shape.

Brow Suspension

In cases where the muscle that raises the eyelid is damaged or weak, a strip of tissue can be taken from the thigh (fascia lata) or a non- absorbable material like silicon or prolene can be used to lift the upper eyelid by fixing it to the brow area.

About Your 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.

What to expect from your ptosis surgery

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.

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.

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.

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.

What makes our ptosis surgery unique?

Holistic approach

OCL Vision’s oculoplastic surgeon, Miss Susan Sarangapani, offers both surgical and non-surgical cosmetic treatments, sometimes combining both as appropriate. This holistic approach allows her to personalise care for each patient and deliver optimal results.

Natural-looking results

Susan Sarangapani specialises in natural-looking results with strong attention to detail, alongside an empathetic consultative approach to ensure she understands exactly what every patient is looking for.

Convenient consultation and treatment

Susan Sarangapani is part of OCL Vision, a group of expert eye surgeons offering consultation, treatment and surgery onsite in one place. Choose from their central London location (close to Harley Street), Harpenden or Bushey.

Expert, highly-trained surgeon

Susan Sarangapani is an expert in her field and has undertaken a fellowship at the internationally renowned Craniofacial Unit of Chelsea and Westminster Hospital, ensuring extensive training in facial and eyelid reconstruction surgery.

Ask the surgeon

Miss Susan Sarangapani blepharoplasty surgeon

How to reduce swelling after ptosis surgery? Swelling after ptosis surgery can be reduced by applying ice packs to the eyelid area in the first 10 days following surgery. A good regimen is to use a frozen gel face mask 4-6 times a day, gently placed on the eyelid area for about 10 minutes at a time. A clean muslin cloth or gauze can be placed underneath the mask to avoid direct contact with the surgical area. No pressure should be placed on the eyelid area, the gel mask should be sanitised between each use and the gel mask should be allowed to defrost until it is flexible when removing from the freezer.

Smoking should be avoided after surgery and strenuous exercise and heavy lifting should also be avoided in the weeks following surgery. Drinking alcohol in the first 48 hours after ptosis surgery can also lead to swelling and bruising and should be avoided.

Susan Sarangapani

Oculoplastic surgeon at OCL Vision

Meet Susan Sarangapani

More ptosis surgery FAQs

Find out the answers to some more of the most frequently asked questions about ptosis surgery, from our expert surgeon Susan Sarangapani.

Will insurance cover ptosis surgery?

Some insurance companies will cover ptosis surgery – this depends on the individual company and also your policy. Usually if an insurance company is considering covering the cost of your ptosis surgery, they will require proof that your droopy upper eyelid is blocking your vision and adversely affecting your daily activities (for example driving) and quality of life. Colour photos will need to be taken to show that the ptosis is blocking your pupil and visual field tests will also be required to prove that your field of vision is compromised. Mild ptosis is usually considered to be cosmetic and surgery is not usually covered by insurance.

Can I get ptosis surgery on the NHS?

Ptosis surgery can be carried out on the NHS – but this is usually for severe cases where the pupil is covered, a visual field test confirms that the droopy upper eyelid is blocking the field of vision and there is documented written proof and photographs that the ptosis is adversely affecting the patient’s quality of life. Mild ptosis is considered to be cosmetic and is not usually eligible for surgery under the NHS.

How long does ptosis surgery last?

In an adult, ptosis surgery usually only needs to be carried out once and the upper eyelid will remain in the correct position. Trauma, cataract surgery (or other surgery or injections to the eye) or rubbing the eyelids can all damage or stretch the muscle that lifts the eyelid up and means that the ptosis can recur. In children, ptosis can recur as the child grows.

Can ptosis be cured without surgery?

Ptosis cannot normally be cured without surgery, except if the ptosis has been caused by an underlying neurological or medical condition that has been treated and resolved. Examples where ptosis can resolve without surgery when the underlying condition has been treated include myasthenia gravis, blepharospasm or thyroid problems.