What is Ptosis Surgery?
Ptosis repair surgery is recommended when the upper lid margin droops and covers part of the pupil, obstructing the superior visual field. An oculoplastic surgeon is able to assess and help with insurance claim for this procedure if the droop is severe enough and satisfies set criteria that distinguishes between cosmetic and medical cases.
The surgery is different from blepharoplasty or double eyelid surgery in that there is more dissection to identify and isolate the deeper levator muscle that lifts the eyelid. The tendinous part of this muscle is re-attached, with or without some shortening, to the firmer structure at the eyelid margin called the tarsal plate. Post-operative swelling may be relatively more evident as a result of the deeper dissection involved.
Read more: What To Expect During Ptosis Surgery?
Post Operative Care
Post-operative care is important after ptosis repair surgery. The following are important care steps to keep in mind:
- Head elevation
Keeping the head at higher level than the rest of the body is recommended to avoid excessive swelling. This is best achieved with the use of 2-3 pillows at night for the first few nights.
- Cold compress
Applying a sterile gauze soaked in cold sterile saline and squeezed dry is an easy and clean way of applying cold compress on the eyelids. Doing so in an air-conditioned room will provide enough cold compression effect to help minimise swelling after surgery. This is usually not required after the first 48 hours.
- Avoidance of exercise and other strenuous activities
Exercise and strenuous activities including yoga with head-down postures are to be avoided as higher venous pressure associated with these activities may lead to re-bleeding from cauterised blood vessels and lead to more bruising and more down time. Care must also be taken not to exert whilst in the bathroom. It is better to resume exercise at the earliest 2 weeks after surgery.
- Avoidance of bath water/ shampoo on eyelid wounds
The eyelid wounds must not come into contact with non-sterile fluids, especially in the first week after surgery. Sterile dressing sets will be provided and instruction given on how to use these to keep the wounds clean so that wound infection can be avoided.
- Avoidance of eye rubbing
Hard eye rubbing could lead to torn stitches or opening of the wound. It could also cause post-operative bleeding which would lead to bruising and longer down time.
- Avoidance of eye make-up
Take care to avoid eye make-up for the first 2 months after surgery. If eye make-up must be applied within this time, take heed to apply light make-up only and remove gently. Even then, it is best to avoid in the first month after surgery.
Post Operative Reviews
You will be asked to come for a post-operative review the day after your surgery to assess the wounds and the amount of post-operative swelling. Depending on the amount of swelling, you will be asked to return for a review a few days later for professional assessment by Dr Looi with a view to a possible adjustment procedure to optimize results. This fine-tuning procedure is considered part of the original surgery and is performed under local anaesthetic. Whether an adjustment procedure is required or not, the stitches will be removed about 2 weeks after surgery.
Will I need to take any time off work?
Patients usually take 2 weeks off work if they need to work on-site. If work from home is possible, it is not necessary to take much time off as ptosis surgery does not prevent one from performing remote computer work. In that situation, time off is only needed on the day of surgery and the day after for complete rest as well as for clinic reviews.
Will I be in pain?
Ptosis surgery is not associated with significant post-operative pain. In fact, most patients are pleasantly surprised at how little pain there is. At the very most, most patients take a few doses of Panadol for any feeling of dull ache after the surgery.
How long does it take for the bruising and swelling to go away?
Post-operative bruising and swelling is most evident on Day 2 and 3. By the second post-operative review at about 1 week, the skin around the eyelids take on a slightly yellow hue as the bruise starts to fade. This is the time when a good assessment is needed to see if any adjustment is needed. By the second week, most of the bruise and swelling will have resolved and the stitches are removed. The last 5% or so of swelling will dissipate gradually over the next few weeks. Rate of healing does vary from patient to patient and is also dependent on how much care a patient takes after surgery.
How long does it take for the scar to fade away?
Generally speaking, the wound in this area heals very well. The surgical scar is hidden in the eyelid crease and is hardly visible when the eyes are open. It will remain as a thin line that may be more prominent initially before it fades to a lighter shade and becomes much less visible, even when the eyes are closed or when looking down. How fast and well the wound heals does vary from patient to patient and can range from just a few weeks to a few months. Good post-operative care in the first few weeks and good skincare thereafter will aid in achieving faster and better wound healing.
In general, ptosis surgery is very well tolerated and care after surgery is straightforward. Our team will take care to provide care instructions and respond to any queries throughout the recovery period.