Contributed and reviewed by: Dr Audrey Looi (Medical Director at Ava Eye Clinic)

Recap: 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. Care is then taken to fashion a nice crease while closing the wound.


female patient preparing to undergo ptosis surgery


Will I be awake during ptosis surgery?

Fairly deep intravenous sedation is provided at the start of the surgery. This allows local anaesthetic to be injected into the eyelid areas without the patient feeling the injections. The patient will be conscious soon after and will be aware during the surgery. This is necessary as the patient will be asked to open eyes a few times during the surgery, to allow the surgeon to judge whether enough lift has been achieved. And to ascertain whether the contour achieved is pleasing. Do not be anxious as this wakefulness is part and parcel of ptosis repair surgery. With the light sedation given, one can look forward to a quick recovery and little nausea after the operation.


Will I feel pain during ptosis surgery?

With the intravenous sedation and local anaesthetic given, pain is not a problem during ptosis surgery. However, there are a few points during surgery where the patient may feel some “pressure” as the surgeon works on the eyelid tissues. Towards the end of the surgery, the local anaesthetic may start to wear off. A top-up of local anaesthetic will help to eliminate any pain at this point. However, if the critical part of the surgery is still ongoing, the surgeon may request that you bear with a slight discomfort before topping up on the local anaesthetic. This balancing act is conducted with the aim to achieve a more pleasing outcome. In summary, a small amount of pain may be encountered during ptosis surgery but this is manageable and patients generally understand the reasons for lesser sedation and careful use of local anaesthetic.


How long does the surgery take?

Most ptosis repair surgeries take from 90 minutes to 2 hours. Occasionally, especially for repeat cases, the surgery may take more than 2 hours. One must expect to spend about half a day at the day surgery in total in most cases.

Ptosis repair surgery is one of the most common procedures performed at Ava Eye Clinic. With the above points in mind and adequate preparation, you will find the surgery a straightforward one with pleasing results.

Read more: What To Expect After Ptosis Surgery?