Thank you for your question.
You submitted your question with several photos.
And you describe in your question that you are 29-years-old and that you have congenital
ptosis and you are willing to travel to have your ptosis corrected.
And you want to be assured of the outcome so that it would be worthwhile traveling.
Well, I can certainly give you some guidance about this type of issue which is a very common
issue in my practice.
A little bit of background, I’m a Board-certified cosmetic surgeon and Fellowship-trained oculofacial
plastic and reconstructive surgeon.
I have been in practice in Manhattan and Long Island for over 20 years.
Eyelid ptosis is one of the most common things that I take care of in my practice and of
course a wide range of different ptosis conditions.
And I have been recognized in the media periodically for this type of surgery.
And people have traveled from around the world for me to do this.
Now that being said, I think it’s very important that you first get a proper evaluation by
a doctor that is more local to you.
The reason is as follows: ptosis surgery has a certain amount of standardized approaches
based on some key elements of an examination.
Now when you do a ptosis evaluation, you look at the eyelid height and you look at a particular
function called the levator muscle function.
Basically, the patient is asked to look down and look up.
And when you’re doing that, you are getting a sense of what kind of strength that muscle
has.
The reason why someone has congenital ptosis has to do with the development of this particular
muscle called the levator muscle.
It’s like the word elevator without the letter “e” and it’s the muscle responsible
for lifting the eyes.
Now just by looking at your photo without the benefit of a physical examination or any
other eye position movement, I would suspect that if you have a relatively significant
ptosis with minimal levator function, then there’s a good chance you’ll need a procedure
called a frontalis sling.
And a frontalis sling is a procedure where, because the muscle that lifts the eyelid is
not that functional, then it requires connecting the forehead muscle which is called the frontalis
muscle that you often use to raise your eyebrows to try to get the eyelids to open.
It’s a very common thing for people who have ptosis.
In fact, a lot of patients who have ptosis, as they get older, they have their forehead
lines get deeper because of this activity.
Nonetheless, this is one possible option.
And when it comes to ptosis surgery, it is also important to get a proper eye evaluation.
It means checking your vision, checking the function of the eye’s ability to protect
itself with eye closure.
Sometimes when you’re being evaluated for ptosis, the ophthalmologist may want you to
also be evaluated by a neuro-ophthalmologist just to make sure that other systemic issues
that could affect eye function are managed before doing the ptosis operation.
Now ptosis surgery of course, when you’re making your decision, you want to look at
the surgeon’s experience and what their recommended approach is.
And between oculoplastic surgeons, there are always going to be different opinions about
what an individual oculoplastic surgeon is going to be comfortable with or prefers.
It is sometimes challenging to make a really ideal choice.
But also understand that when a person is born with ptosis particularly when they have
moderate to severe ptosis with minimal to moderate levator muscle function, the accuracy
of achieving an optimal result has to be within a certain range.
And a lot of times with patients who are a little bit older like yourself, we actually
do ptosis surgery with a patient awake and that way we can actually adjust the eyelid
height and actually sit the patient up during surgery to make sure that the height and the
symmetry looks good during surgery.
So I think it’s a good idea for you to first find some qualified, experienced oculoplastic
surgeons locally.
Get some opinions.
If you want to travel and get additional opinions, of course that’s a choice and make a decision
with whomever and wherever you feel comfortable.
So I hope that was helpful, I wish you the best of luck and thank you for your question.