Can You Develop Ptosis After Blepharoplasty

Upper Blepharoplasty is a type of eyelid surgery that can enhance the upper eyelid appearance and minimize the signs of ageing. It can treat a variety of cosmetic issues such as drooping and sagging eyelids, puffiness, and overhanging skin, all of which can make you appear older and tired. The procedure is especially popular among Asians who want to raise their upper eyelids and achieve a more visible upper eyelid fold.

Upper blepharoplasty is considered a low-risk procedure with little downtime. However, it is still surgery, and it may result in some unpleasant side effects. Upper eyelid ptosis, or droopy eyelids, is a complication that some people experience after blepharoplasty. But can this aesthetic surgery actually contribute to such droopiness? What could be causing your eyelids to droop after blepharoplasty, and what should you do if this happens? Please continue reading to learn more about this.

Can you get ptosis after blepharoplasty?

Ptosis (drooping of the upper eyelid) can occur as a complication following blepharoplasty surgery. However, it is extremely rare and usually occurs in patients who were predisposed or had mild ptosis prior to surgery.

It is possible to experience transient ptosis and minor asymmetry in the first one or two weeks following your blepharoplasty procedure. This is typically just a normal side effect that will fade over time. When you fully recover from the procedure, your eyelids should appear normal.

Chronic or longer-lasting ptosis after eyelid surgery may occur due to a variety of reasons including supratarsal fixation, septal levator adhesions, septal suturing, or trauma to the levator muscle. Before undergoing the procedure, make sure to discuss all potential complications and risks with your surgeon. It is also critical that you select an experienced plastic surgeon in Singapore to examine your eyelid skin and anatomy as well as determine if blepharoplasty is right for you.

What causes the eyelid to droop after blepharoplasty?

Many factors can contribute to ptosis after blepharoplasty. It could be due to the anatomy of your eyes but it could also be because of poor surgical performance. Here, we will list some of the possible causes of droopy eyelids after blepharoplasty.

• Pre-existing ptosis. It is possible that you had slightly droopy eyelids prior to your surgical procedure but were unaware of it due to excess skin hanging over them. In such cases, after removing the excess eyelid skin and fat, your brow may move downward, giving you a droopy appearance. That is why it is critical that your surgeon carefully examine your eyes and brow position during your initial consultation and consider whether there is a risk of postoperative ptosis.
• Overcorrection. When the surgeon removes too much tissue at the time of blepharoplasty, your eyebrows may become too heavy and shift downward. As a result, your eyelids may appear droopy. It is important that the surgeon you choose has sufficient experience and can determine how much skin to remove from your lids in order to achieve satisfactory results.
• Damage to the muscle or nerve. Blepharoplasty includes opening the orbital septum and removing excess skin and anterior orbital fat from the upper eyelids. While the procedure can be safe when performed by a qualified and experienced plastic surgeon, there is always a risk of complications, including damage to the levator muscle or levator aponeurosis. The levator muscle is located behind the upper eyelids and is responsible for lifting them. Injury, dehiscence, or disinsertion of this muscle can result in drooping of the upper eyelid. 
• Scarring. In some cases, scarring from the incision can pull down on the eyelid and cause it to droop. Nonetheless, this complication is rare when performed by an experienced and trained surgeon who knows how to position external eyelid wounds in a way that avoids asymmetry and scarring.
• Wound healing. Blepharoplasty involves an eyelid incision, usually along the lash line. So, you can expect a little swelling and bruising as you recover. In some cases, however, the swelling and pulling of the eyelids can cause temporary ptosis. Such droopiness usually goes away after 1 to 3 weeks, but it can last longer.
• Age-related changes. Even though upper eyelid blepharoplasty can rejuvenate your eyes, it will not prevent your skin from ageing. Over time, the levator muscle can weaken and cause the eyelid to droop, even after a successful blepharoplasty.

Blepharoplasty is normally a low-risk procedure and in very rare cases it can lead to ptosis. To minimize the risk of any complications, be sure that you are in the hands of a qualified plastic surgeon. 

How can you fix ptosis after upper blepharoplasty?

If your ptosis is secondary to excessive bruising, eyelid edema or hematoma, it will most likely resolve on its own within a few weeks. Applying an ice pack and sleeping with your head elevated can help you heal faster and reduce bruising. When ptosis occurs as a result of levator muscle trauma or overcorrection, additional surgical intervention may be required to correct it. The specific approach will depend on the cause and severity of the ptosis. Possible surgical options include:

• Revision blepharoplasty. Revision blepharoplasty is a surgical procedure used to correct or improve the outcomes of previous eyelid surgery (blepharoplasty). It can be used to treat asymmetry, unsatisfactory cosmetic results, functional issues, or complications from the original surgery. You can benefit from this procedure if your ptosis is caused by overcorrection or scarring. Secondary upper lid blepharoplasty is normally a more complex surgery than primary blepharoplasty. It must be performed by an oculoplastic or plastic surgeon who has specialized skills and experience in eyelid surgery.
• Brow ptosis repair. Brow ptosis repair is a surgical procedure which is used to correct drooping of the eyebrows also known as brow ptosis. It can help you reduce saggy skin from ageing as well as fix droopy eyelids caused by previous surgery, or nerve damage. The procedure involves repairing or reinforcing the muscles and tissues that support the eyebrows in order to raise the brows and achieve the desired eyelid elevation. 
• Ptosis correction surgery. This is a surgical procedure that can treat both mild upper eyelid drooping and severe ptosis with poor levator function. It involves repositioning the drooping eyelid to its correct position, often by repairing or reinforcing the muscle and tissues that support the eyelid. The surgery does not only enhance the aesthetic appearance but also a vision that may be obstructed by the hanging eyelid. There are a few types of ptosis correction techniques that can be used to improve the function of the levator muscle during ptosis surgery including levator advancement, Muller's muscle-conjunctival resection, frontalis suspension and sling procedure. 

Whether you need revision blepharoplasty or ptosis repair depends on your needs, your goals, the severity and causes of ptosis and the amount of levator function. Your surgeon will be able to advise you on what procedure is suitable for your situation and help you achieve the best possible outcome.

Is ptosis normal after blepharoplasty?

Some patients may experience transient ptosis following their blepharoplasty procedure. It is completely normal and is typically secondary to swelling, bruising or edema around the eye. In such cases, the droopiness should disappear within a few weeks.

However, long-term ptosis is not a normal or expected outcome of this plastic surgery. Although it is not a common occurrence, it can occur in some cases due to factors such as weakened muscles or nerve damage during surgery. The severity of the ptosis and its impact on the appearance and function of the eyelids can vary. Oftentimes revision surgery is needed to correct the ptosis.

Before undergoing upper eyelid surgery, make sure to discuss all potential risks and complications with your surgeon so that you have a clear understanding of what to expect and what to do if problems arise.

How long does ptosis last after upper blepharoplasty?

In some cases, ptosis can be temporary and resolve on its own within a few weeks or months after surgery. In other cases, ptosis may be permanent and require additional surgical intervention. The duration of ptosis after blepharoplasty can vary and depends on several factors, including the degree of ptosis, the underlying cause of the condition, and the individual's healing process.

If ptosis occurs after blepharoplasty, it is important to seek prompt medical attention and consult with a surgeon for proper evaluation and treatment. In some cases, the doctor may recommend revision blepharoplasty or upper eyelid ptosis surgery to fix the issue.

How common is ptosis after upper blepharoplasty?

Ptosis, or droopy eyelid is a complication that can arise after upper lid blepharoplasty. The frequency of this complication varies, but it is generally considered to be relatively rare, occurring in less than 5% of cases.

The risk of eyelid ptosis after upper blepharoplasty can be influenced by a number of factors, including the skills and expertise of the surgeon, the patient's individual anatomy and healing process, and the specific techniques used during the procedure.

It's important to discuss the potential risks and benefits of upper blepharoplasty with your plastic surgeon, including the risk of ptosis and the steps that can be taken to minimize this risk. Your surgeon should also be able to provide you with more information on the frequency of this complication in their own practice.

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