Dr Mohamad Baba

Ptosis surgery

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Ptosis surgery is an operation that lifts a droopy upper eyelid. Ptosis happens when the muscle that raises the eyelid becomes weak or its attachment becomes loose. This can make the eyelid sit lower than normal and may block part of your vision. It can also make the eyes look uneven and cause tiredness in the forehead from constantly lifting the brows to see better. Surgery aims to lift the eyelid to a more natural height and improve both function and appearance.

You may benefit from ptosis surgery if you have:

  • A drooping eyelid that affects your vision.
  • Forehead strain caused by constantly raising your eyebrows to see more clearly.
  • Difficulty reading, driving, or carrying out daily activities because your eyelid obstructs your sight.
  • A tired, heavy, or uneven appearance around the eyes.
  • Congenital ptosis (a drooping eyelid present since birth).

It is important to note that ptosis surgery does not remove excess eyelid skin. If significant loose skin is also present, your surgeon may recommend combining the procedure with an upper blepharoplasty to achieve the best functional and cosmetic result.

There are several surgical techniques to perform ptosis surgery:

  • Anterior approach – performed from the front of the eyelid through the natural eyelid crease.
  • Posterior approach – a scarless technique where the incision is made on the inner surface of the eyelid.
  • Brow suspension – typically used for severe droopy eyelids, often due to congenital ptosis.

The procedure usually takes around 30–45 minutes.

It is performed under local anaesthetic, similar to dental anaesthesia. The surgeon may use either an anterior approach (through the eyelid crease) or a posterior approach (from inside the eyelid). The muscle that lifts the eyelid is then tightened or reattached to improve eyelid position. If required, the eyelid crease is carefully reformed using fine stitches. In cases of congenital or severe ptosis, the eyelid may be suspended to the forehead muscle for better lifting support. Stitches are usually placed within the natural crease, making them less visible.

Overall, the procedure typically takes 30–45 minutes.

The anaesthetic injections may sting briefly, but once numb you should not feel pain. Afterwards, most patients only need simple pain relief such as paracetamol.

  • Bruising and swelling are expected for 1–2 weeks.
  • Stitches are usually removed after 7-14 days.
  • Swelling gradually improves but can take up to 3 months to fully settle.
  • Most people return to work and social activities within 1–2 weeks.

Results are long lasting but the eyelid can change again over time due to ageing or muscle changes. Some patients may need further surgery later in life.

  • Doing nothing. In adults, ptosis does not harm the eye and surgery is optional. In young children, a droopy eyelid can lead to a lazy eye if it covers the line of sight. In these cases, surgery may be needed urgently to protect vision.
  • A ptosis prop attached to glasses. This lifts the eyelid mechanically but is usually used when surgery is not appropriate.
  • There are no non-nurgical treatments that reliably lift a droopy eyelid.

Complications are uncommon but can include:

  • Bruising and swelling.
  • Infection.
  • Temporary irritation or dryness of the eyes.
  • Asymmetry, where the eyelids may not match perfectly.
  • Under-correction or over-correction of the eyelid position.
  • Need for further surgery to refine the result.
  • Visible scarring in anterior (external) approaches.
  • Small lumps caused by sutures.
  • Temporary blurred vision.
  • Dry eyes.
  • Rare eyelid retraction (pulling of the eyelid).
  • Extremely rare risk of bleeding behind the eye, which may affect vision.
  • Allergic reactions to anaesthetic or dressings.

Your surgeon will explain these risks in detail during your consultation.

  • Apply cold compresses for the first 24–48 hours.
  • Sleep with your head elevated for 2 nights.
  • Use antibiotic ointment on the wound for 2 weeks.
  • Clean the area with cooled boiled water and cotton wool for 10 days
  • Avoid bending, heavy lifting and strenuous exercise for 2 weeks.
  • Avoid eye make-up for 3 week.s
  • Avoid contact lenses for 2 weeks.
  • Protect scars from sunlight with sunglasses and SPF for several months.

You should get in touch with us if you experience:

  • Severe pain that is not controlled by painkillers.
  • Sudden loss or drop in vision.
  • Increasing redness, swelling, or discharge from the wound.
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