Eyelid Ptosis - Why Frontalis Sling Should be Carefully Considered after Previous Surgeries

[@myrawhues]

Hello Sir !!! I’ve had jaw winking syndrome almost with unnoticeable ptosis from childhood , I was operated for levator disinsersion when I was 10 years old after which I started having problem of opening my eye , after two years the same doctor operated again for frontalis suspension but that kinda failed . My eyelid drooped and I had to tilt me head upwards to make it look a bit better and pull my brows upwards . I am 22 years now and visited an oculoplastic surgeon who said that he will do frontalis suspension again with proline . My levator function is 3-4mm and bells are good and extraocular movement is negative . I want to ask that if I undergo surgery would my eye size become symmetrical ? And would I be able to close my eyes during blinking and sleeping ? I have no crease for now of the left effected eye , my doc said that the scar would hide behind your crease , can I get my crease back with this like the normal eye ? What do you suggest about this surgery ? Plzz reply …

[@AmiyaPrasadMD]

Hi @myrawhues, I hope you understand that for a proper second opinion, I would have to examine your eyelids like your oculoplastic surgeon did before giving you recommendations. Also, the results of your surgery are dependent on your current anatomical condition, as well as how your surgery is performed. I would need to physically examine you to answer all your questions in detail. I hope this clarifies things for you.

[@Leon-cj8hd]

My wife got a frontalis sling operation when she was 5/6 after congenital ptosis. 30 years later she is very depressed about the asymmetry of the eyes and the scars of the operation. One lid has a different wrinkle and seems bigger. Also lid lag is present why you notice the ptosis quickly. No other problems besides the psychological effects though. Lubrication is mandatory but tolerable I guess. Is there any option to correct or redo the surgery to improve results?

[@AmiyaPrasadMD]

Hi Leon, It is possible to improve an old frontalis sling, but an examination is needed to determine if your wife is a candidate for additional surgery. I hope this helps you.

[@garlapatiapurva4675]

Hi Doctor I have ptosis from my birth but my family didn't observe that now i am 28 years and i recognise that i have ptosis to my left eye.could you please check my photograph ang give me a clarity. Could you please suggest any non surgical treatment for this. How can send photography to you.

[@AmiyaPrasadMD]

Hi @garlapatiapurva4675, As there are possible neurological causes for eyelid ptosis, I can't diagnose the cause of your eyelid ptosis without a physical examination. Ptosis caused by a weak, stretched, or detached muscle in the upper eyelid can only be treated with surgery. You can refer to these videos about how we diagnose, and treat eyelid ptosis; and the possible neurological causes of ptosis: kzbin.info/www/bejne/bZi6hJ2HmMpmerM kzbin.info/www/bejne/mX3MinuCgbWVZ8k

[@bonsailady]

Thank you so much for sharing your video and well explained about frontalis sling surgery. I had my 1st eyelid surgery 3 months ago. My left eye is droopy and . I was born with congenital ptosis. I'm not happy for the result and they cut some skin but still one eye is big and one eye is small. I was thinking about going back and get another surgery and my Dr said like what you said in this video about exposure irritation, and the eye become dry and this is my concern. I wish my parents can afford to help me to correct my eye when I was a child, unfortunately I was born poor and can't afford to get surgery. I don't know what to do after I watched your video. I wish theres a way without hurting my eyes and see better.

[@AmiyaPrasadMD]

Hi @bonsailady, Sorry to hear about your problem. I suggest you ask your surgeon if the muscle was treated, or if only the eyelid skin was addressed. Eyelid ptosis is due to the muscle lifting the upper eyelid having little to no function, not the eyelid skin. I hope this helps you.

[@saeedgavahi8895]

Excellent presention

[@AmiyaPrasadMD]

Thank you, Saeed Gavahi! Glad the video helped you!

[@sojitabraham4414]

My son is 2 months old. He jas ptosis on his right eye. Docter sugested to have frontalis sling and whivh is happening in 24th this month. His eyelid is covering most of the pupil. Can he not have anything else other than frontalis sling. Is choosing frontalis sling keep me option less if his eye droops again in the future?. Can you please answer for this. Should tell my docter to consider some other methods?... Please reply me

[@AmiyaPrasadMD]

Hi @sojitabraham4414, Sorry to hear about your son's problem. Frontalis sling is usually recommended for congenital ptosis when there is little to no function of the muscle that lifts the eyelid called the levator muscle. There is another procedure some surgeons recommend for infants called frontalis muscle flap, but I don't perform this procedure as I only operate on adults with eyelid ptosis. Without an examination like your doctor did, I would have to defer to their recommendation. I hope this helps you.

[@sojitabraham4414]

Does he require another surgery as grew up ( eyes grow as he gets older) even if the current surgery is successful?

[@AmiyaPrasadMD]

Hi@@sojitabraham4414, Surgery for congenital ptosis is expected more than once in a lifetime. The eyelids blink thousands of times a day, so there is a lot of wear and tear over the years. I hope this clarifies things for you.

[@koonagueroagnis8174]

Can frontalis sling with silicon be reversed or weakened if lid lag is too much?

[@AmiyaPrasadMD]

Hi KoonAgueroAgnis, Yes, since ptosis correction surgery is so precise, sometimes further enhancement is needed. Your surgeon should have a revision policy in place for ptosis correction surgery. All surgeons experienced in treating ptosis know that such a precise surgery sometimes needs additional enhancement. I hope this clarifies things for you.

[@erichunter4123]

At birth I was born with a lazy eye (amblyopia) months after birth I under went Frontalis Sling surgery. I am now the age of 25 and have slept with my right eye open (the eye that had the procedure) for all those years. I have noticed that my eye lid has reached its drooping point again, covering very little of my pupil including my eyelashes, disturbing my vision. Are there any advancements in the medical field that allow the eyelid to maintain symmetry with the left eye as well as giving functionality to fully close the during sleep (including blinking without forcing) and opening?

[@AmiyaPrasadMD]

Hi Eric Hunter, It is expected to need more than one ptosis correction surgery in a lifetime due to the frequent muscle activity of the upper eyelids (think about how many times the eyelids blink in a day). A physical examination is needed to determine what the best approach would be for your case. You can refer to this video about it - kzbin.info/www/bejne/oaLUg6OAnb-FgLs

[@grace_olsn]

Is there other types of surgerys I can get other than the frontails sling with severe congenital ptosis? My eyelid is still dropping on the outer corner.

[@AmiyaPrasadMD]

Hi @grace_-ks3xv, Sorry to hear about your problem. The frontalis sling is a last resort procedure when there little to no levator muscle function. An examination is needed to assess your levator muscle function before other treatment options can be considered. I hope this clarifies things for you.

[@grace_olsn]

@@AmiyaPrasadMD if I were to do any other procedure like the external approach would it just prevent me from closing my eye?

[@AmiyaPrasadMD]

Hi@@grace_olsn, I would have to physically examine your condition to give you a proper second opinion. I hope you understand.

[@martina-tx4mf]

I have congenital ptosis and I had this type of surgery almost one year ago, but my eyelid started dropping right after the surgery and right now it is like I didn't have it. Is it possible getting another one?

[@AmiyaPrasadMD]

Hi martina p, It is possible, but did you follow up with your surgeon soon after you noticed the immediate drooping? Having it addressed after year may require surgery to be done all over again, but if it occurred soon after the initial surgery, your surgeon should have a revision policy in place as further enhancement is sometimes needed after ptosis correction surgery. You can refer to this more recent video about needing ptosis correction again after a previous surgery - kzbin.info/www/bejne/anerdoqnhbCNg7c

[@martina-tx4mf]

Amiya Prasad, M.D. thanks Doctor for the reply. One month ago, I was operated again by the same surgeon because I was rejecting the sling. He suggested to not re-do this type of surgery because there’s a high chance that I could reject the sling again. Is that true? Is there another type of surgery that I could get?

[@AmiyaPrasadMD]

Hi@@martina-tx4mf, The frontalis sling is already a last resort procedure if you have little to no levator muscle function. It's not clear if you rejected the sling material, which can be synthetic like Gore-Tex, or from your own body like a fascia lata graft. I hope this clarifies things for you.

[@martina-tx4mf]

@@AmiyaPrasadMD Thank you. And it was a synthetic material.

[@AmiyaPrasadMD]

Hi@@martina-tx4mf, You can ask your surgeon about a graft material from within your body. I hope this helps you.

[@anandhid9977]

Hi Dr. this is anu..I am from india.. i want this correction from you Dr.. How this is possible

[@AmiyaPrasadMD]

Hi Anandhi D, This would have to take place in one of our locations in the US as I do not practice medicine in India. Our offices are located in Manhattan, New York City which you can call at [phone]; Garden City, Long Island at [phone]; or Vienna, Virginia at [phone]. You can also reach us through www.prasadcosmeticsurgery.com, www.eyelifts.com, or www.pufffyeyes.com by filling out a contact form, and we will get back to you. I hope to hear from you soon.

[@varunuikareddy6526]

hi, I have Marcus Gunn jaw winking syndrome and have had a levator resection when I was younger do you think having the frontalis sling would ruin the face symmetry. I was also wondering if it would reduce the jaw winking, thank you

[@AmiyaPrasadMD]

Hi varunuika reddy, If you have a frontalis sling, then your eyelids would no longer be attached to the levator muscle which causes the winking, so a frontalis sling can treat the jaw winking. However, a frontalis sling has its own downsides, which can review in the video. I hope this clarifies things for you.

[@varunuikareddy6526]

@@AmiyaPrasadMD ok thank you

[@AmiyaPrasadMD]

You're welcome,@@varunuikareddy6526!

[@preetchahal2650]

@@AmiyaPrasadMD Hlo sir plz tell me after surgery eyelid is moved or not and how many days after lid would be moved.

[@AmiyaPrasadMD]

Hi@@preetchahal2650, It is possible, depending on how your eyelid surgery was performed. There is no number of days that applies to everyone, so following up with your surgeon after surgery is important, especially if there are any issues, or if you have concerns about recovery and final results. I hope this clarifies things for you.

[@ahmaddaudnagar8037]

Modrete good lpd action surgury permanent rhega sir ya temporary

[@AmiyaPrasadMD]

Hi ahmad daudnagar, While the results of ptosis surgery can last many years, you have to understand that the levator muscle is used thousands of times a day to blink and close, over many years, so ptosis surgery should be expected more than once in a lifetime. You can refer to this video about it - kzbin.info/www/bejne/anerdoqnhbCNg7c

[@TheBerfin252]

Hey, i have congenital ptosis in ny right eye. I had a surgery 3 weeks ago but now my eyelid is worse. There is an undercorrect and it is worse than before surgery. I had levator resection anterior appoach. I still have vision in my right eye but when i look up you can see that the eyelid does not get pulled back. Do you think i will need a frotnalis sling for a next procedure? I can send you pictures from your email if that would be better for you to undertand. Please resond back, i would appreciate it so much

[@AmiyaPrasadMD]

Hi Berfin A, Sorry to hear about your problem. A ptosis exam is needed to measure if you still have levator muscle function left. If there is little to no function left, then a frontalis sling can be considered. A frontalis sling is not decided lightly as it does involve a learning curve for the patient to raise and close their eyelid with the frontalis muscle. I hope this clarifies things for you.

[@DannyH77]

@@AmiyaPrasadMD I’ve seen many different ways to do frontalis sling surgery on KZbin what’s the most updated version of the surgery for both eyelids

[@AmiyaPrasadMD]

Hi@@DannyH77, Oculoplastic surgeons use comparable techniques and materials for a frontalis sling procedure, but there are nuances in customizing the procedure for each patient's unique situation. It is a matter of what best suits your individual situation. I hope this helps you.

[@mahadwehliye1089]

Hi, Doctor I had ptosis surgery yesterday and I can not close my eye completely... what is the procedure?

[@AmiyaPrasadMD]

Hi mahad wehliye, The correct procedure would be to follow up with your surgeon. Any surgeon who is experienced in ptosis correction surgery knows that enhancements may be needed after surgery because the surgery is very precise, so adjustments may be needed after initial surgery. Your surgeon should expect this to happen on occasion, at least. I hope this helps you.

[@musicalchild]

I had it done 6 months ago and I still can't close my eye

[@slikybump]

hello, I have marcus gunn jaw winking syndrome and I had ptosis surgery twice when I was young. People notice that when I blink the eyelids do not blink in unison. I sort of have to use more force than what is normal to get both my eyes to close all the way. Also sometimes the eye that didn't have surgery will do a quick autonomic blink but the eyelid with the surgery will not do anything so it looks like i'm blinking with one eye. Beyond that, if I look down it's very obvious to people looking at me that something is wrong. Are there any surgeries or anything on the horizon that could fix any of these problems? This all was caused from forceps damaging my eye when I was born. I was stuck. I'm hoping that as technology progresses there will be a way to fix this so my eyelids are normal.

[@AmiyaPrasadMD]

Hi Jarrell Burris, Sorry to hear about your problem. A physical exam, as well as your detailed medical history would be needed to determine what else can be done for you.

[@slikybump]

@@AmiyaPrasadMD but in general (not advice for me) are there new options for someone in that position?

[@AmiyaPrasadMD]

Hi@@slikybump, Not sure about "new", but I've been able to help patients with Marcus jaw winking syndrome who were previously treated by other oculoplastic surgeons.

[@AmiyaPrasadMD]

Hi@Pauliesha Forbes, Sorry to hear about your problem. I suggest you seek a pediatric ophthalmologist for a proper diagnosis, and possible treatment. I hope this helps you.

[@aparna4206]

Bro ..You are from India right ? I have the same problem .Please tell me if you have approached any doctor in india and have corrected this problem ...or will we have to live with this defect ?

[@mohrussi651]

Hello doctor, I performed surgery that opened in the eyebrow and a little from the nose, and I cannot open the eye completely. Half of us are very afraid. Is this something normal?

[@AmiyaPrasadMD]

Hi Moh russi, Sorry to hear about your problem. It is not normal because properly performed eyelid surgery does allow the eyelids to function well. I would need to examine your eye area to see what can be done for you. For some guidance right now, you can refer to this video about how I avoid, and revise eyelids that can't fully close - kzbin.info/www/bejne/l6TaZnuNZb6MbZY

[@akidulislam9036]

@@AmiyaPrasadMD Plz send your hospital adress

[@AmiyaPrasadMD]

Hi@@akidulislam9036, Our offices are located in Manhattan, New York City which you can call at [phone], Garden City, Long Island at [phone], or Vienna, Virginia at [phone]. You can also reach us through www.prasadcosmeticsurgery.com, www.eyelifts.com, or www.pufffyeyes.com by filling out a contact form, and we will get back to you. I hope to hear from you soon.

[@juliascurato4031]

My eyes are really big and I have droopy and asymmetrical eyelids. I want to get ptosis surgery too, but I’m afraid my eye would look so big that I would look like as if I’m giving a “stare” to everyone.

[@AmiyaPrasadMD]

Hi Julia S Curato, Ptosis surgery is only required if you have trouble lifting your upper eyelid all the way to open your eyes. Ptosis surgery does not make your eyeball bigger as it only treats muscle that lifts the upper eyelid called the levator muscle, or the other muscles that connect to the levator. You can refer to this video about how eyelid ptosis is diagnosed and treated - kzbin.info/www/bejne/bZi6hJ2HmMpmerM

[@terryblaze1839]

My right eye is worse dueti car crash . It is lower an inch

[@AmiyaPrasadMD]

Hi@@terryblaze1839, Sorry to hear about your problem. Eyelid ptosis can be caused by trauma or an injury, but it can still surgically corrected. You can refer to this more recent video about how eyelid ptosis is diagnosed, and treated - kzbin.info/www/bejne/bZi6hJ2HmMpmerM

[@kumarteluguvlogs6540]

Hi Doctor I have ptosis in my right eye since birth now age is 25 is it possible for treatment. If possible pls give aexplanation for below 1 The Surgery will be for life time or after few year again required? 2.eye blinking is possible or not 3.while sleeping eye close or not 4 is anyone identified as surgerydone. ?

[@AmiyaPrasadMD]

Hi Kumar, 1. Eyelid ptosis surgery is usually required more than once in a lifetime because you have to imagine that the eyelid blinks thousands of times a day, so the levator muscle that lifts the eyelid can still weaken after some time. 2. Eye blinking can still be done, but for more severe cases where there is little to no levator muscle function, it's the muscle in the forehead that raises the brow called the frontalis muscle that is attached to lift the eyelid, so you may need a different muscle to raise the eyelid 3. Your eyes close completely when sleeping, if your surgery is done correctly by an oculoplastic/oculofacial plastic surgeon 4. If you are asking if it looks obvious, it depends on the surgeon performing the procedure. You can review my many videos on eyelid ptosis, and see for yourself that my patients do not appear to have had surgery. I hope this clarifies things for you.

[@kumarteluguvlogs6540]

Thank you very much for your quick response sir, Sir Approximately how many years it will be same , post treatment Please explain about side effects And I was asked few doctors who is specilized in ptosis they said that one time surgery is enough and there is no other side effects and all they said everything will be fine but still i have doubt on them, can you plz explain me once again thank you sir.

[@AmiyaPrasadMD]

Hi@@kumarteluguvlogs6540, There is no set number of years that apply to everyone as degree of levator muscle function in patients, and style of surgery varies. Surgery is not subject to side effects. Sorry to say that if your surgeons believe eyelid ptosis correction is a permanent surgery, then they are not experienced in ptosis surgery. Eyelid ptosis correction surgery is only performed by oculoplastic/oculofacial surgeons, so you may want to check their credentials, especially if you have seen several as it is a very specialized type of eyelid surgeon. I hope this clarifies things for you.

[@kumarteluguvlogs6540]

Sir if you don't mind can you share your e mail address , will share my photos with you

[@AmiyaPrasadMD]

Hi@@kumarteluguvlogs6540, You can send your pictures through prasadcosmeticsurgery.com/virtual-consultation/ but this a preliminary evaluation, not a formal consultation. A formal, one-on-one Skype of FaceTime video consultation with me can arranged through prasadcosmeticsurgery.com/skype-virtual-consultations/ I hope to hear from you soon.

[@ridomrido7172]

l wan to have ptosis surgery because my school friends are often bullied since then l'm afraid to leave the house

[@AmiyaPrasadMD]

Sorry to hear that, RIDO M RIDO. Depending on your age, you should talk to your parents about seeing a pediatric ophthalmologist, or an oculofacial/oculoplastic surgeon. I hope this helps you.

[@ahmaddaudnagar8037]

Potosis surgury ka koi permanent surgury sir

[@AmiyaPrasadMD]

Hi ahmad daudnagar, While the results of ptosis surgery can last many years, you have to understand that the levator muscle is used thousands of times a day to blink and close, over many years, so ptosis surgery should be expected more than once in a lifetime. You can refer to this video about it - kzbin.info/www/bejne/anerdoqnhbCNg7c

[@SanjayKumar-to1iz]

Nice

[@firozkhan-up3oh]

Give me namber

[@AmiyaPrasadMD]

Hi mohammed Younus, Our offices are located in Manhattan, New York City which you can call at [phone], and Garden City, Long Island at [phone]. You can also reach us through www.prasadcosmeticsurgery.com, www.eyelifts.com, or www.puffyeyes.com by filling out a contact form, and we will get back to you. I hope to hear from you soon.