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As we age, the upper eyelid skin stretches and the muscles weaken, causing the excess skin and muscle to gather in the upper eyelids.  It is often accompanied by drooping of the eyebrows and occasionally by ptosis, a lower upper eyelid margin.  As the eyebrow/eyelid complex ages, there is a gradual crowding of the eyes. As it becomes more advanced, it can affect one’s vision. In those cases, insurance may cover the cost of the procedure.

The goal of ptosis repair at the UNC Center for Facial Aesthetics is to restore the upper eyelid to a more youthful but natural facial appearance, and avoids the “surprised” appearance some eyebrow/eyelid surgeries can produce.

What’s the difference between the surgical techniques for ptosis repair?

The primary difference between the surgical techniques for ptosis repair is the anterior approach (incision is made on the outside of the eyelid), and the posterior approach (incision is made on the underside of the eyelid).

As Dr. Clark has developed his technique for ptosis repair, his strong preference is for the posterior approach because the eyelid contour feels more natural with this technique. Most often, this technique requires a deeper level of sedation (general anesthesia) than an upper eyelid blepharoplasty (local anesthesia).

If ptosis repair is performed, the ptosis repair and upper blepharoplasty are performed at the same time.

What are possible side effects from ptosis repair?

Similar to any surgery, bleeding and infection are risks but these are very low (<10%). Asymmetry of the eyelids (requiring revision), worsening of dry eye complaints, and development of a “stye”, are additional low risks with ptosis repair.

In any surgery around the eye, an extremely rare complication that must be considered is loss of vision however this risk is far less than 1%. This complication is why any eyelid surgeon should be very familiar with the complex anatomy of the eyelid. Patients frequently have bruising and swelling after surgery which gradually subsides over a few days to a few weeks after surgery.


If you would like to schedule a consultation at the UNC Center for Facial Aesthetics, please call 984-974-2255 to make an appointment.