Lowering Overcorrected Ptosis Correction: Reversing Ptosis Surgery

Lowering Overcorrected Ptosis Correction, i.e., Reversing Ptosis Surgery

I would like to post about this topic today.

If you look at the patient’s right eye (left side on the photo) compared to the opposite eye, a significant amount of the white of the eye is exposed. Take a look at the arrow.

It is clearly visible when zoomed in.

Several years have passed since the initial surgery.

In such cases, if we think simply from a layperson’s perspective, will the correction be undone just by removing the stitches used for the ptosis correction?

The answer is no. This is not a surgery to simply ‘undo’ ptosis correction. It is a new procedure called ‘retraction surgery.’

The method involves a new surgical approach where the Müller’s muscle beneath the levator palpebrae superioris and even the conjunctiva underneath must all be dissected.

The concept is to essentially recreate a form of ptosis and then perform the ptosis correction anew.

The most common error occurs because the eye appears smaller under anesthesia, making it look as though the retraction surgery was successful. However, in most cases, a relapse occurs later.

As one performs this procedure frequently, a certain level of know-how is accumulated.

The opposite eye appeared slightly sleepy, and I anticipated that ptosis correction would hardly be necessary; however, upon opening it up, I found that the eye-opening muscle had become detached.

This is a photo from the 5th day. The patient visited because they were curious if everything was settling into place correctly.

The retraction surgery seems to have gone well, and the symmetry looks good so far.

However, we must not let our guard down. As explained to the patient, there are many cases where the eye becomes larger again between one and two months due to various reasons such as scar contracture. This leads to a significant dilemma: whether to open it up again for further retraction surgery or to wait.

This decision is made based on my judgment and must be determined through trust with the patient.

Since it is only the 5th day, there is still swelling, but as time passes, both eyes will open slightly more than they do now, and the lines will likely become a bit more natural.

This is the pre-operative video.