Non-Incisional Ptosis Correction - SM Plastic Surgery

The non-incisional method adjusts the muscle through the conjunctiva without cutting the lid, whereas the incisional method opens the skin and handles muscle and tissue directly. Non-incisional leaves no visible scar and tends to recover quickly, suiting mild ptosis; where sagging is moderate or greater, or the lid is thick with skin laxity, incision may suit better. The method varies with the eye, so the decision follows a detailed assessment.

Entering through the conjunctiva on the inner side of the lid leaves no incision scar on the outer skin. Fine fixation points do form inside the lid, and how swelling subsides and how fast recovery goes vary from person to person.

It suits mild ptosis where the lid is thin and fat or skin sagging is not pronounced. It can be considered where weak eye opening makes the eyes look sleepy, or where the forehead is habitually used to open them; where sagging is moderate or greater, or the lid is thick, incision may suit better, so the decision follows a detailed assessment.

Because the strength of the muscle is adjusted and fixed, the correction tends to hold; but with time, or with how the eyes are habitually opened, the fixation can loosen and the correction fade. Re-adjustment can then be considered, and how well it holds differs with the lid and the person.

With no incision, swelling is comparatively light and the return to daily life tends to be quick; it varies, but daily life is generally possible around 3–5 days. Settling into a natural eye area can take longer, and the pace of recovery differs from person to person.

Because the skin is not cut, there are no external stitches to take out. The suture that holds the muscle from inside the eyelid stays in place and maintains the correction. At follow-up visits we check how the fixation is holding and how far the eyes open.

If the corrected eye opening fades, the eyes may look sleepy again as they did before surgery, or you may feel your forehead tensing to open them. Sometimes only one side loosens and the difference between the two eyes becomes noticeable. If you notice such changes, we check the fixation at an examination and discuss whether readjustment is appropriate.

The fixation sits on the conjunctival side, so the eye can be sensitive early on and it is better to postpone wearing lenses. They can be resumed once the swelling and irritation have settled and recovery is stable, and the timing differs from person to person. We look at the condition of the eye at your visit and advise when to start.

The procedure takes about 30 minutes under local or sedation anesthesia, and because no incision is made you can go home the same day. Swelling and blurred vision can be inconvenient, so it is better to avoid driving or important commitments, and if you have sedation we recommend coming with someone who can accompany you. Recovery varies from person to person.

The approach goes through the conjunctiva on the inside of the eyelid, so a rubbing sensation or irritation can occur in the early period. It usually eases as recovery progresses, though how much is felt varies from person to person. If the discomfort continues, please come in and have the condition checked rather than putting up with it.

Repeated rubbing or pressing can loosen the fixation, so it is worth being especially careful in the early period. If itchiness or dryness is what makes you rub your eyes, it helps to look into that cause as well. How long the correction holds differs with the condition of the eyelid and daily habits.

Activities that raise your temperature or send blood to the face can prolong swelling and bruising, so it is better to avoid them early on. Start with light activity and build up gradually, and leave strenuous exercise and saunas until the swelling has settled well. The timing depends on how recovery is going, so we advise you at the follow-up visit.

Ptosis correction can be considered even after vision correction surgery, provided the eye is stable. The cornea, tear film and any dryness need to be checked first, and in some cases an ophthalmology consultation is required. If you tell us when you had the surgery and which type it was, we will review it together with your eye condition.

It is generally decided once growth has largely settled and the person fully understands the procedure, and minors should attend the consultation with a guardian. Eye-opening strength and the condition of the eyelid matter more than age as criteria. We confirm the condition at the examination before deciding whether and how to proceed.

When the eyes open wider, the surface can feel drier in the early period, and irritation of the conjunctiva may add a gritty sensation. This usually eases as recovery progresses, though people with existing dry eye may notice it more. If you have dryness symptoms, please tell us at the consultation beforehand.