Can Double Eyelid Surgery Correct Ptosis?

Patients who want to adjust more than one feature at a time are far from uncommon, but most procedures are specialized to the point of generating only certain results. In consultations with patients, we have encountered a fair number who want both to eliminate ptosis (or droopy eyelids) while also adding an eyelid crease to their features. Traditionally, these are two separate procedures, but below we look at the options available to patients who want double eyelid surgery to correct ptosis. While this might not be technically available, there are ways for patients to achieve both results while undergoing only a single visit for surgery.

What Is Ptosis?

Ptosis, also known as eyelid droop or droopy eyelids, is a condition in which the upper eyelid hangs lower than usual. This can be caused by a variety of factors, including age-related weakening of the muscles and tendons that control the upper eyelid or an injury to the area. However, injury and illness can also prove to be causes or factors in developing ptosis, especially at younger ages. Ptosis can affect one eyelid at a time, causing a sense of asymmetry, or it can be apparent in both eyelids at once.

In regards to its cosmetic appearance, patients express concern that sagging eyelids can make them appear tired or aged, often at odds with how they feel, creating a sense of dissonance in their appearance versus personal identity.

While this condition is often mostly of cosmetic concern for patients, it can also lead to some functional issues as well, namely that the drooping eyelid can interfere with vision. In some cases, the eyelid may also cause irritation to the eye’s structures. With the right procedure, a board-certified surgeon can reliably and effectively correct ptosis, restoring a drooping eyelid to a more alert and youthful position.

Overview of Double Eyelid Surgery

Double eyelid surgery, also known as Asian blepharoplasty, is a cosmetic surgical procedure that creates an upper eyelid crease according to the patient’s aesthetic preference. This procedure typically involves removing excess skin and fat to create a more aesthetically pleasing look without altering the underlying structures in a negative way. Patients may have the procedure on both eyelids, or on a single eyelid in order to achieve facial symmetry. The procedure typically takes about one to two hours, though this varies, and the patient can return home following the procedure on that same day.

Does Double Eyelid Surgery Improve Ptosis?

On its own, double eyelid surgery only focuses on the creation or enhancement of an eyelid fold for patients. The procedure is not necessarily designed to correct for ptosis or other cosmetic concerns regarding the eyelid, instead it targets the specific outcome of an eyelid fold or crease. While this outcome still creates an aesthetic change according to the patient’s goals, it does not alter the structures that affect the position of the eyelid.

This would fall under the domain of a procedure called ptosis repair, which specifically targets the muscles and tissues affecting the position of the upper eyelid. By removing excess skin and tightening the remaining tissues, a surgeon can use this procedure to reduce eyelid sagging and restore the eyelid to an alert, youthful position.

What Is It Like to Combine Procedures?

In many cases, patients may elect to have both procedures in a single operation, making optimal use of the day of their surgery. A benefit of combining the two procedures in a single operation is that it allows your surgeon to approach each aspect of the procedure with a synthesized result in mind. If the procedures were separated, your surgeon would need to work around the previous procedure’s results, creating a more complex scenario.

Instead, a combined procedure allows for the two procedures to work together in delivering exceptional results. On the patient’s side of events, they may experience a better outcome with less interference in their lives as would be felt with two separate surgeries. The combined procedure tends to take about two hours, though this varies from case to case, and does not require significant additional recovery time. As with each individual procedure, patients should be able to return home the same day and begin focusing on healing and recovery.

Overview of Combining Ptosis Repair and Double Eyelid Surgery

• Can be completed in a single operation
• Easier to create results that build upon each other
• Approximately the same recovery time as a single procedure
• Only a mild increase in the duration of the procedure
• Reduces eyelid drooping while also creating an eyelid crease

If you are looking to achieve both aesthetic and functional correction in your upper eyelids, a combination of double eyelid surgery and ptosis repair may be the ideal solution. Discuss this option with your board-certified surgeon to determine if it is right for you.

Understanding What Results to Expect

It is important to consider that the results of any surgery can vary from patient to patient. This is even more true when combining two procedures, as each individual will have a unique anatomy that may affect their overall outcome. With a comprehensive consultation and evaluation by an experienced surgeon, patients can better understand what results they should reasonably expect from this combined approach. The results of both ptosis repair and double eyelid surgery are designed to be long lasting, but various factors can affect your results. We encourage every patient to follow their post-procedure instructions carefully to improve their results and reduce the risk of any complications. It is also important for patients to know that their final results may only be apparent after swelling has completely faded, which typically occurs several weeks to a couple of months after their procedure.

Schedule a Consultation

We encourage patients interested in achieving both aesthetic and functional outcomes for their eyelids to schedule a consultation with board-certified surgeon, Dr. Kenneth Kim. During this visit, he will evaluate your individual case and discuss the options that are available to you. With double eyelid surgery and ptosis repair being two highly reliable corrective procedures, patients can expect to see lasting results that improve both eyelid function and aesthetics. Contact the office of Dr. Kim today to set up your consultation and learn more about both procedures, discuss your candidacy, and start on your path toward results.

References

1. Asian double eyelid. Stanford Medicine. https://med.stanford.edu/cosmeticsurgery/aestheticservices/face/asian-double-eyelid.html. Accessed March 1, 2023.
2. High Double Eyelid Fold Correction Using Wide Dual-Plane Dissection. Annals of Plastic Surgery, Vol. 78, No. 4 April 2017.
3. Clark K, Shacknai G. Eyelid surgery. American Society of Plastic Surgeons. https://www.plasticsurgery.org/cosmetic-procedures/eyelid-surgery. Accessed March 1, 2023.
4. Jung-Woo Hu, MD, Jun Hee Byeon, MD, PhD, Hyung-Sup Shim, MD, PhD, Simultaneous Double Eyelid Blepharoplasty and Ptosis Correction with a Single-Knot, Continuous, Nonincisional Technique: A Five-Year Review, Aesthetic Surgery Journal, Volume 36, Issue 1, January 2016, Pages 14–20, https://doi.org/10.1093/asj/sjv201.
5. Kim KK, Granick MS, et al. American Society of Plastic Surgeons Evidence-Based Clinical Practice Guideline: Eyelid Surgery for Upper Visual Field Improvement. Plast Reconstr Surg. 2022 Aug 1;150(2):419e-434e. doi: 10.1097/PRS.0000000000009329. Epub 2022 Jul 27. PMID: 35895522.
6. Adjunctive Techniques to Traditional Advancement Procedures for Treating Severe Blepharoptosis Plastic and Reconstructive Surgery, Vol. 133, No. 4 April 2014.