Ptosis - Men 70's Before & After Case 146

This patient in his 70s presented with gradually smaller eye opening overtime, making him appear older than he felt. 

On evaluation, Dr. Phan noted lid ptosis, with the eyelid margins resting near or at the center of the pupils. Dr. Phan also noted mild excess skin anticipated the skin to appear more prominent after successfully raising the eyelid margins. To address both the lid ptosis and dermatochalasis, Dr. Phan recommended bilateral external ptosis repair and blepharoplasty. This involved incisions placed in the natural eyelid creases, shortening and tightening the levator muscles with internal sutures to help the eyelids elevate more effectively, and removing excess skin. The patient elected to proceed with ptosis repair alone, as the heavier eyelid folds did not bother him and were consistent with his appearance in youth. 

Patient, pictured here 10-days after bilateral external ptosis repair, demonstrating natural repositioning of the eyelids and restoration of his appearance, without looking overdone. 

To further improve symmetry, the patient may choose neuromodulator injection to the overactive right frontalis muscle in the forehead. This will allow the right brow to come down and, in turn, allow the right upper eyelid also to rest at a more comparable height to the left side.