By Carla Walsh
I suffered from a condition called ptosis (pronounced toe-sis), the medical term for droopy eyelids. Since I was a kid, I was often told I looked sleepy and disinterested. What made me unhappier was that one eye was droopier than the other. I remembered being cruelly teased that I looked like I had a brain injury because one eye was way smaller than the other. If eyes are the windows to our soul, a defective pair of eyelid curtains can give others a wrong impression of our personality and mood.
I felt a lot of eye strain and headaches, which my plastic surgeon later explained was due to my constant exertion to lift my eyelids to see better. She also pointed out that I tilted my neck backwards unknowingly to see better – the answer to my grueling neckaches.
Nine months ago, sick and tired of how I looked and felt, I decided to go for ptosis correction surgery. What I would say about the surgery was that I wished I did it earlier. My vision was brighter, and my aches and pain went away. Looking better was an undeniable bonus. I love my larger and now symmetrical peepers, and the surgery also removed my sagging upper eyelid skin and improved the contour of my eyelids.
The week of downtime that followed was tolerable. I had more swelling and tearing in the first 3 days after surgery. My eyelids did feel a little fuller than usual for a few weeks but I was able to go back to work 1 week after surgery. Before my surgery, I spent weeks researching online on upper eyelid surgeries. Clearly a common surgery, there was more information online than I could digest, and I ended up consulting my plastic surgeon a few times to clarify my concerns before the surgery. It’s for my eyes after all! Surgery was definitely the right move for me and I’m glad to share the answers I found and my experience on upper eyelid surgeries.
Who is suitable for upper eyelid surgery or blepharoplasty?
Many Orientals lack a double eyelid fold (also known as a supratarsal crease). Creating a double eyelid crease, commonly referred to as double eyelid surgery, brightens the eyes by making them appear bigger and more awake. The surgery can be done in 2 ways, depending on the condition of your upper eyelid skin and puffiness.
The first method is a suture blepharoplasty. This technique sculpts a double eyelid fold by placing stitches through tiny 2 mm cuts along the fold. A good choice for those with thin, non-saggy eyelid skin, suture blepharoplasty has less swelling and downtime, often less than a week. The drawbacks? It is not suitable for those with very puffy or loose eyelid skin.
The second method is an incisional blepharoplasty. I had my ptosis correction done using this technique. Incisional blepharoplasty creates a lasting double eyelid by placing a full incision along the crease. Durability aside, the incisional method is also more suited for those with saggy or puffy eyelids. A preferred technique for such eyes because it allows the removal of excess skin and fat in the eyelid, further beautifying the eyes.
Oriental eyes also commonly have an epicanthal fold, which blunts the inner angle and shortens the eye. An epicanthoplasty can be added to the blepharoplasty surgery to open up the inner corners and lengthen the eyes.
Do I have ptosis? Is ptosis correction surgery covered by insurance?
If you suffer from true ptosis (or blepharoptosis), your eyelid is blocking your vision and corrective surgery is considered medically necessary and covered by most insurance schemes and Medisave. Your plastic surgeon will be able to advise if you have the condition and qualify for ptosis correction surgery, which is sometimes referred to as “functional blepharoplasty”.
Ptosis can give rise to a list of complaints that affect a person’s function and daily activities:
- Eye strain and discomfort
- Part of field of vision blocked by eyelids, which may affect activities like driving
- Head tilting to improve vision, leading to neck and shoulder aches
- Some suffer from ptosis when looking down which impairs reading
In ptosis correction, the eye-opening “levator” muscles are re-tightened which instantly corrects the droopiness by lifting up the eyelids. The surgery is done through an incision along the upper eyelid crease. If you do not have an existing double eyelid fold, then a new crease is created, which is a plus for those who yearn for a defined double eyelid.
What do I have to look out for before and after blepharoplasty surgeries?
If you are on blood thinners, have a blood or clotting disorder, have high blood pressure or have dry eyes or other eye conditions, do inform your plastic surgeon as extra precautions may need to be implemented, such as stopping the medication temporarily or controlling your blood pressure.
My plastic surgeon advised that I omit the 5 ‘G’s: Garlic, Ginger, Glucosamine, Gingko and Ginseng. She was referring to the supplements, so eating them in moderation in your diet is permissible. I was also told to avoid fish oil and vitamin supplements. She explained that these supplements serve to boost circulation, which may lead to more bleeding during surgery.
Eyelid tapes and glue should be avoided for at least 2 weeks before the surgery to minimise skin irritation. Long term use of these “crease aides” in fact harm the skin, causing irritation and skin sagging (yikes) over time.
My ptosis correction took 2 hours and I was awake throughout, although I did have a light sedative to help me relax. The numbing cream and injection I had at the beginning helped loads – I did not feel much at all and went home soon after the surgery. I was given eye drops, antibiotics, anti-swelling tablets and told not to wear contact lens for a week. The sutures was done by my surgeon in a special way that, after a week, my stitches were painless to remove.
After the surgery, the downtime will include swelling, bruising and tearing for 1 -2 weeks, depending on the type of surgery. Expect less downtime in suture blepharoplasty, and more with ptosis correction. Risks of eyelid surgeries include dry eyes, poor scarring and unevenness. Bleeding, infection and vision blurring are very uncommon complications.
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Are there non-surgical ways to correct ptosis?
Well, there are “eye crutches”, which are bars placed on the inside of eyeglasses to help lift the eyelid. It is very cumbersome and does not correct the underlying problem – hardly a surprise that it is not a popular device. So unless you are way too young or old, or your health is too poor to undergo even the mildest form of surgery, then surgery is the best way forwards.
For aging eye changes though, thanks to advances in laser technology, many non-surgical treatments are available for eye rejuvenation. Ask your doctors for treatment catered for eyelids because not all lasers can be used on the eyelids due to its proximity to the eyeball. Tailored for eyelid skin, the SmartX Lite Eye, is a fractionated carbon dioxide laser that tightens by targeting skin collagen. Another way to rejuvenate the delicate area of the face is the use of plasma energy. The cutting edge Neogen Plasma delivers precise pulses at a depth which boost collagen production. The two treatments are combined synergistically in SW1 Clinic’s Miracle Eye Reviver Program, one of their best-selling programs for non-surgical eye rejuvenation. Apart from laser, Thermage Eye uses radiofrequency energy to penetrate deeper into the skin to stimulate your body’s natural renewal of collagen, and effecting skin tightening and contouring.
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