Ptosis correction surgery is designed to address upper eyelid drooping, a condition that may cause visual obstruction and eye fatigue. By strengthening or adjusting the function of the levator muscle, the procedure allows the eyelids to open more fully, restoring a clear visual field and enhancing the overall aesthetics of the eyes.
Eyelid ptosis refers to the upper eyelid covering part of the iris, causing the eyes to appear dull, heavy, or fatigued. In more severe cases, it may obstruct the visual field and lead to eye strain. Some individuals unconsciously recruit their forehead muscles to keep the eyes open, which over time can result in forehead fatigue or temporal headaches.
Eyelid ptosis refers to the downward position of the tarsal plate—the firm structure located beneath the eyelid skin near the eyelid margin. The levator muscle functions like a hand that lifts the tarsal plate; when it contracts, it pulls the eyelid margin upward, exposing the iris and allowing the eye to open. If the levator muscle is weak, the lifting force becomes insufficient, causing the tarsal plate—and thus the eyelid margin—to continue covering part of the iris even when the eyes are open. This levator-related dysfunction is what we refer to as true eyelid ptosis. Although the tarsal plate is not visible externally, we can infer its position and the strength of the levator muscle by observing the location of the eyelash root, which serves as a surface indicator of the eyelid margin height.
The levator complex consists primarily of the Müller's muscle and the levator palpebrae superioris (levator muscle). There are many potential causes of levator muscle weakness, and once internal medical conditions have been ruled out, surgical treatment may be considered.
In children, ptosis may obstruct vision or induce astigmatism that affects visual development. In adults, it may cause visual obstruction, eye fatigue, dullness, or aesthetic concerns. In such cases, surgery can help restore a brighter and more refreshed appearance.
When the eyes cannot fully open, we sometimes rely on lifting the eyebrows to assist in opening them. For self-assessment, it is important to first eliminate the influence of the eyebrows. When the eyes are closed and fully relaxed, the eyebrows should naturally return to a neutral, original position. Begin by closing your eyes, then use your fingers to gently press down on the eyebrows to prevent them from lifting. Open your eyes and look into the mirror. Observe how much of the iris is visible. If part of the iris is covered, move closer to determine whether the obstruction comes from the eyelid skin or the eyelid margin (lash line). If it is the eyelid margin, you may refer to the severity levels above to determine whether you have levator muscle weakness.
The following symptoms may accompany levator muscle weakness. Strengthening the levator muscle during surgery can simultaneously improve these upper eyelid-related conditions:
This method shortens the working distance of the levator muscle to enhance its lifting efficiency, without removing any tissue.
Through an incision on the conjunctival side, the levator complex is accessed to either shorten the levator's working distance or excise a portion of the levator muscle, thereby enhancing its function by reducing its effective length.
For mild levator muscle weakness, a small skin-side incision is made at the mid-portion of the upper eyelid to shorten the levator muscle and improve its lifting function.
Entering from the skin side, the levator function can be enhanced either by shortening the levator muscle's working distance or by excising a portion of the levator aponeurosis.
When the levator function is significantly weakened, the elasticity of the conjunct fascial sheath can be utilized to enhance the efficiency of the levator mechanism.
If the levator function is severely weakened, or if the orbicularis oculi muscle has been compromised before surgery, the amount of strengthening required may lead to temporary lagophthalmos lasting from one week to one month postoperatively. As long as artificial tears and ophthalmic ointment are used according to medical instructions, most patients gradually recover over time.
One week before surgery:
・Discontinue double-eyelid tapes for at least one week.
・Stop anticoagulant medications (such as aspirin) after confirming with your prescribing physician.
・Stop all dietary supplements (including fish oil, ginkgo, ginseng, and vitamin E).
・Avoid smoking and alcohol from one week before surgery until one month after surgery.
On the day of surgery:
・Arrive with no makeup and remove any eyelash extensions.
・Do not wear accessories or metal items; remove piercings in advance.
・If you wear contact lenses, you may arrive wearing them, but they must be removed before surgery. Please bring a lens case, glasses, or sunglasses for after the procedure.
・Local anesthesia does not require fasting; you may eat and drink as usual.
・Please refrain from driving or riding a motorcycle afterward.
・Cold and warm compresses: Apply cold compresses during the first 72 hours after surgery to help reduce swelling and bruising. After 72 hours, you may begin warm compresses to enhance circulation and promote healing.
・Wound care and dressing changes: Keep the incision area dry and change the dressing as instructed. If skin sutures are present, they are generally removed around 6–10 days postoperatively depending on healing.
・How to change the dressing: Clean the wound twice daily using sterile cotton swabs dipped in normal saline, pat dry, and apply the prescribed ointment. When performing cold or warm compresses, place a layer of gauze between the skin and compress to avoid infection.
・Medications and ocular hygiene: Use the prescribed eye drops and/or ointment as directed to prevent infection and promote healing.
・Eye use and daily habits: Avoid prolonged screen time (mobile phone or computer) or long periods of looking downward to allow adequate rest for the eyes.
・Diet and medications:
- Take pain relievers as prescribed to ease postoperative discomfort.
- Avoid irritant foods and substances such as tobacco, alcohol, tea, coffee, spicy foods, and supplements (e.g., vitamin E, lingzhi, traditional Chinese medicine).
- Maintain a light diet, drink sufficient water, and increase intake of high-protein foods and vitamin C to support wound healing.
TEL 02-2700-8069
Add Our Official LINE
2F, No. 263, Sec. 1, Dunhua S. Road,Da'an District, Taipei City 106, Taiwan
Our clinic operates by appointment only.