How to Tell If Slightly Uneven, Drooping Eyelids are Actually Ptosis and Require Surgery скачать в хорошем качестве

How to Tell If Slightly Uneven, Drooping Eyelids are Actually Ptosis and Require Surgery

A woman was told that she has upper eyelid ptosis of her right eye and that it's bilateral. She wants to know what surgery would be performed to correct it. Dr. Amiya Prasad, a cosmetic oculofacial plastic surgeon, explains that whenever he sees a patient with ptosis, he would ask how long the ptosis has been like that. He would also ask if it was something new or has been happening over time. A thorough history is critically important to establish the diagnosis of ptosis. If it was mentioned to the patient that they have ptosis, or if there was an incidental statement that they were never aware of, then it means that they were never bothered by it. Ptosis in itself is not a reason to do surgery unless the patient is concerned about the aesthetic appearance or if there is also a functional issue related to vision. In order to do a proper ptosis examination and to evaluate whether a person needs one eye or both eyes done, they ultimately would need a proper ptosis physical evaluation. The eyelid muscle called the levator muscle is very sensitive and there are certain things about that muscle that makes it more complicated to deal with. This is why 99.9% of board certified plastic surgeons don't do this type of surgery and this is the domain of the oculofacial plastic surgeons. That being said, one of the things that is tricky about ptosis is a particular physiologic basis called Hering's law that has to do with the amount of tone each eyelid receives. It's called muscle innervations or the amount of tension that muscle has. If a person lifts one eyelid, the other eyelid would actually come down. That's why during ptosis surgery, in the pre-operative photos, a person can look like one eye is low and the other eye is high. Then when a surgeon does just one side, the first side can look high and normal and the other side can be low. A patient has to decide if they are bothered about the ptosis at all. Within the normal population, 1- 2 millimeters difference between the eyes is accepted as normal and most people don't notice it. When people notice ptosis, it is because other people tell them. It takes several exact visits for Dr. Prasad to make a decision before he decides to move forward with a ptosis operation. When a person comes in with a relative subtle amount of ptosis, he wants to look at them at several times of the day. Maybe at the end of the day, they can be more fatigued and the ptosis is more prominent. Dr. Prasad recommends that she meet with qualified experienced oculofacial plastic surgeons who can guide her. She should get some opinions, look at their work and get a sense of what threshold would be right for her. She submitted one photo and it's clear that there's a slight difference between the two eyes, but for Dr. Prasad it's only slight. For more information, visit our website: http://prasadcosmeticsurgery.com/pras...