Droopy eyelids can be happen at birth (congenital ptosis) or it can also develop over time due to a nerve disorder, muscular dystrophy, past eye surgeries — and even excessive tugging of the eyelids.
Medically known as ptosis (pronounced “toe-sis”), the eyelid hangs over the eye ever so slightly, making a person with ptosis appear perpetually sleepy. In severe cases, the droopy eyelid can cover part of the pupil, interfering with vision. As a result, patients with droopy eyelids tend to constantly raise their brows to compensate for the weak lifting of eyelids, which can cause fatigue and headaches.
The good thing is, ptosis only affects appearance and does not affect actual physical health. Still, those pesky droopy eyelids can make it difficult to look sharp if they give the semblance of fatigue all the time.
If the eye is the window into the soul, then droopy eyelids are — quite literally — dowdy curtains that’re blocking light and energy from shining through.
Ptosis surgery can help to lift those curtains and let those peepers see the light of day, in its full glory.
An aesthetic procedure very much like double eyelid surgery, ptosis surgery is safe and advanced today. We cover the low-down on the different surgical techniques, what to expect in terms of procedure and the cost of ptosis surgery in Singapore.
What causes droopy eyelids?
Droopy eyelids are caused by weak levator muscles, making it difficult to lift the eyelids. Studies found that about 60% of the cases are caused by ageing, resulting in the loosening of the levator aponeurosis. 10% of cases are congenital ptosis, 11% are neurogenic ptosis (e.g. cerebral vascular incidents etc), while others are due to mechanical reasons such as trauma from eye procedures or eyelid tumors.
There’s also studies that found that the ptosis condition is also a common result of Botox and eye fillers administered by an inexperienced doctor.
Things like wearing contact lenses, eye rubbing and having cataract surgery done have all been implicated as potential causes of ptosis.
In particular, the study found that wearing hard or soft contact lenses was associated with increased risk of ptosis. The repeated stretching of the eyelid to pop in lenses can cause the eyelid muscle to weaken over time.
So yes, those eyelids are delicate things. Not just the skin mind you, but the muscles that werk to lift your lids up — day in, day out. Not a good idea to be chor lor about it as we apply eye make-up, put on lenses, cleanse our eyelids, etc. Don’t say we didn’t warn you!
3 types of ptosis surgery
The doctor would typically give a recommendation based on the cause of your ptosis and also the severity of eyelid droop.
The eyelid droop is measured by something doctors call the Marginal Reflex Distance (MRD). This refers to the distance between the upper eyelid and pupil. Your MRD should measure less than 2mm if you have droopy eyelids.
There are three ptosis surgical methods to treat droopy eyelids:
1. Suture Ptosis (also known as non-incisional ptosis)
The suture method is a scarless stitching method — very similar to the suture method that we talked about here for double eyelid surgery. This is done by stitching on the levator muscle to enable the tissue to lift the eyelid up accordingly. In general, this is more suitable for people with mild ptosis.
2. Incisional Ptosis
The incisional method is done by cutting through the droopy eyelid in order to reach the levator muscle. This is usually the most suitable method if you have moderate to severe ptosis and/or if you have excess eyelid fats or skin.
3. Frontalis Suspension Technique
The Frontalis Suspension method also uses sutures, but this time, the stitches connect eyelid tissue to the muscles located over the eyebrows — a bit like suspension cables of a bridge. This is suitable for severe cases involving weakened levator muscles as this allows your forehead muscles to substitute for levator muscles in lifting the eyelids.
Who should I see for ptosis surgery?
In Singapore, ptosis surgery is done by a plastic surgeon. Go to a reputable one who has done thousands of ptosis surgery cases as it is a delicate procedure that requires meticulous dissection at the eyelid area.
Ptosis surgery is usually performed under local anesthesia as a day surgery, and typically takes about 1 to 2 hours of operating time.
The risks of ptosis surgery
The eyelid muscle is delicate so choosing an experienced surgeon who knows how to handle the eyelid surgery with care and precision is paramount. Some risks that can occur during surgery include infection or scarring of the sutures.
The surgeon is also the best person to diagnose the cause and severity of your droopy eyelids, and from there, recommend the best procedure for your particular condition accordingly.
Another risk is more of an aesthetics concern, i.e. the results of your eyelids may not appear as what you desire. For example, it may not be as high as you’d wanted or conveyed to the doctor. Or somehow, the eyelids do not appear symmetrical on both sides after the procedure.
This boils down to communication with the surgeon, and making sure that both of you are on the same page in terms of the aesthetics of it.
A more severe risk is damaged nerves resulting in the complete loss of eyelid movement. This is considered very rare and should not occur if you choose a surgeon in Singapore with good experience and credentials.
The cost of ptosis surgery in Singapore.
In general, the ballpark cost of ptosis surgery in Singapore is about $5,000 to $10,000++ with local anesthesia.
If you are squeamish and want to opt for general anesthesia, i.e. to be unconscious during surgery, there would be an additional cost of hiring an anesthetist which may rack up the total bill to be in the range of $8,000 to $12,000++.
Can Insurance or Medisave be used for ptosis surgery?
Rejoice: ptosis surgery is considered a medical condition in the eyes of the Ministry of Health (MOH) in Singapore. So this makes your ptosis bill claimable under both insurance and Medisave.
Also read: Double eyelid surgery in Singapore: 21 FAQs You Must Know
However, do note that MOH requires you to get this verified with an ophthalmologist in order to claim Medisave for your treatment. The assessment by the ophthalmologist would entail measurements of your MRD — and it has to be less than 2mm.
Ptosis recovery — is it bearable?
There is no pain during the procedure as local anesthetic is applied to numb the eyelid area.
However, when the anesthesia wears off, you may feel a throbbing pain at the eyelids. They would also appear swollen and some bruising may occur. You are advised to apply a cold compress on the first two days to reduce swelling and prevent inflammation of the wound.
The swelling and bruising can last for up to two weeks. Full recovery of the eyelid skin will take up to three months.
If you’re keen to do ptosis surgery in Singapore, there’s nothing like reading reviews of surgeons who specialize in ptosis surgery online and poring over forums with ptosis surgery threads. Pro tip: ask to see before-and-after photos from your surgeon to gauge his work!
After all, plastic surgery has been likened to art and if your face is the canvas, you’ve got to like your artist, n’est-ce pas?
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[…] caveat: not everyone is suitable for the stitching method. If you have droopy eyelids (ptosis) or eyelids with excess skin, you may not be suitable for this non-incisional stitching […]