What Is Ptosis?

Ptosis is a condition in which the upper eyelid droops or closes involuntarily. This is different from having excess or hooded eyelid skin, which may also make the eyes look droopy. Ptosis may develop in childhood or adulthood as a result of a compromised or stretched eyelid muscle. One or both eyes may be affected. Patients often feel that the droop is more noticeable when they are tired and in photographs. 

What Causes The Eyelids To Droop?

There are two muscles that lift the eyelid, called the Muller’s muscle and the Levator.  Ptosis results from an anatomical or functional abnormality of one of these muscles. Potential causes include:

  • Congenital ptosis is caused by natural levator muscle weakness.
  • Levator aponeurosis dehiscence is a common age-related stretching and thinning of the levator muscle.
  • An Infection or inflammation causing significant swelling of the eyelid may lead to stretching of the muscle
  • A growth or tumor on the eyelid or in the eye socket  Dysfunction or damage of the nerve innervating one of the muscles A growth such as a sty on the eyelid

While most ptosis is caused by stretching of the muscle, a thorough examination is necessary to assess eyelid function, establish the correct cause and recommend the right treatment.  

What Is Ptosis Repair Surgery?

Ptosis repair is a term that describes various surgical techniques performed to lift the eyelid into the proper position. There are two muscles that lift the eyelid.

The Muller’s muscle is smaller and located on the back (posterior) portion of the eyelid. It lifts the eyelid about 2 millimeters. The other, larger muscle is called the levator and lifts the eyelid 14-15mm. The two common techniques work by tightening one of these muscles.

The Muller’s muscle is tightened via the posterior or internal approach, without a visible scar, in patients with mild ptosis. Levator advancement is often utilized in those with more significant drooping. Either of these procedures can be combined with blepharoplasty surgery when both are necessary for the best results. Dr. Levin performs both techniques for ptosis repair in her Westport, CT office to help patients treat drooping eyelids and rejuvenate the eyes.

Ptosis Repair Procedure

Ptosis repair is typically conducted in an outpatient setting. Findings of the diagnostic evaluation performed during the initial consultation dictate which surgical approach is taken. 


External ptosis repair is done in people with moderate to severe ptosis and adequate levator muscle function. In this technique, a local anesthetic is administered in conjunction with light IV sedation. An incision is then made in the natural crease of the upper eyelid. The levator muscle is tightened, and its attachment is repositioned to the connective tissue in the eyelid (the tarsus). Towards the end of the procedure, the patient is asked to open their eyes to ensure. The best eyelid position, contour, and symmetry. Internal ptosis repair tightens the Muller’s muscle. This technique is best for patients with mild ptosis. 

As this procedure is short, it is generally well-tolerated with local anesthesia alone or in combination with oral or IV sedation. As the name implies, the incision is on the inner aspect of the eyelid, without a visible scar. Dr. Levin uses dissolvable sutures with this approach, eliminating the need for their removal.   In patients with ptosis and excess or hooded eyelid skin, ptosis surgery is usually combined with upper blepharoplasty for the best results. It can also be combined with lower blepharoplasty in those desiring to rejuvenate the entire eye area.

Before & After Ptosis Repair

What Is the Recovery After Ptosis Surgery?

As with most eyelid procedures, ptosis correction recovery is about 1 week. In the first 48-72 hours, swelling and bruising may worsen, with rapid improvement after. Icing is recommended for the first 48 hours while awake. The eyelid(s) may feel tight, look droopy or open, and look asymmetric. This is all normal and improves as the swelling resolves and the tissues heal. Patients are usually seen 6 days after their surgery for evaluation and suture removal when needed. Normal physical activity can be resumed 7-10 days after surgery and eye makeup in 12-14 days. 

Risks Of Ptosis Repair Surgery

It is important to undergo ptosis repair performed by a board-certified oculoplastic surgeon who is familiar with the unique characteristics of this condition. Unfortunately, ptosis often goes unrecognized or undiagnosed, leading to unsatisfactory eyelid surgery results. As an oculofacial plastic surgeon, Dr. Levin has additional training and experience that enables her to diagnose and treat ptosis. While uncommon, there are a few risks associated with ptosis repair, including under or overcorrection, asymmetry, and dry eye. A revision or additional surgery may be undertaken in rare instances of failure to improve the eyelid position further. 

Ptosis Repair FAQs

What is the cost for a ptosis repair with Dr. Levin?

What is the cost for a ptosis repair with Dr. Levin?

The cost for ptosis repair is $4500 for bilateral and $2500 for unilateral.

Our Patient Reviews

Dr. Levin is an excellent doctor. I received Botox injections and fillers under my eyes, cheeks and temples. She was very thorough and took her time explaining and answering all my questions. The wrinkles were smoothed and my entire face looks much more youthful and rested. I would absolutely without hesitation recommend Dr. Levin to all my friends. The results are amazing.

I had surgery with Dr. Levin for droopy eyelids. From the first to the last appointment I felt as if I was her only patient. She spent as much time with me as needed, answered all my questions and alleviated all my concerns. The surgery went very well, and I’m very happy with the results. Everything you would want from a doctor! Highly recommend.

Saw doctor Flora Levin for a Botox consultation. She took her time explaining everything to me, and was very thorough. I scheduled the procedure, and was very happy with the results! She followed up within a week after the procedure to check, and make sure i got the results that i expected. Would highly recommend!

Dr. Levin is extremely knowledgeable in the field of cosmetic surgery and cosmetic rehabilitation. Her diagnosis is astute and her hands are gentle. She is most generous with her time. It is the patient and not the clock that comes first. I have already recommended Dr. Flora Levin to a great many colleagues.

Dr. Levin is an outstanding surgeon. She somehow takes the time to fully understand a patient's goals and expectations. My procedure was over two years ago and I still cant believe how good I look and feel! I would highly recommend her to anyone! PS I was told I look more like the sister of the bride rather than her mom! Thank you, Dr Levin!!!

“Dr. Levin was amazing! She answered all my concerns and thoroughly explained everything to me prior to the procedure and even though I was awake, Dr. Levin’s calm and reassuring presence made me feel perfectly at ease during the relatively painless procedure. My recovery went quickly and smoothly and I couldn’t be more thrilled with the cosmetic result. The change in my look is subtle and natural looking. I am so pleased I chose Dr. Levin to do my surgery. I look refreshed and awake now and I wish I had it done sooner!”

“Dr. Flora Levin is the most caring, professional doctor I have ever encountered. She preformed eyelid surgery on me, and she is a true perfectionist. I am always told how beautiful my eyes are. Thank you Dr. Levin. I think you are wonderful!!!”

Significant "smoker's lines" (I've never smoked a day in my life!) and "elevens," both from a life of expressiveness now come back to haunt me! Met Dr. Levin at Yale and followed to her office in Bridgeport. She's a "doctor's doctor" in my opinion, with brilliant knowledge, wonderful manner, patience and finesse in her work. Absolutely worth it!

Dr. Levin operated on me. I am an R.N. working with plastic surgeons. I was very picky regarding my choice of cosmetic, oculoplastic surgeons. She was the right choice. I couldn't be happier. The office staff was very helpful as well. The atmosphere was welcoming and professional. I would highly recommend Dr. Levin.

I am in awe of the artistry of her work and am ecstatic with the results of my surgeries. I felt very comfortable during my office visits because she spent the time with me. I also felt very comfortable during my recoveries. My face used to be crooked and now it is symmetrical. My eyes are no longer hooded and she has given me a wider field of vision. An unintended consequence is that I look years younger and the results are very natural. I am a very happy patient and I highly recommend Dr. Flora Levin without reservation.

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