Restorative eyelid surgery

Cause and treating of entropion

The most frequent cause is the loss of elasticity in aging tissue, weakening the eyelid structure.

In rarer cases, this imbalance may have trauma-based origins.

Treating the entropion

In all cases the eye must be protected with an eyewash and lubricating ointment. In most cases, a surgical procedure is highly recommended.

The chosen eyelid surgery is based on clinical assessment to determine the nature of the problem.

The specific case of spasmodic entropion

In some cases, the entropion may be caused by hyperactivity of the orbicularis muscle (combined with tissue slackness). In this context, I recommend Anti Wrinkles Treatment injections to weaken the orbicularis muscle and to treat the entropion permanently.

Practical information

• Anaesthetic : potentiated local (neuroleptanalgesy)
• Length of the procedure : around one hour
• Hospitalization : ambulatory
• Downtime : 5 to 8 days (with an eyewash and ointment treatment)

Complications and risks

In rare cases, bleeding, infections and other complications may occur. These issues should be discussed prior to the operation. In the majority of cases, patients are satisfied with results.

Cause and treating of ptosis

Ptosis, also known as, “palpebral ptosis” or “blepharoptosis”, is when the upper eyelid collapses as a result of complications with the levator muscle in the upper eyelid. It can be unilateral or bilateral.

Ptosis is diagnosed when the eyelid is no longer in the normal position: It collapses and can occasionally obstruct the field of vision, or even affect the eyesight if it covers part of the pupil.

Based on the level of sagging, a distinction is made between minimal, moderate, and severe ptosis. Muscle strength is assessed after a series of eye exercises and this determines the necessary surgical procedure.

The causes of ptosis

There are multiple causes of palpebral ptosis: Muscle deficiency may be hereditary, trauma-based, or related to a neurological or muscular condition.

Congenital ptosis is one that is present from birth where the origin is neuromuscular.

A highly-particular form of ptosis also exists, called “Marcus Gunn Syndrome”. This is a rare form of ptosis associated with eyelid retraction when the patient opens their mouth or chews.

With age, the levator muscle in the eyelid may become dislodged and lead to a collapsed eyelid.

Treating ptosis

Reinserting the aponeurosis would place the muscle back in its original anatomic position. Muller muscle resection is the shortening of a small muscle located on the posterior side of the eyelid.

The main advantage of this technique is that it is performed without any incision made to the skin. Nevertheless, this surgery is only recommended for specific clinical criteria and has not proved to be 100% efficient for every case

Practical information

• Anaesthetic : local (so that real symmetry can be obtained from an active face)
• Length of the procedure : around one hour
• Hospitalization : ambulatory
• Downtime : 5 to 8 days (with an eyewash and ointment treatment)

Complications and risks

A surgical procedure performed on an abnormal muscle is not always predictable and thus, post-operative eyelid symmetry and corrective eyelid surgery are not always possible. Hypercorrection or hypocorrection are some issues that may occur.

Following ptosis surgery, temporary non-occlusion (eyelid closing defect) is frequently observed; which usually improves rapidly. In rare cases, bleeding, infections and other complications may occur. These issues should be discussed prior to the operation.

Notably, the eyelid is the eye’s protective membrane. It ensures the eye is well lubricated. The ideal position is determined by anatomic layout and there is usually a perfect balance between the upper and lower eyelids.
Any imbalance may lead to anomalies concerning the eyelid position and can have direct consequences on the eyeball.