The Weekly Lid Referral for Failed Eyelid Lift

By Joseph Walrath, MD | May 14, 2012 | Blepharoplasty, Cosmetic Reconstruction, Eyelid Malposition, Ptosis, Reconstruction

It’s now 5 straight weeks in which I’ve performed a reconstructive ptosis surgery on a patient who had undergone two and sometimes three prior failed eyelid surgeries. ┬áMy rule of thumb is simple: I don’t do the same surgery twice if it failed the first time. One of the most recent patients who had recalcitrant ptosis of the upper lid is pictured below:




He had undergone two surgeries in the past, but the right lid remained low. In addition, a deep hollow was present above the lid on the right. My surgical goals involved a desire to match the left eyelid’s height and contour, with its slightly lateral lid peak. I also wanted to get rid of that deep hollow.

After lifting the lid to the appropriate height in the operating room, using a more advanced surgical technique (“levator resection”) than typical lid lift (“levator advancement”), I then proceeded to advance the superficial fat of the eye socket in an effort to fill out the deep space above the upper lid. Below is a postoperative week #1 photo (with a touch of swelling that still needs to go down).