Ptosis Surgery

This patient had very severe upper lid ptosis and was unable to see well due to his very

droopy lids. Ptosis repair was performed to help improve his lid position ability to see

well in her periphery.

Preoperative Diagnosis: Upper lid ptosis

Procedure performed: Upper lid ptosis repair

This patient has ptosis in his upper lids and excess fat pockets in his lower lids. A minimally invasive upper lid ptosis repair was performed. Lower lid blepharoplasty was

also performed at the same time to remove excess fat pockets in his lower lids.

This patient wanted an improvement in her upper lid position She has mild upper lid ptosis (droopy lids). A mild upper lid ptosis (micro ptosis) repair was performed. A small amount of skin was also removed. Notice the impr ovement in lid position and the symmetry between the two eyelids after ptosis surgery.

Patient Seeing Up

This 72 year-old male had droopy upper lids which were affecting his vision. He underwent upper and lower lid surgery to lift his upper lids and to rejuvenate his lower lids. A posterior approach ptosis surgery was performed to help lift his lids. Excess skin was also removed from his upper lids. After surgery, he was able to see better and look more refreshed.

Preoperative Diagnosis: Bilateral upper lid ptosis and brow ptosis, lower lid excess fat pockets.

Procedure performed: Bilateral upper lid ptosis repair (blepharoplasty) and external browpexy, lower lid blepharoplasty.

This patient had a right upper lid ptosis and it was affecting his vision and appearance. He underwent a minimally invasive procedure to lift the right upper lid. He has healed well and very happy with his results.

Preoperative Diagnosis: Right upper lid ptosis.

Procedure performed: Right upper lid ptosis repair.

This patient had droopy upper lids (ptosis) and also low set brows (brow ptosis). He underwent ptosis repair to lift his lids and his brows. The lid ptosis repair was done through a minimally invasive technique which allowed for rapid recovery. He did well and was able to look more awake and rested after having undergone surgery. He was also able to see better.

Preoperative Diagnosis: Upper lid and brow ptosis.

Procedure performed: Upper lid and brow ptosis repair.

This 66 year old female had severe ptosis in her left upper lid and was affecting her vision. She underwent a left upper lid ptosis repair using a minimally invasive posterior approach technique. No skin was removed. She has healed well and now sees better, looks more refresh and rested.

Preoperative Diagnosis: Left upper lid ptosis.

Procedure performed: Left upper lid ptosis repair.

This 58 year-old male had excess skin in his upper lids, which was causing him to have difficulty seeing.His brows were also low set which was worsening his excess skin in his upper lids. He also had lower lid bags and excess skin and underwent a lower blepharoplasty at the same setting. A blepharoplasty like incision was made to remove the excess skin in the upper lids. An external browpexy procedure was also performed to help stabilize and lift his brows and lids to more natural looking position. He looks more awake and refreshed after undergoing lid surgery.

Preoperative Diagnosis: Bilateral upper lid ptosis and brow ptosis, lower lid excess fat pockets.

Procedure performed: Bilateral upper lid ptosis repair (blepharoplasty) and external browpexy, lower lid blepharoplasty.

This is the same patient as seen above who had left upper lid ptosis (you can see the differences well in this view of the upper lid positions) and excess lower lid skin and some prolapse of orbital fat. Note the improvement in his lower lid appearance after undergoing surgery. He has natural-looking results with a significant improvement in his lower lid “excess” skin and you can also see how the prolapsed fat pads are not present anymore.

Preoperative Diagnosis: Bilateral upper lid ptosis, upper and lower lid dermatochalasia (excess skin) and fat prolapse.

Procedure performed: Bilateral upper lid ptosis repair, upper and lower lid blepharoplasty, lower lid chemical peel (TCA 30%).

Preoperative Diagnosis: Bilateral upper lid ptosis, upper and lower lid dermatochalasia (excess skin) and fat prolapse.

Procedure performed: Bilateral upper lid ptosis repair, upper and lower lid blepharoplasty, lower lid chemical peel (TCA 30%).

Preoperative Diagnosis: Bilateral upper lid ptosis, upper and lower lid dermatochalasia (excess skin) and fat prolapse.

Procedure performed: Bilateral upper lid ptosis repair, upper and lower lid blepharoplasty, lower lid chemical peel (TCA 30%).

Preoperative Diagnosis: Bilateral upper lid ptosis.

Procedure performed: Bilateral upper lid ptosis repair.

This 58 year-old male had excess skin in his upper lids, which was causing him to have difficulty seeing.His brows were also low set which was worsening his excess skin in his upper lids. He also had lower lid bags and excess skin and underwent a lower blepharoplasty at the same setting. A blepharoplasty like incision was made to remove the excess skin in the upper lids. An external browpexy procedure was also performed to help stabilize and lift his brows and lids to more natural looking position. He looks more awake and refreshed after undergoing lid surgery.

Preoperative diagnosis: Bilateral upper lid ptosis and brow ptosis, lower lid excess fat pockets

Procedure performed: Bilateral upper lid ptosis repair (blepharoplasty) and external browpexy, lower lid blepharoplasty

This 65 year-old female had excess skin in her upper lids and had difficultly seeing well. She underwent an upper lid ptosis repair to help remove the upper lid skin via a blepharoplasty-like procedure. She also underwent a cosmetic lower lid blepharoplasty with a chemical peel. She has healed well with little signs of having prior surgery and is very happy with her results.

Preoperative diagnosis: Bilateral upper and lower lid excess skin, lower lid aging changes with excess fat pockets.

Procedure performed: Bilateral upper lid ptosis repair (blepharoplasty), lower lid blepharoplasty with fat repositioning, chemical peel to lower lids

This62 year-old female had some excess skin in her upper lids which was resulting in her having difficulty seeing well. She had to raise her brows higher to see better. She underwent upper lid ptosis surgery; redundant skin was removed using a blepharoplasty incision. The incisions healed well and she looks more awake and can see better. She also underwent lower lid cosmetic blepharoplasty to remove her excess fat pockets along with a chemical peel.

Preoperative diagnosis: Bilateral upper and lower lid aging changes

Procedure performed: Bilateral upper and lower lid blepharoplasty, chemical peel to lower lids.

This 65 year-old female had undergone prior upper and lower lid surgery and now has droopy upper and lower lids (ptosis of upper lids and lower lid retraction). She has to raise her brows to see better. Upper lid ptosis surgery was performed using a minimally invasive technique. All the incisions on the upper lids were made internally so there are no visible scars. She also had lower lid revisional eyelid surgery using Alloderm graft and a canthoplasty. A lower lid blepharoplasty was also performed to remove her excess fat pockets. She has healed well and the upper and lower lids now rest in a more natural-looking position.

Preoperative diagnosis: Bilateral upper lid ptosis, lower lid retraction, lower lid excess fat pockets.

Procedure performed: Bilateral upper lid ptosis repair, revisional lower lid retraction repair using Alloderm graft and canthoplasty, and lower lid blepharoplasty.

This 38 year-old femalewished to undergo upper eyelid surgery to help remove the excess kin in her upper lids. The excess skin was resulting in difficulty seeing and headaches. She also noticed some mild hollowing in her lower lid infraorbital rim area (tear trough area), which looked like mild lower lid dark circles. She underwent an upper lid blepharoplasty to remove the excess skin. Restylane hyaluronic acid fillers were also used to place volume in her lower lids at the same time to help improve her dark circles. She appears more rested after surgery and able to see better. Her headaches have also improved. This photograph was taken four months after surgery.

Preoperative diagnosis: Bilateral upper lid ptosis, lower lid infraorbital hollowing

Procedure performed: Bilateral upper lid blepharoplasty, hyaluronic acid fillers to her lower lid infraorbital area using Restylane.

This 26 year old female has had a longstanding ptosis in her right upper lid and wished to have it repaired. She had such significant ptosis that her right brow was compensating to help lift her lid; as a result, her right brow was in a higher than normal position. She underwent a minimally invasive, posterior approach surgery to elevate the right lid to match her other side. No skin was removed; the whole procedure was done through incisions that are not visible. She healed well and was very happy with her results. Notice that her right brow also returned to a more normal position. She feels more awake appearing and feels great about herself and appearance.

Preoperative diagnosis: Right upper lid ptosis.

Procedure performed: Right upper lid ptosis repair using a posterior approach (no skin incision).

This 69 year-old female had droopy upper lids. They were affecting her vision and wished to have them repaired. A posterior approach ptosis repair was performed using a minimally invasive technique. No skin was removed. The patient’s photographs were taken three weeks after surgery and she had minimal to no swelling by the time her post operative photograph was taken. She sees better now and very happy with her more refreshed and natural look.

Preoperative diagnosis: Bilateral upper lid ptosis.

Procedure performed: Bilateral upper lid ptosis repair.

This 42 year old female had longstanding droopy lids in both upper eyes most likely from long term contact lens use and wished to have them repaired. She wanted to look more awake and be able to see better. She underwent an upper lid blepharoplasty to remove the excess skin in addition to ptosis repair to lift the lids. She healed remarkably well after surgery with little to no signs of having prior surgery.

Preoperative diagnosis: Bilateral upper lid ptosis and excess skin

Procedure performed: Bilateral upper lid ptosis repair, upper lid blepharoplasty

This 68 year old female had longstanding droopy lids, left worse than right. Notice how high her left brow is due to its compensation and trying to help lift the left lid up higher. She underwent a ptosis repair using a minimally invasive posterior approach technique. No skin was removed. The patient had minimal swelling and was able to resume most of her daily activities within a few days after surgery. She has healed well and can see better now and is very happy with her results. Note the improvement in her left brow position as well after surgery (it is not as high as it was prior to surgery).

Preoperative diagnosis: Bilateral upper lid ptosis.

Procedure performed: Bilateral upper lid ptosis repair.

This 78 year-old male was bothered by his droopy upper lids. He was having difficulty seeing well and had to raise his brows and lids to see better. He underwent upper lid ptosis repair. He also had a droopy left brow which was also affecting his vision. He underwent a minimally invasive left upper brow ptosis repair to help lift his brow. A cosmetic lower lid blepharoplasty was also performed at the same time. He has healed well in his post operative photos (3 months after surgery), can see better, and looks more refreshed.

Preoperative diagnosis: Bilateral upper lid ptosis and brow ptosis, lower lid excess fat pockets

Procedure performed: Bilateral upper lid ptosis repair, upper and lower lid blepharoplasty with fat repositioning to lower lids, and left external brow pexy

This 44 year old male had longstanding droopy lids in both upper eyes and wished to have them repaired. They were bothering him while driving and always looked tired. He underwent a ptosis repair to lift the lids and also an upper lid blepharoplasty to help remove the excess skin. He healed well after surgery and was able to see better and feel more rejuvenated.

Preoperative diagnosis: Bilateral upper lid ptosis and excess skin

Procedure performed: Bilateral upper lid ptosis repair, upper lid blepharoplasty

This child was born with a very ptotic eyelid which was blocking her from using the left eye. She would rub her left eye in an effort to try to help lift it up. She underwent a frontalis fixation ptosis surgery which requires the use of silicone suspension rods to keep her left eyelid elevated. She did well and regained vision in her left eye.

Preoperative Diagnosis: Left upper eyelid ptosis.

Procedure performed: Left upper eyelid frontalis fixation ptosis surgery

This patient had not only droopy upper lids but had excess skin hanging over her lashes resulting in difficulty seeing well. She also had an asymmetric brows such that her left brow was ptotic (more droopy than the right brow).

She underwent a mild upper lid ptosis repair and removal of her excess upper lid skin. She also underwent a left upper lid brow ptosis repair through an internal browpexy technique.

Preoperative Diagnosis: Upper and lower lid dermatochalasia, upper lid mild ptosis, mild upper lid ptosis, facial aging, and lower lid fat prolapse.

Procedure performed: Upper and lower lid blepharoplasty and periorbital fat grafting, mild ptosis repair. Deep plane face lift (facialplasty), brow lift, and periorbital fat and facial fat grafting performed by Dr. Richard Zoumalan.

Surgeons: Christopher Zoumalan, MD. Oculoplastic Surgeon; Richard Zoumalan, MD. Facial Plastic Surgeon, Beverly Hills, California.

This patient had a progressively droopy left upper lid. She has been a long time contact-lens user which has been associated with ptosis in younger patients. She underwent left upper lid ptosis repair and is now very happy with her results.

Preoperative Diagnosis: Left upper lid ptosis

Procedure performed: Left upper lid ptosis repair

This patient wished to have an upper and lower lid cosmetic blepharoplasty. He was unhappy about his asymmetric upper lids and “loose” skin in his lower lids. He had mild ptosis (droopy lid) of his left upper lid as well. He underwent upper lid ptosis (droopy lid surgery) repair as well as upper and lower lid blepharoplasty. He specifically underwent a lower lid orbicularis suspension flap (skin-muscle flap) blepharoplasty where the skin and muscle where re-suspended to allow for the removal of excess skin while tightening the underlying muscle layers. This is one of the types of techniques that Dr. Zoumalan uses when performing a lower lid blepharoplasty. The post-operative photo was taken four months after undergoing surgery. You can read more about this type of blepharoplasty technique at the PDF link below at the end of this page.

Preoperative Diagnosis Above: Upper lid ptosis and upper and lower lid dermatochalasia.

Procedure performed: Upper lid ptosis repair, upper lid blepharoplasty and lower lid blepharoplasty using a lower lid orbicularis suspension flap (skin-muscle flap) technique. Note how well the scars have healed. They are virtually undetectable even four months out from surgery.

This patient has always had “full” upper lids such that he has always had a mild amount of skin nearly draping above his eyelashes. He wished to undergo a conservative procedure that would allow for him to see better while also allowing for him to look closer to what he looked like years prior. He had low set eyelid creases with a double lid and wished to keep them at that position after surgery. The photo on the right was taken 3 weeks after surgery and you can already see the improvement in his upper lids. You can also see the very little swelling that he has. Some patients swell more than others after surgery, but Dr. Zoumalan uses rapid-recovery techniques to allow for optimal healing after surgery.

Preoperative Diagnosis: Upper lid dermatochalasia (extra skin) resulting in lid hooding and ptosis.

Procedure performed: Bilateral upper lid blepharoplasty.

Preoperative Diagnosis: Upper lid excess skin and lid ptosis (droopy lid) resulting in difficulty seeing well and a tired appearance, lower lid bags and excess skin.

Procedure performed: Bilateral upper lid blepharoplasty, upper lid ptosis repair, and lower lid blepharoplasty.

Preoperative Diagnosis: Upper lid and brow ptosis resulting in difficulty seeing well and a tired appearance.

Procedure performed: Bilateral upper lid blepharoplasty, upper lid ptosis repair, and upper lid external browpexy (brow ptosis repair).

Preoperative Diagnosis: Upper lid and brow ptosis resulting in difficulty seeing well and a tired appearance.

Procedure performed: Bilateral upper lid blepharoplasty, upper lid ptosis repair, and upper lid internal browpexy (upper lid brow ptosis repair done through an internal suture technique).

Preoperative Diagnosis: Upper lid and brow ptosis resulting in difficulty seeing well and a tired appearance.

Procedure performed: Bilateral upper lid blepharoplasty, upper lid ptosis repair, and upper lid external browpexy (upper lid brow ptosis repair).

This patient had extra skin (dermatochalasia) in her upper lids along with ptosis. Note the tired appearance of her eyes and lids. She also had a right nasal lesion that she wanted removed.

Preoperative Diagnosis: Bilateral upper lid ptosis and dermatochalasia.

Procedure performed: Bilateral upper eyelid ptosis repair and upper lid blepharoplasty (The eyelid position was lifted and excess skin was also removed). This photo was taken 3 months after undergoing the surgery.

The patient had significant upper lid skin and wished to have it removed to help improve her vision and also to look more younger and awake. She had no visible upper lid creases (had a “single upper” lid) and wished to undergo “double eyelid” surgery.

This photo is taken one month after surgery. She desired a lid crease position around 6mm in both upper lids and you can notice that she is healing well. There is still some swelling in the upper lid which is common in Asian eyelid surgery for up to 2 months. Although the results are subtle, she now has a double eyelid and also sees better and appears more awake.

Procedure performed:Asian eyelid (double eyelid) surgery

Surgeons: Christopher Zoumalan, MD. Beverly Hills, California.

Preoperative Diagnosis: Severe upper lid ptosis. The patient was born with mild congenital ptosis which got worse with age.

Procedure performed: Bilateral upper lid ptosis repair. No skin was removed. The procedure was performed through a minimally invasive posterior approach.

Preoperative Diagnosis: Severe upper lid ptosis.

Procedure performed: Bilateral upper lid ptosis repair. No skin was removed. The procedure was performed through a minimally invasive posterior approach.

Preoperative Diagnosis: Severe upper lid ptosis. The patient was born with mild congenital ptosis which got worse with age.

Procedure performed: Bilateral upper lid ptosis repair and blepharoplasty.

Preoperative Diagnosis: Severe upper lid ptosis. The patient was born with mild congenital ptosis which got worse with age.

Procedure performed: Bilateral upper lid ptosis repair. No skin was removed. The procedure was performed through a minimally invasive posterior approach.

Preoperative Diagnosis: Right upper lid ptosis.

Procedure performed:Right upper lid ptosis repair. No skin was removed. The procedure was performed through a minimally invasive posterior approach.

Preoperative Diagnosis: Significant upper lid ptosis.

Procedure performed: Bilateral upper lid ptosis repair. Excess nasal skin and protruding fat pads were removed through small incisions near the medial (nasal side) of the lid crease.

Preoperative Diagnosis: Right upper lid ptosis and bilateral upper lid excess skin (dermatochalasia).

Procedure performed : Right upper lid ptosis repair and bilateral upper lid blepharoplasty.

This gentleman had age-related ptosis which was worsened from multiple prior eye surgeries.

Preoperative Diagnosis: Right upper eyelid ptosis.

Procedure performed: Right upper eyelid ptosis surgery.

This gentleman had two prior eyelid surgeries for his ptosis but neither helped him. He underwent a ptosis surgery to appropriately elevate his upper eyelids. He was able to see better and have a more alert appearance as well.

Preoperative Diagnosis: Bilateral upper eyelid ptosis, persistent despite prior surgical attempts.

Procedure performed: Bilateral upper eyelid ptosis repair.

This female had dermatochalasia of her upper lids along with mild upper lid and brow ptosis of her eyelids. She also had some laxity in her lower eyelids which was causing her symptoms of tearing. She underwent an endoscopic brow lift, ptosis repair, and blepharoplasty in her upper eyelids. A minimal tightening of her lower eyelids was also performed which we term as a canthoplasty. You can appreciate that she appears more youthful in her appearance and can see better as well.

Preoperative Diagnosis: Bilateral upper lid dermatochalasia, eyelid ptosis, upper brow ptosis, and lower eyelid laxity.

Procedure performed: Bilateral upper eyelid blepharoplasty, ptosis repair, endoscopic brow lift, and lower eyelid canthoplasty.

This patient was bothered by a mild ptosis in her right upper eyelid from long-term contact lens use. She underwent an “adjustable” ptosis surgery on the right upper eyelid and did well with her recovery.

Preoperative Diagnosis: Mild right upper eyelid ptosis.

Procedure performed: Right upper eyelid ptosis repair using an “adjustable” technique.

This patient suffered a trauma to this right eyelid and eye several years ago which left him with a right ptotic eyelid. He was having difficulty seeing and it was affecting his self-esteem. Unilateral ptosis surgery is extremely challenging since patients often assume the results to be always symmetric with the other eyelid. We all have inherent asymmetry in our facial features to begin with and achieving symmetric results is often difficult and the patient needs to be aware of that.

Preoperative Diagnosis: Traumatic right upper eyelid ptosis.

Procedure performed: Right upper eyelid ptosis repair.

This patient had severe ptosis which was worsened with age. He had difficulty seeing and wished to have an improvement in his vision and appearance.

Preoperative Diagnosis: Severe bilateral upper eyelid ptosis.

Procedure performed: Bilateral upper eyelid ptosis repair.

This patient was having difficulty seeing with the extra skin hanging over his eyelashes. This is called blepharoptosis. By carefully removing his skinand respecting the natural appearance he wished to maintain, he was able to see and look better.

Preoperative Diagnosis: Upper eyelid blepharoptosis (dermatochalasia).

Procedure performed: Upper eyelid blepharoptosis repair/ blepharoplasty.

This patient had right upper eyelid ptosis which was worsened with age. She had difficulty seeing and wished to have an improvement in her vision and appearance.

Preoperative Diagnosis: Right upper eyelid ptosis.

Procedure performed: Right upper eyelid ptosis repair.

This patient had undergone prior upper and lower blepharoplasty in the past. He complained of a droopy appearance to his upper lids and irritation in both eyes due to the retraction in his lower lids. He had ptosis in his upper lids which may have worsened with time. He wished to have his eyelids appear more natural appearing, see better and improve his irritation.

The goal of my surgery was to help him see better by lifting his eyelids and also to correct the laxity and retraction he had in his lower lids. Retraction of the lower lids is a result of a downward displacement of the lower lids either from prior surgery (cosmetic or trauma), thyroid related problem, or just as a result of aging changes. The retraction in his lower lids prevents him from closing his eyes at well so he has problems with excessive exposure to the eye. This results in his irritation and redness to the eyes. As a result, he underwent bilateral upper lid ptosis surgery with no additional removal of eyelid skin though. He also underwent retraction repair to help lift up his lower lids to a more normal position by a canthoplasty. A canthoplasty is a type of a lower lid resuspension technique. You can read more about this in the following sections: 1) ectropion repair and 2) reconstructive lower lid surgery.

Preoperative Diagnosis: Bilateral upper lid ptosis and lower lid retraction.

Procedure performed: Bilateral upper lid ptosis surgery and lower lid retraction repair through a canthoplasty lid resuspension technique.

This patient has moderate right lower lid retraction in addition to mild upper lid ptosis. She is unhappy with the asymmetric appearance to her lids and wished to have them corrected. She also complained of a persistent ocular irritation to the right eye which was due to the lower lid retraction she had and subsequent dry eyes.

She underwent a mild upper lid ptosis repair and a right lower lid retraction repair using a lid resuspension technique (canthoplasty) and a posterior spacer tissue graft. We were able to improve the symmetry in her lids and also alleviate her ocular symptoms and dry eye syndrome.

Preoperative Diagnosis: Bilateral upper lid ptosis and right lower lid retraction.

Procedure performed: Bilateral upper lid ptosis surgery and right lower lid retraction repair through a canthoplasty lid resuspension technique and posterior spacer tissue graft.

Preoperative Diagnosis: Bilateral upper lid ptosis, upper and lower lid dermatochalasia (excess skin) and fat prolapse.

Procedure performed:Bilateral upper lid ptosis repair, upper and lower lid blepharoplasty, lower lid chemical peel (TCA 30%).

Preoperative Diagnosis: Bilateral upper lid ptosis, left upper lid lesion, lower lid laxity. Lower lid laxity was resulting in tearing.

Procedure performed: Bilateral upper lid ptosis repair, excision of left upper lid lesion, and canthoplasty (lower lid resuspension).