Eyes that look sleepy, ‘ptosis’, if you neglect it, may lead to reduce vision, and create forehead wrinkles
Eyes that look sleepy, ‘ptosis’, if you neglect it, may lead to reduce vision, and create forehead wrinkles
  • Philip Choi
  • 승인 2022.03.25 14:32
  • 댓글 0
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Ptosis affects tired eyes, forehead wrinkles if you neglect it, may lead to reduce vision
Double eyelids surgery is not enough to the effect of ptosis correction
Generalized surgery but it is not easy, need to open the possibility of re-surgery

If you are often told that you look sleepy and your impression is blurred, or if your eyes look sleepy even if you put pressure on your eyes, you may consider surgery to increase the size of your eyes. However, this may not be a simple cosmetic problem that can be solved by growing the size of eyes.

There is a muscle levator palpebrae superioris in the upper eyelid that opens the eyes. When the strength of the muscle is weakened, the upper eyelid sags downward and eyes look sleepy, a phenomenon called blepharoptosis. Generally, it is normal when the pupils are well exposed, but if there is ptosis, the upper eyelids cover the pupils, and in severe cases, the pupils are blocked, limiting the field of view. When the eyes are opened, if the pupils are covered by more than 2mm, it is considered ptosis. 

Various types of blepharoptosisCourtesy by Dr. Dongjun Yang, founder of Cheongdam U Beauty Medical CenterThere is ptosis, the upper eyelids cover the pupils, and in severe cases, the pupils are blocked, limiting the field of view. When the eyes are opened, if the pupils are covered by more than 2mm, it is considered ptosis.
Various types of blepharoptosis(Courtesy by Dr. Dongjun Yang, founder of Cheongdam U Beauty Medical Center)

Ptosis is divided into congenital and acquired. Congenital ptosis is caused by congenital weakness of the levator muscle due to heredity, and in acquired ptosis, injuries to the lavator muscle appear due to surgery such as double eyelid surgery. In addition, the causes of acquired ptosis include myasthenia gravis and other neuromuscular diseases. Although it is not an abnormality of the levator muscle, due to aging, the skin loses elasticity and the upper eyelid sags. 

If you have ptosis, you tend to lift your chin when you look at an object, and if the habit persists, your eye will become tired easily and your posture may deteriorate. Myopia and astigmatism may occur because the upper eyelid blocks the pupil, preventing the retina from focusing properly. In particular, congenital ptosis can interfere with the development of vision form an early age, leading to amblyopia. 
Also, there is a habit of raising the eyes using the forehead and eyebrows to raise the upper eyelids, which may cause deep wrinkles on the forehead. If you simply look at the wrinkles on the forehead cosmetically and try to improve them, problems may arise. 

Dr. Dongjun Yang, a founder of Cheongdam U beauty Medical Center, said, “Sometimes, unaware that he has ptosis, he simply gets botulinum toxin on his forehead to get rid of wrinkles on his forehead. It can be happened that the forehead muscle is paralyzed, it is impossible to use the forehead, so there is situation in which the eyes cannot open.”

Congenital ptosis can cause myopia and astigmatism because the upper eyelid blocks the pupil from a young age, preventing the retina from focusing properly, and it can interfere with vision and lead to amblyopia. (This image is not related to the content of the article)
Congenital ptosis can cause myopia and astigmatism because the upper eyelid blocks the pupil from a young age, preventing the retina from focusing properly, and it can interfere with vision and lead to amblyopia. (This image is not related to the content of the article)

In order to ptosis correction, the surgical method is decided after determining the degree of drooping eyelids and the function of the levator muscle. If the eyebrows do not move significantly when the eyebrows are opened while pressing the eyebrows firmly, the function of the levator muscle remains to some extent. If he can’t open his eyes well, the function of the levator muscle doesn’t remain.

If the function of the levator muscle remains, a part of the levator muscle is cut off and the upper eyelid is raised up to the length of the cut muscle and sutured. It is a method of strengthening the function by shortening the length of the muscle. If the eyelids are thin and not too sagging, it is possible to do it without a muscle incision. The length of the muscle is shortened by tying the middle of the levator muscle with a thread. If the levator muscle is not functioning or is too weak and resection is not sufficient for the treatment effect, the method of fixing the upper eyelid to the forehead muscle using an autologous fascia or artificial material is used to move the eyelid using the forehead muscle. 

These ptosis surgeries have been developed as ptosis correction over time. Recently, the effect of surgery has been applied for cosmetic purposes as well. Although there are no symptoms of ptosis, there are more cases of surgery to open the eyes larger and more clearly. 

There is a misconception that ptosis correction is double eyelid surgery. Double eyelid surgery is a surgery that creates wrinkles on the upper eyelid and gives the effect of making the eyes look bigger. Ptosis correction is a surgery that makes the pupils appear more clearly when the eyes are opened. If you have ptosis symptoms and you do only double eyelid surgery without correcting ptosis, the double eyelid line may be thickened, or the eye size may not change. Above all, functional discomfort will not be improved, so it is better to have ptosis surgery together. 

Dr. Yang emphasized, “For the ptosis correction, it is important to find an experienced doctor who can accurately diagnose your eyes and explain various cases that may occur after surgery.”
Dr. Yang emphasized, “For the ptosis correction, it is important to find an experienced doctor who can accurately diagnose your eyes and explain various cases that may occur after surgery.”

Ptosis correction is on of the most common surgeries performed in plastic surgery, but it is not a simple surgery. 

Dr. Yang said, “As a plastic surgeon, the pressure of only performing doubled eyelid surgery is less. Surgical results are easy to come by. But ptosis correction surgery is not like that. The ptosis surgery can be completed in 5 to 10 minutes as short as possible, but it can take as long as 30 minutes or even an hour at the longest. Humans all have some asymmetry, and it is difficult to make both eyes symmetrical with surgery alone. So, I explain to patients it would be good if it could be done at once, but there may be some asymmetry, so there is possibility that it will be corrected again later.” 

Additionally, he emphasized, “Therefore, it is most important to find an experienced doctor who can accurately diagnose your eye and explain various cases that may occur after surgery when you want to have ptosis correction.”


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