Ptosis Repair Surgery: What Dallas Patients Should Know About Droopy Eyelid Correction

Ptosis, the medical term for drooping of the upper eyelid, is a condition that affects patients across the age spectrum. It can cause a tired or aged appearance, impair peripheral or even central vision in severe cases, and significantly affect quality of life. Dr. Tanya Khan, a board-certified ophthalmologist and fellowship-trained oculoplastic surgeon serving Dallas, Plano, and Fort Worth, specializes in ptosis evaluation and surgical repair.

What Causes Ptosis?

Aponeurotic Ptosis

The most common type in adults. Caused by stretching or detachment of the levator aponeurosis, the tendon connecting the levator muscle to the eyelid. This is age-related, progressive, and may be accelerated by contact lens wear or eye rubbing. The levator muscle itself is intact; it is the attachment that has weakened.

Myogenic Ptosis

Caused by a disorder of the levator muscle itself, such as chronic progressive external ophthalmoplegia or myasthenia gravis. Identifying and treating the underlying neuromuscular condition is an important component of management.

Neurogenic Ptosis

Caused by a problem with the nerve supply to the levator muscle. Horner’s syndrome and third nerve palsy are the most common causes. Ptosis of sudden onset, particularly if associated with double vision, headache, or other neurological symptoms, requires urgent evaluation.

Congenital Ptosis

Present from birth, usually due to maldevelopment of the levator muscle. Congenital ptosis requires prompt evaluation and treatment in children to prevent amblyopia (lazy eye) from developing due to visual axis obstruction.

Ptosis vs. Excess Eyelid Skin (Dermatochalasis)

This is one of the most important distinctions in oculoplastic surgery. Ptosis is drooping caused by a problem with the muscle or its attachment, the eyelid margin itself is low. Dermatochalasis is excess upper eyelid skin that overhangs the lashes, but the eyelid margin is in a normal position. The treatment is different: ptosis repair elevates the eyelid margin; blepharoplasty removes excess skin. Some patients have both and benefit from both procedures.

Ptosis Repair: Surgical Options

Levator Advancement

The most common surgical approach for aponeurotic ptosis. The surgeon tightens or reattaches the levator aponeurosis to the eyelid through an incision in the upper eyelid crease. This is typically performed under local anesthesia so that the patient can open their eyes during surgery, allowing precise height and contour adjustment.

Mullerectomy (Posterior Approach)

An internal approach that tightens Muller’s muscle from behind the eyelid. Performed in patients with good levator function who respond to phenylephrine eye drops.

Frontalis Suspension

For patients with very poor levator function, including many cases of congenital ptosis, the eyelid is suspended from the frontalis brow muscle using a sling.

Insurance Coverage

Ptosis repair is a functional procedure when the drooping eyelid is causing documented visual field obstruction. In these cases, health insurance, including Medicare, typically covers the surgery. Dr. Khan’s team assists patients with the documentation and prior authorization process.

Dr. Khan provides ptosis repair and eyelid surgery to patients in Dallas, Plano, Fort Worth, Austin, and throughout North Texas. To schedule an evaluation, contact Khan Eyelid Surgery today.

For more information about procedures and treatments at Khan Eyelid and Facial Aesthetics by Ophthalmic surgeon Dr. Tanya Khan. Click here to contact us.

Taking patients from in and around Dallas, Plano, Fort Worth, Grapevine, Garland, Mesquite, Carrollton, Irving, Frisco, Texas and more.