Medical Eyelid Surgery
Our clinic's ophthalmologists, Dr. Ashenhurst and Dr. Hill, can assist with different medical eyelid surgeries in Calgary. Medical eyelid surgery can help with eye conditions like ptosis and blepharoplasty. Depending on the surgery and the severity of your condition, Alberta Health may cover the surgery.
Types Of Procedures
Ptosis is the term used when the upper eyelid droops. There are multiple causes as to why this occurs. There can be problems with the eyelid muscle, nerve or tendon. Some ptosis is due to the heaviness of the brow, and the eyelids themselves are normal. When ptosis is due to excessive skin and fat, this is called mechanical or functional ptosis.
Alberta Health Care will NOT cover a functional repair cost unless the skin fold covers more than half of your pupil. This is considered to be a cosmetic blepharoplasty instead of medical eyelid surgery and is not insured. If the eyelid muscle is still functional, a tightening of this muscle will be performed. We can tighten either from the undersurface of the lid or through the skin.
There are various treatment options for ptosis, depending on the cause of your ptosis.
Aponeurotic ptosis is the most commonly acquired type of ptosis and the most common cause of ptosis. It typically occurs due to aging. An aponeurotic repair requires the shortening of the aponeurotic muscle of the levator to treat ptosis.
Levator resection refers to a surgery that shortens the levator muscle. It is typically used when patients still have some amount of levator function. When children have congenital ptosis, they usually require a larger levator advancement than adults would.
Frontalis Sling - Fascia/MersileneFrontalis Sling - Fascia/Mersilene
For this procedure, the ophthalmologist will harvest some of the fascia muscle or use a synthetic alternative to create a sling. The sling will aid in pulling the eyelid up. A frontalis sling is helpful in cases where there is very little function left in the levator muscle. TARSORRHAPHY is a surgical procedure by which the upper and lower lid margins are united. This is usually done to improve eyelid closure or to correct uneven lid openings.
A browplasty elevates the eyebrows back to a normal position and can be done by various techniques. While a browplasty is typically a cosmetic procedure, it can also be used medically to repair acute eye ptosis, causing severe vision blockage.
Lateral Canthal Tightening
Lateral canthal tightening tightens the lower lid's tendon and is frequently combined with blepharoplasty to correct or prevent sagging of the lower lids.
Lid lengthening is required when the upper or lower eyelid has been shortened by scar tissue. Relaxing incisions are made on the inside of the lid to release the scar tissue. In severe cases, a graft is required to support the eyelid.
Entropion is a condition in which the eyelid and lashes roll in and rub against the cornea. Several types of eyelid operations are performed for the correction of this condition.
Ectropion is when the eyelid rolls outward. Surgery is aimed at tightening loose tissues or releasing scars. Sometimes skin grafts can be used to treat ectropion.
Scleral Show Treatment
Scleral show is a term referring to the white area under the cornea being visible. Scleral show is normal in many people but not everyone. It can be more noticeable following any lower lid surgery, including blepharoplasty. It can also result from thyroid eye disease (bulging eyes), strabismus, or strabismus surgery.
There are various treatments available to treat scleral show, including a skin graft, lifting techniques, blepharocanthoplasty paired with a brow lift, or the use of fillers. Our ophthalmologists will be able to help you determine the best treatment plan.
Dermatochalasis is a condition resulting from the loss of elastic tissue and relaxation of the skin and the underlying muscles in the upper and lower lids. This is often associated with orbital fat prolapse, in which normal fatty tissues bulges forward in the lid. This fatty tissue causes puffiness or "bags," which gives a tired or sad appearance.
Dermatochalasis is treated through blepharoplasty, which removes the excess skin, fat and muscle, getting rid of the puffiness.
Lesion Removals & Chalazion Incision & Drainage
A chalazion is a small cyst that develops on your eyelid. Sometimes a chalazion can go away on its own, but sometimes it can get blocked and require draining. If your chalazion starts to block your vision or does not go away after months, it is important to seek medical attention.
Typically lesion removals and chalazion incision and drainage are performed under a general anesthetic for children. Please follow the same post-op care as other eyelid surgeries. We do not typically request a follow-up afterwards unless specifically requested by your ophthalmologist.Contact Us To Learn More
- You should take things easy over the next week—no sports or swimming for a week after the operation.
- You may begin icing once home after surgery. Use a cloth soaked in a bowl of ice water or use cold gel packs for 10 minutes every 2 hours or so the day of surgery. This decreases swelling. You may change to warm compresses for 10 minutes, 3-4 times per day in a few days once the initial swelling has resolved. The warm compresses will help improve circulation.
- Be sure to place an old towel over your pillow to prevent staining. It is normal for the wounds to leak over the first night or two.
- A follow-up will have been scheduled for you, if necessary, at our office on 17th Ave SW. We will give this to you on the day of surgery or by email. Sometimes you can do your follow-up with your referring doctor if you are from out of town.
- If you haven't received a follow-up, expect a call from our office to schedule one in the next couple of days.
- Any sutures should be kept lubricated with Maxitrol or Tobradex ointment twice a day for two weeks.
- You may use a cleanser, such as Baby shampoo or SkinCeuticals Gentle Cleanser, after 24 hours to keep your sutures clean. Mix the cleanser with warm water and use a clean face cloth to gently wash away any crusting on or around the suture line twice daily.
- You may give Motrin, Tylenol, or Advil as needed.
What Is Normal After Surgery?
- Some bleeding and oozing are expected for the first day or two.
- Bruising, redness, and often swelling last two weeks or more and are a normal reaction to the sutures.
- Small bumps and crusting around the sutures are common.
- Some sutures may come out in a few days, which is not a problem if the wound remains closed.
- Most people's lids still look puffy, uneven, and bruised for at least a week or two after the surgery. Don't panic! Completion of the healing process can take months, and there will be an ongoing improvement.
- The incisions may get itchy, lumpy, or red for a time as they heal. This is normal!
- Numbness in the eyelash area is common for a month or so after surgery.
What Is NOT Normal After Surgery?
- Uncontrolled swelling, bruising, pain, or loss of vision are medical emergencies. If this happens, contact Dr. Ashenhurst during office hours by calling 403-245-3171. You may also go to the nearest emergency department or contact HealthLink (Dial 811).
- Excessive bleeding is rare. If your child should experience excessive bleeding, apply pressure on the wound with ice packs. Have them lie quietly with their head elevated. Contact us if the bleeding is uncontrolled.
- Loss of stitches and opening of the wound is not an emergency but should be addressed within a day or two. Please call the office, and we will arrange for you to be seen as soon as possible. Often the wound can be closed with tape or re-sutured without affecting the final scar.
- Yellow, green, or foul-smelling pus draining from the incision is not normal. Please advise us if you experience this as soon as possible.
Rescheduling Or Cancelling
If you need to cancel or reschedule the surgery, we need at least one week's notice. If you do not provide one week's notice, there will be a rebooking fee of $500. Exceptions are made for emergencies with supporting documentation. Please call 403-245-3171 as soon as you can.
Contact our office for any other questions about your upcoming ptosis surgery.