I want to share a case I found difficult to put down — a revision after a ptosis correction that did not go as planned at another clinic.
Let me walk through this recent patient.
Before coming to us, she had undergone ptosis correction plus incisional double eyelid at another clinic. One eye had not turned out well, and her original surgeon brought her in to me himself.
This is the side that had failed. The conjunctiva was protruding, the mucosa was showing, and the lashes were excessively flipped upward.
Both eyes together. The patient's left eye clearly needed urgent attention.
The challenge with cases like this is that asymmetry tends to develop when a different surgeon does the revision. And operating on the relatively acceptable contralateral side at only one month post-op is a tough call.
As a rule, the best window for early revision is within two weeks of the original surgery; for smaller adjustments, six months out can also be a good time. The window between those — at one month — is harder.
When we do operate inside that one-month window, it is because the upside of revising now outweighs the downside of waiting.
Leaving her in this state for six more months would have been miserable for the patient, and a difficult position for her surgeon as well.
The revision usually takes about an hour.
One week post-op. The conjunctival prolapse has resolved and the eye shape looks much better. We will of course want to see how it looks at one month and six months as well.
Comparing the before-and-after, the improvement is clear.
From here it is a matter of watching the healing.
Her original surgeon did his best for her, but the most courageous thing was that he came in with the patient himself and asked an experienced colleague to take it from here.
Because the two eyes were operated on by different surgeons, there is a slight shape difference between them. We will see how things look beyond six months — if the residual asymmetry is acceptable, we leave it; if not, a further adjustment may be needed.
Even now, though, the shape is dramatically better than before.