As the skin ages, changes can appear across the entire body, including the eyelids. Collagen production slows, muscle tone weakens, and the skin begins to sag. Around the eyes, these changes can lead to drooping eyelids that may obstruct vision or affect facial appearance.
At The Mack Cosmetic Center in Tampa, we offer surgical solutions for dermatochalasis and ptosis to help correct these concerns. These conditions often involve excess skin or weakened muscles around the eyelids. Surgery can address both function and appearance with long-lasting, natural-looking results.
What Is Dermatochalasis?
Dermatochalasis of the eyelid refers to excess skin that hangs over the upper or lower eyelid. It often looks like loose or crepey skin that can bunch up or weigh down the eyelid. In some cases, the tissue presses on the lashes or even blocks part of your vision. You might notice a tired or heavy look around the eyes, especially toward the end of the day. We usually see this more in older patients, but it can also appear earlier depending on genetics and skin elasticity.
What Causes Dermatochalasis?
Dermatochalasis of both upper eyelids usually develops from age-related changes in the skin around the eyes. As collagen breaks down, the skin loses support and starts to sag. Genetics can speed this up, especially if your parents or siblings have dealt with similar issues. Some patients also develop it after long-term sun exposure, which breaks down the skin’s structure. It is also more common in patients with certain medical conditions like thyroid eye disease or chronic swelling.
What Is Ptosis?
Ptosis is defined as the drooping of the upper eyelid. The two classifications of ptosis are “congenital” and “acquired”. Most of the patients who present with ptosis at The Mack Center have the acquired type of ptosis. Ptosis can cause visual loss, particularly with obstruction of the peripheral vision. Patients may also notice difficulty with reading, as the ptosis is often worsened when looking down. Ptosis will also decrease the overall amount of light that reaches the eye and can reduce visual acuity, particularly at nighttime.
What Causes Ptosis?
The two types of ptosis are congenital and acquired. By far the most common presentation at the Mack Center is acquired. This is secondary to involution or aging changes of the eyelids. The second cause of ptosis is congenital, which is due to problems with the development of the muscle that raises the eyelid.
What Kinds of Symptoms Would a Patient Have with Ptosis?
Patients with ptosis typically present to the Mack Center with complaints of loss of the superior visual field and peripheral vision. Patients note difficulty driving, reading, and interference with other daily activities. This condition can only affect one eyelid, though most times it will affect both upper eyelids. Ptosis is a progressive condition, and usually will progress slowly over many years.
How Are Dermatochalasis and Ptosis Diagnosed?
We diagnose dermatochalasis and ptosis through a physical exam and a review of your symptoms. During your visit, we check the position of your eyelids, the strength of your eyelid muscles, and how much the skin may be affecting your vision. We might ask if you’ve noticed changes in your peripheral vision or any fatigue around the eyes. In some cases, we perform a visual field test to measure how much of your vision is blocked. Photos can also help us document the eyelid position and guide surgical planning.
How Do We Treat Dermatochalasis and Ptosis?
The treatment for ptosis is surgery, with various surgical options. The surgery is performed on an outpatient basis. During the patient’s initial evaluation, ocular, medical, and surgical histories are obtained to identify appropriate candidates for ptosis repair. It is very important that the surgeon be aware of any history of dry eyes. The discussion of any coagulation problems or blood thinners will also be ascertained, as well as any history of thyroid eye disease, previous eyelid surgery, or eyelid trauma. Dr. Mack will then perform the examination to measure the position of the upper eyelid height and crease and to measure the amount of functioning of the muscle that lifts the eyelid. This information will be used to determine the surgical procedure to correct the ptosis or dermatochalasis.
Less common types of ptosis can also be diagnosed through other tests, which are also performed after the initial consultation with Dr. Mack. Commercial insurance carriers and Medicare may cover the surgical repair of ptosis if the impairment of the peripheral vision meets certain criteria. During the patient’s initial test, visual field testing will be obtained with the eyelids taped and untaped to determine the level of the patient’s functional impairment of the peripheral vision and also the potential for visual improvement. External photographs will also be obtained, and the visual field and the external photos will then be sent to the commercial insurance carrier for predetermination of the surgery.
What Type of Anesthesia Is Used for Dermatochalasis and Ptosis Surgical Correction?
The type of anesthesia used for dermatochalasis and ptosis surgical correction is IV sedation (MAC anesthesia), which is performed as an outpatient. MAC anesthesia is a procedure where the anesthesia team administers small increments of a sedative to allow the patient to be relaxed, at which time the local anesthetic is administered for the patient’s comfort. Patients find this to be a very comfortable means to have surgery. Immediately following the surgery, ice packs will be placed on the patient’s eyelids. The patient will be discharged home with ice packs.
What Is the Recovery Following Ptosis Repair?
Recovery following dermatochalasis and ptosis repair includes applying topical antibiotic steroid ointment for the first week following surgery. Sutures are removed at approximately 7-8 days following the surgery. The patient is asked to apply ice compresses to the bilateral upper eyelids following ptosis repair for the first 48 hours following surgery. Post-operative evaluations to monitor the patient’s progress will occur at the Mack Center.
What Can the Patient Expect Following Surgical Correction of Ptosis and Dermatochalasis?
Following completion of the ptosis repair by Dr. Mack, the patient will have swelling and bruising of the upper eyelids. The patient is asked to avoid bending, lifting, and straining for the first week following surgery and to have limited activities. The patient is also asked to apply ice packs and antibiotic steroid ointment. It is also recommended for the patient to take arnica and bromelain post-operatively to decrease the amount of bruising and swelling. At the one-week post-op visit, when the sutures are removed, the patient will still have evidence of bruising and swelling, but it should be much improved from the day after surgery. The patient should notice an improvement in their superior and peripheral vision, which will help with the patient’s function of daily activities, including driving and reading.
FAQs About Eyelid Surgery
Will I Look Natural Following Ptosis and Dermatochalasis Surgery?
The goal of the Mack Center is to have patients look natural with all of their procedures and surgeries. It is very important with ptosis surgery to position the upper eyelid so that peripheral vision is improved, but also so that the patient can still close the eyes without any difficulties. This is particularly important for patients who have a prior history of dry eyes.
Can Ptosis and Dermatochalasis Be Treated at the Same Time?
We often treat ptosis and dermatochalasis during the same surgical session. When both conditions are present, addressing them together allows us to correct excess skin and lift the eyelid muscle in one operation. This approach helps streamline your recovery and avoids the need for two separate procedures. During your evaluation, we measure the eyelid height, muscle function, and skin redundancy to plan both treatments appropriately. If you qualify for surgery, we’ll explain how we combine the techniques to meet both functional and structural needs.
Will Insurance Cover My Eyelid Surgery?
Insurance may cover eyelid surgery when it affects your vision. If the test for functional impairment shows that excess skin is blocking your peripheral vision, we can submit those results, along with photographs, to your insurance provider for review. Coverage decisions depend on the severity of the obstruction and your specific insurance plan.
Will I Have a Scar After Eyelid Surgery?
You will have a scar, but we place the incision in the natural crease of your eyelid to help it blend in. Over time, the scar typically fades and becomes less noticeable. We give you detailed instructions on how to care for the incision as it heals. Most patients find that any visible scarring becomes minimal within a few months.
Can Eyelid Surgery Be Combined With Other Procedures?
Eyelid surgery can be combined with other treatments. Some patients also ask about lower eyelid procedures or cosmetic options like brow lifts or skin resurfacing. We review your goals and determine what makes sense to combine based on your anatomy and medical history. Combining procedures can reduce overall recovery time, but we always consider safety first.
How Soon Will I See My Full Results After Eyelid Surgery?
Swelling and bruising are common for the first week or two after surgery. As the tissue heals, you’ll gradually start to see the changes in your eyelid contour and field of vision. Most patients see their final results within six to eight weeks. We monitor your healing during follow-up visits to make sure everything progresses as expected.
Choosing The Mack Center for Eyelid Surgery in Tampa
When you come to The Mack Center for eyelid surgery, you will have a surgeon with extensive experience in oculoplastic and facial surgery. We offer detailed evaluations, clear explanations, and surgical plans based on both function and appearance. Dr. William Mack brings years of experience in eyelid surgery and continues to teach and present on the subject across national and international forums. His background in both cosmetic and reconstructive techniques helps us customize the right approach for each patient.
We stay current with advancements in oculoplastic surgery and regularly participate in research to refine how we treat eyelid conditions like dermatochalasis and ptosis. Our office is committed to making sure you feel informed, prepared, and supported through every step of the process. We’re available to answer your questions, explain test results, and provide written resources when needed. From your first consultation through your post-op visits, you’ll receive attentive care from surgeons focused on safe and effective outcomes.
Next Steps for Eyelid Surgery in Tampa, FL
Treating dermatochalasis and ptosis with eyelid surgery can improve your field of vision and restore the natural contour of your eyelids. When both conditions are present, we can often address them in one surgical visit to reduce downtime and support a more efficient recovery. At The Mack Cosmetic Center, we use detailed measurements, testing, and evaluation to determine the right approach for each patient. For more information on Tampa eyelid surgery, contact Dr. Mack’s office at (813) 875-5437 to schedule a consultation today.
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