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Can Ptosis surgery correct drooping upper eyelids and sagging lower eyelids in 1 procedure?

Plastic Surgery Aesthetic Medicine Eye Health

Is it possible to combine the surgery correcting ptosis, and the procedure to reduce sagging lower eyelids? If yes, how will this impact medical costs, as I understand that only ptosis can be claimed from Medisave?

DOCTOR’S ANSWER (3)

You will definitely need to be examined in detail, however in general, ptosis and lower lid surgery can certainly be performed together. 

For the condition of ptosis - certain tests may need to be performed in order to ascertain that this is a functional problem before Medisave may be used to help pay for this procedure.

Similarly for the lower lid - if there is a functional problem due to the sagging, for example causing in-turning of the lashes, or out-turning of the punctum, then Medisave may be used to help pay for this procedure.

If both the upper and lower lids require functional correction, then they may both be performed at the same sitting. However if one of them is deemed to be a cosmetic procedure, then you should not do them at the same sitting.

Detailed evaluation by your Oculoplastic surgeon will help you in your decision making process. Best of luck with your surgeries!

ESG

1128 views 4 Sep 2018
Dr Terence Goh
"Plastic Surgeon at AZATACA Plastic Surgery"
(14 Reviews)

Hi,  Thanks for you question. This is a common question that I get from my patients. 

Yes!  While ptosis correction surgery and lower eyelid surgery are two separate procedures, it is possible to combine both ptosis correction surgery and lower eyelid surgery. Doing both procedures simultaneously usually results in lower costs than if you were to do the surgeries separately. 

During ptosis correction surgery, the levator muscle that controls opening of the upper eyelid can be stitched and advanced to increase the eye opening. Extra skin from the upper eyelid can also be removed to provide a more youthful appearance or create a more obvious double eyelid crease. While this can be modified to include lateral brow skin, surgery in the upper eyelid WILL NOT be able to treat the lower eyelid skin sag. However, there are other considerations to be made before you decide if you should combine the surgery. 

The lower eyelids sag due to a change in the quality of the skin, muscle as well as the lower eyelid fat and tissues that hold the fat. As such, skin excision may have to be combined with procedures to remove or redrape the fat in the lower lid and also to tighten the orbicularis oculi (eye) muscle to give a more youthful and rejuvenated appearance. 

Allow me to clarify the issue of ptosis and Medisave claim. As Dr. Goh E-Shawn has explained, only ptosis with functional impairment of your vision will qualify for Medisave claims. In my experience, I have had some patients who have successfully claimed from Medisave, as they have fulfilled the criteria stipulated by Ministry of Health, and other patients with less severe ptosis who have had to pay for the surgery on their own. While not unheard of, it is less common for lower eyelid conditions to be eligible for Medisave claims. 

That said, as the surgeries are separate and will not be considered as one procedure, it will not have an impact on your Medisave claims if you decide to combine them in one setting.

Finally, the choice to combine the surgeries depend on you. Most of the time, if both upper lid and lower lid surgeries are required, my patients would choose to do the procedure together. Besides the issue of costs, my patients are also informed that there may be more swelling and bruising if the 2 procedures are done together. 

Eyelid surgery can be complex and challenging and it's important to get it right the first time. Do seek an in-person consultation with a plastic surgeon who has a special interest in blepharoplasty (eye surgery) to further explain what I have mentioned to you in greater detail. 

Hope this help and all the best!

1116 views 4 Sep 2018

Ptosis correction surgery will address drooping of the upper eyelids.

While this procedure can be done at the same time as a lower eyelid procedure, there is not a single procedure that can address both the upper and lower eyelid drooping.

1157 views 31 Aug 2018
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