Ptosis and blepharoplasty surgery.

Acquired senile ptosis of the upper eyelid is a common condition in the elderly population and is often accompanied by varying amounts of dermatochalasis, which may mask its presence. Blepharoplasty of the ptotic lid, without repair of the ptosis, may result in exaggeration of the drooping eyelid postoperatively. Acquired senile ptosis is produced by dehiscence or disinsertion of the levator aponeurosis and is characterized by a high or absent eyelid crease, thinning of the upper eyelid tissue, and normal levator function. Frequent causes of acquired ptosis include dermatochalasis, eyelid edema from trauma or allergies, previous ocular surgery, or use of contact lenses. When discovered, repair of the ptosis should be performed at the time of blepharoplasty to produce the best functional and cosmetic result. It is important for every surgeon who performs blepharoplasties to be aware of the presentation and management of acquired senile ptosis for consistent surgical results.