Levator advancement is ptosis surgery that tightens and repositions the levator muscle-tendon complex to raise a drooping upper eyelid. It is used when levator function is adequate but the lid margin sits too low.
Procedure
Through a skin crease or conjunctival incision, the surgeon exposes the levator aponeurosis, advances it on the tarsal plate, and adjusts tension to achieve the desired lid height and contour. Intraoperative adjustment is often done with the patient sitting up.
- Suitable for aponeurotic (age‑related or contact lens‑related) ptosis
- Can be combined with blepharoplasty to remove excess skin
- Requires good Bell’s phenomenon and corneal protection
- Fine‑tuning may be necessary post‑operatively for small asymmetries
Recovery
Bruising, swelling, and temporary lid stiffness are common. The lid may initially appear slightly over‑ or under‑elevated before settling.
- Cold compresses and lubricants improve comfort in the first days
- Follow‑up visits check lid height, symmetry, and corneal safety
- Revision surgery is occasionally required for significant residual ptosis
- Most patients achieve improved field of vision and eyelid symmetry
