To make my eyes bigger
Widen the eye opening without leaving scars on the skin
Who is ptosis surgery suitable for?
- For those who want to enlargen the opening of the eyes.
- For those who want to reduce the difference between the left and right eye opening.
An explanation of ptosis surgery
Ptosis is a condition in which the eyelids do not open properly.
Others may say that you look sleepy or grumpy.Ptosis surgery can enlargen the opening of the eyelids.
In Primo Azabujuban Clinic, we offer two ptosis surgeies, either through a skin incision or from the conjunctival side, depending on the patient’s symptoms and goals.This is the most effective eyelid surgery technique to enlargen the eyes.
The most common causes of droopy eyelids are birth factors, contact lenses, and aging.People with this condition have a habit of raising their eyebrows, so the distance between their eyelashes and eyebrows becomes wider, making the upper part of their eyes look hollow.Forehead wrinkles tend to appear, making you look older than your age.The constant use of the forehead muscles can also lead to headaches and stiff shoulders.
All of these symptoms can be improved by ptosis surgery.
Your eyelids will naturally open wider, and you won’t be using your forehead muscles as much, which will reduce wrinkles and lower the position of your eyebrows.It also improves the hollowness of the eyelids, producing a more youthful look.
Symptoms of Ptosis
It is difficult to open the eyes and the amount of the iris that we can see is smaller.There is also a tendency for some lower eye sclera to be seen.To lift the eyebrows, the distance between the eyelashes and the eyebrows increases.Wrinkles also appear on the forehead.
After eyelid ptosis surgery
The surgery increases the area of the iris and reduces lower eye sclera visibility.Eyebrows will be lowered and forehead wrinkles will be reduced.
Features of our ptosis surgery
- You can choose to approach from the front side of the eyelid (skin side) or from the back side (conjunctival side).
- During surgery for both methods, you will be asked to look in a mirror whilst in a sitting position to check the eye opening and adjust the left-right difference.
- For local anesthesia, we use 34G ultra-fine needles (needle thickness 0.2mm) to minimize pain.
- The front side (skin side) approach also creates a double eyelid.
- The back side (conjunctival side) approach leaves no scar on the skin.
- The swelling goes down quickly, in about 3 to 7 days.
- Fat removal is also available upon request.
- The day after surgery, you can shower, wash your face, and apply makeup except for on your eyelids.
- Buried sutures are tightly sewn with 7-0 ultra-fine absorbable thread. Skin sutures are removed on the fourth or fifth day.Scarring will be minimal.
- Skin suturing with transparent thread is also possible.
- You can apply makeup to your eyelids the day after the stitches are removed.
Ptosis surgery explanation
There are two ways to perform ptosis surgery: from the front side of the eyelid (skin) or from the back side of the eyelid (conjunctiva).
During surgery for both methods, you will be asked to look in a mirror whilst in a sitting position to check the eye opening and adjust the left-right difference.
The front side method is appropriate for those who also want to create a double eyelid, or for those who have a lot of skin flabbiness.The incision is made along the desired line.Depending on the patient’s wishes, a skin incision can be made using a CO2 laser to reduce bleeding.If there is a lot of sagging, the excess skin is removed.
The orbicularis oculi muscle, anterior eyelid tissue, and submuscular connective tissue are also removed as needed.Any excess orbital fat is also removed.Skin-side ptosis surgery may be combined with ROOF resection depending on the case.
The levator palpebrae superioris muscle is shortened and reattached to the tarsal plate. Fine adjustments are made during surgery whilst the patient is in a sitting position to check the upper eyelid opening.The degree of the upper eyelid opening and the difference between the left and right eye are carefully adjusted.After that, a general anesthetic is administered, and then the skin and deep tissues are carefully sutured with 7-0 ultra-fine absorbable thread over the entire incision area.
We internally suture with high-performance absorbable ultra-fine thread and externally suture with non-absorbable ultra-fine thread.
We also offer skin suturing with ultra-fine transparent thread.
In the back side approach, an electric scalpel is used to make a bleeding-controlled incision on the back side of the eyelid (conjunctival side) to adjust and refix the levator palpebrae superioris muscle.The main advantages of conjunctival side ptosis surgery are no scarring on the skin, and little swelling (only a few days). Also, more detailed adjustments can be made to correct the left-right difference and the degree of eye opening according to the patient’s preference.
Aftercare for ptosis surgery (skin side)
《After surgery》
Condition of the affected area
The double eyelid line is sutured with a very fine black thread.The stitches are usually removed in 4-7 days.
The double eyelid is a little wider and tighter than expected. This is due to temporary edema.
Bruising may occur around the eye.Any bruising will usually disappear in 1-2 weeks.
Depending on the double eyelid line, the width of the double eyelid may be narrower than before surgery.As the eye opening widens, the double eyelid becomes narrower.
Post-operative checkup and aftercare
You will be examined by the doctor after surgery just before you go home.
Antibiotics, painkillers (the pain is usually mild, but we prescribe them just in case), and gastric medicine will be prescribed for 3 days after surgery.
Surgery may cause temporary dryness of the eyes.After surgery, we will prescribe two kinds of eye drops and one ointment for dry eyes.
Please apply the eye ointment before going to bed, and use the tape to keep your eyes shut. and use the tape to keep your eyes shut.
Lifestyle advice
You can wash your hair and take a shower on the same day after surgery.
Please only wash your face with water, not soap.You can use soap or facial cleansing foam from the next day onwards.However, please do not rub the wound.If the thread gets stuck or it tears, it may bleed.Please do not pick the scab or any other part of the wound, and try to rest.
Please do not apply any cosmetics to the affected area until the stitches are removed.
Please refrain from taking a bath and doing strenuous exercise for about a week.
Make-up can be applied after surgery except around the eyes.
When sleeping, please use cushions to elevate your upper body and head.
Please refrain from drinking alcohol and smoking for about a week.
Contact lenses can be worn from the third day after surgery if there is no discomfort.They certainly can’t be worn 2-3 hours after surgery due to the effects of anesthesia.
《Days 4-7 after surgery》【Book an appointment for stitches removal】
Condition of the affected area
The swelling will go down in a week or two.The double eyelid will be a little wider and tighter than expected. This is due to temporary edema.Things will completely settle down in about 6 months.
Initially, the scar will be red.The redness varies from person to person, but it will subside in about 1-2 months.In rare cases, there may be a slight bump due to edema.
There may be bruising around the eye.Any bruising will disappear in 1-2 weeks.
Decreased sensation may occur on the eyelash side of the incision.This usually takes a few months to recover.
Post-operative checkup and aftercare
You will be examined by a doctor 4-7 days after surgery.
Your stitches will be removed.
Lifestyle advice
Skin lotion and creams can be applied after stitches removal
Eye makeup is also OK, once the stitches are removed.
Please avoid rubbing the eye area too much.
Please continue to use eye drops to prevent dry eyes.
From the 7th day after the day of surgery, you will be able to take a bath and exercise as usual.
After removal of stitches, please keep the scar moisturized and UV protected.Our wound cream (1,100 yen inc. tax) can be applied to make the wound less prominent.
《1-3 months after surgery》【 It is recommended that you visit for a checkup at this time.】
Condition of the affected area
The wound will gradually heal completely, but there will be some swelling for a while.
The redness and elevation of the scars will vary from person to person, but they will all settle down in 1-2 months.
In rare cases, the suture thread may come out.Since it is a fine absorbable thread, it can usually be left untreated, but if you are concerned about it, we will remove the stitches.
Post-operative checkup and aftercare
You will be examined by a doctor.
There is no post-operative procedure.
Lifestyle advice
Please continue to moisturize and UV-care your scars.
《6 months after surgery》【 It is recommended that you visit for a checkup at this time.】
Condition of the affected area
The wound has almost fully healed.
Numbness of the eyelash side and scar redness will both have improved.
Post-operative checkup and aftercare
You will be examined by a doctor.
There is no post-operative procedure.
Lifestyle advice
You can resume all of your daily activities.
Aftercare for ptosis surgery (conjunctival side)
《After surgery》
Condition of the affected area
The conjunctiva is sutured but not the skin.
In rare cases, bruising may occur around the eye.The eyes might turn bloodshot too.These symtoms will vary from person to person, but they will disappear in 1-2 weeks.
After ptosis surgery, the width of the double eyelid will be narrower due to better eye opening.In rare cases, the double eyelid may disappear after surgery.
There may be some eye discharge containing blood. This is usual, so please wipe it off gently.
There may be a stinging pain after surgery.It usually improves after a few days, but if the pain persists, we will treat it immediately.
Post-operative checkup and aftercare
You will be examined by the doctor after surgery just before you go home.
Antibiotics, painkillers (the pain is usually mild, but we prescribe them just in case), and gastric medicine will be prescribed for 3 days after surgery.
Improving the eye opening may cause temporary dryness of the eyes.After surgery, we will prescribe two kinds of eye drops and ointment for dry eyes.Please apply the eye ointment before going to bed, and use the tape to keep your eyes shut.
Lifestyle advice
You can wash your face and hair in the shower the same day after surgery.
Please refrain from taking a bath and doing strenuous exercise for about a week.
Make-up can be applied after surgery except around the eyes.Eye make-up can be applied the day after surgery.
Contact lenses can be worn from the seventh day after surgery if there is no discomfort.
Please do not rub the wound.In rare cases, bleeding or dislodging of the sutures may occur.Please do not pick the scab or any other part of the wound.
When sleeping, please use cushions to elevate your upper body and head.
Please refrain from drinking alcohol and smoking for about a week.
《7 days after surgery》【Book an appointment for stitches removal】
Condition of the affected area
The swelling will go down in a week or two.
There may be some eye discharge containing blood. This is usual, so please wipe it off gently.
In some cases, bruising may occur.The eyes might turn bloodshot too.These symptoms will vary from person to person, but everything will disappear in 1-2 weeks.
Post-operative checkup and aftercare
You will be examined by a doctor.
Lifestyle advice
From the 7th day after the day of surgery, you will be able to bathe and exercise as usual.
Please continue to use the eye drops and eye ointment to prevent dry eyes.
Please do not rub the eye area.In rare cases, bleeding or dislodging of the sutures may occur.
《2 weeks after surgery》【Visit for a checkup】
Condition of the affected area
The swelling has almost gone.
The eye will open better and the double eyelid will be slightly narrower.
After surgery, if you want to widen a narrow double eyelid, or if the double eyelid disappears, you can have the buried suture method after 2 weeks.
Post-operative checkup and aftercare
You will be examined by a doctor.
If you wish, we can widen the double eyelid using the buried suture method.
Lifestyle advice
You can bathe and exercise as usual.
Please continue to use the eye drops and eye ointment to prevent dry eyes.
Please do not rub the eye area.In rare cases, bleeding or dislodging of the sutures may occur.
《1-3 months after surgery》【 Visit for a checkup】
Condition of the affected area
The wound will gradually heal completely, but there will be some swelling for a while.
Post-operative checkup and aftercare
You will be examined by a doctor.
There is no post-operative procedure.
Lifestyle advice
Please continue to use the eye drops and eye ointment to prevent dry eyes.
Please do not rub the eye area.In rare cases, bleeding or dislodging of the sutures may occur.
《6 months after surgery》【Visit for a checkup】
Condition of the affected area
The wound has almost fully healed.
Post-operative checkup and aftercare
You will be examined by a doctor.
There is no post-operative procedure.
Lifestyle advice
You can resume all of your daily activities.
FAQ
Questions answered about ptosis surgery.
Click on each question to see the answer.
In the case of ptosis surgery (where the skin is incised), the swelling around the eyelid will go down in 4-5 days.
The swelling duration will vary depending on the width of the desired line.If the double eyelid is wider than 10 mm, the swelling may last for 1-2 months.
In the case of ptosis surgery (conjunctival side), the swelling around the eyelid will go down in 3-4 days.
A swelling under the double eyelid line may last for a week or two.
In the case of ptosis surgery (skin side), makeup can be applied as usual, except for the eyelids.
Stitches are usually removed 4-5 days after surgery.The day after stitches are removed, you can apply makeup to your eyelids.
In the case of conjunctival-side ptosis surgery, makeup can be applied everywhere as usual.
For 1-3 months after surgery, there will be some redness and stiffness, but makeup can still be applied.
We use sutures with absorbable thread (6-0 PDS), which results in a clean scar.
If you have persistent redness, we will provide appropriate treatment at the post-operative checkup (free of charge).
Conjunctival-side ptosis surgery leaves no scar.
Post-operative pain is usually very mild.You will be given a mild analgesic and anti-inflammatory drug, just in case.
In the case of conjunctival-side ptosis surgery, you may feel mild stinging for a few days.
After surgrey, the eyes will be dry, so we will prescribe you eye drops and eye ointment.
Please apply the eye ointment just before going to bed, and use the tape we give you to keep the eye closed.
The surgery takes about 1 hour and 30 minutes.
Our ptosis surgery is performed from either the skin side or from the conjunctival side.
Surgery from the conjunctival side does not leave a scar on the eyelid because no incision is made.
A scalpel is used for the skin side, but an electric scalpel is used for the conjunctival side.
We can also improve ptosis using a needle and thread.
Pain will be minimal. Our local anesthetic contains extra agents to reduce any discomfort.To minimize injection pain, the amount of anesthetic used is kept to a minimum of 1-1.5 cc for both eyelids.
Pain is also minimized by using an ultra-fine 34G needle, as well as a new needle for each eyelid.
The local anesthetic is administered very slowly which minimizes pain.
For those who are still afraid of pain, we offer general anesthesia.Under general anesthesia, you will be comfortably unconscious and breathing as usual.
Fees
| Ptosis Surgery | Aponeurosis fixation | ￥660,000 |
|---|---|---|
| Fascia grafting (in severe cases) | ￥880,000 |
All fees displayed include tax.
Risks and side effects
Underneath is a list of things that may occur.
In order to prevent any of these symptoms from occurring, we take safety measures and perform treatment with the utmost care.
We also have a solution for any symptoms should they occur.We will always improve your symptoms.
Post-operative course
Swelling
Major swelling will go down in 2-4 days after surgery.Mild swelling may be noticeable for a week or two.
Things will completely settle down in about 6 months.
Bruising around the eye.
There may be bruising around the eye.It sometimes occurs, but it will disappear in a week or two.
Eyelid discomfort
Immediately after ptosis surgery, the eyelids will feel strange.This will disappear over time.
Wound healing
You will see some redness for 1-2 months after surgery.This will disappear over time.
Sensory abnormalities
The skin on the eyelash side of the incision line will become less sensitive.This will improve over time.
Risks, side effects, and complications
Exposure of buried absorbable sutures
We will remove the stitches.
Infection
Although rare, there is risk of infection with any surgery.
If infection occurs, it may be necessary to treat it with antibiotics or remove any pus by small incisional drainage.
Too wide / narrow double eyelids
After the swelling has subsided, we will evaluate the shape and may then perform revision double eyelid surgery to adjust the width.Depending on the line, the eyelid opening may be larger and therefore the width of the double eyelid may be narrower.
Disappearance of the double eyelid line
In the case of the incision method, it is extremely rare for the lines to disappear, but if they do, we will re-open the incision, remove orbital fat, and apply internal treatments.
Changes in eyelid morphology
The angle of the eyelashes may change, and the mucous membrane at the eyelid margin may become more prominent.The incision method reliably creates a firm and deep double eyelid.
Changes in facial impression
If the eyelids open more easily, the eyebrows will be lowered and forehead wrinkles will improve.When the eyebrows are lowered and the eyes are open wide, the double eyelids may become narrower, giving a slightly harsh impression.
Lack of eye opening; too much eye opening; difference between left and right eye.
Ptosis surgery is performed again to adjust the eye opening.
Poor eyelid closure
If the eyes are open too much, it may be difficult to close the eyelids.
Dry eye
As the eyelids become larger and the eyes open more easily, they may dry out more easily.
Decreased vision
It is very rare to have decreased vision after ptosis surgery.
Patients with droopy eyelids may experience improved vision as they are naturally squinting, i.e. their eyelids are partially covering the pupils.
After surgery, the eyelid will open more, and when it no longer touches the pupil, this squinting phenomenon will disappear and vision will appear to have decreased somewhat.This is not a loss of vision.
Hering’s Law
When one eyelid is surgically opened, the other eyelid which was initially good, may then not open as well.One in three patients may require surgery on the other eyelid too.
Click here for all other eye area surgeries.
Eye surgery list
Detailed information on each eye surgery procedure, including case photos, case progress photos, procedure duration, post-operative course, downtime, aftercare, risks, side effects, and complications.
Supervising Doctor
Under the supervision of our plastic surgeons, we operate our website in accordance with medical advertising guidelines.
NORIHIRO OHBA M.D. Ph.D.
HEAD DIRECTOR/DIRECTOR
Qualifications and Academic Affiliations
Doctor of Medicine
Board Certified Plastic Surgeon, Japan Society of Plastic and Reconstructive Surgery
Board Certified Aesthetic Plastic Surgeon, Japanese Society of Aesthetic Plastic Surgery
Board Certified Aesthetic Plastic Surgeon, Japanese Society of Aesthetic Surgery
Anesthesiologist certified by the Ministry of Health, Labor and Welfare
Member of International Society of Aesthetic Plastic Surgery (ISAPS)
International Member of American Society of Plastic Surgeons (ASPS)
Member of Japan Society of Cranio-Maxillo Facial Surgery
Member of Japan Society of Laser Surgery and Medicine
Career
Graduated from Osaka City University Faculty of Medicine, 1996
Osaka City University Hospital Plastic and Reconstructive Surgery, 1996-1999
Osaka City University Graduate School of Medicine, 1999-2003
Osaka City University Hospital Plastic and Reconstructive Surgery, 2003-2005
Sano Memorial Hospital Plastic and Reconstructive Surgery(part-time)
Daito Central Hospital Plastic and Reconstructive Surgery(part-time)
Ritz Cosmetic Surgery Tokyo Clinic, 2005-2008
Primo Azabujuban Clinic, 2009~
Head Director, Primo Medical Corporation, 2011~
Head Director/Director, Primo Azabujuban Clinic, 2020~
