For those who are considering ptosis (insurance surgery) in Osaka. At Kamogawa Clinic, our plastic surgeons will determine the cause (tendinous, sagging skin, etc.) and propose a treatment plan that will both restore function and provide a natural-looking result.
Table of Contents:
1. our approach to ptosis surgery and for those considering ptosis surgery
2. Difference between "insurance" and "free treatment" in ptosis surgery
3. ptosis surgery from all over Osaka
4. second opinion for ptosis is also available
What is ptosis?
6. compensatory effects of ptosis and its impact on systemic symptoms
7. "Could I have a droopy eyelid?" One-minute Self-Check
8. "What Happens If Left Untreated?" Effects of Ptosis
9. Can a droopy eyelid be treated non-surgically?
10. ptosis: plastic surgery or ophthalmology?
11. Is ptosis surgery covered by insurance?
12. ptosis surgery flow
13. precautions on the day of ptosis surgery
14. how long is the downtime after ptosis surgery? When do you start working?
15. postoperative (during downtime) precautions after ptosis surgery
16. risks and side effects of ptosis surgery
17. why our clinic is the best choice for ptosis surgery
18. fee for ptosis surgery
19. ptosis frequently asked questions
20. supervisors and authors
Our Approach to Ptosis Surgery and For Those Considering Ptosis Surgery
Ptosis surgery is an important treatment not only for the appearance of the eyelid, but also for the day-to-day and cosmetic aspects of the patient's life. Although droopy eyelids are often viewed as a "cosmetic problem," the drooping eyelids often obstruct vision and affect quality of life (QOL). We take this seriously and propose the best treatment plan according to each patient's condition and wishes. We will do our best to ensure that our patients are satisfied with their post-operative changes. Eyelid surgery not only improves the appearance of the eyelid, it also restores confidence and leads to a more comfortable life.
Difference between "insurance treatment" and "free treatment" in ptosis surgery
There are two types of eyelid surgery for droopy eyelids: “insured” surgery, which is covered by health insurance, and “uninsured” surgery, which is performed outside the framework of insurance. In both cases, a plastic surgeon performs the surgery with an awareness of both "function" and "appearance" in mind. The major difference is that the treatmentGoals (where do you want to end up?)to whether there are any insurance restrictions.
Insurance treatment is designed to improve lowered eyelids and improve the opening of the eyes to provide the vision necessary for daily living.
Application guidelinesThe case is for those who are medically judged to require treatment, such as: narrow vision, difficulty in opening the eyes, headache, stiff shoulders, and other discomforts arising from the narrow vision.
About Treatment: We will take care to make your eyes as natural and healthy as possible within the scope of treatment in accordance with insurance rules. Once function is restored, many patients can expect to have a more youthful appearance.
Estimated costFor those who pay 30% of the total cost, the total cost for both eyes is approximately 40,000-50,000 yen.
Free treatment is chosen when you want to reflect your more detailed design wishes and “specialties” beyond the framework of disease treatment.
Application guidelinesThe case may be: when there is no obvious functional impairment, but you want to lift your eyelids for anti-aging purposes, or when you want to achieve a more defined desired double line/shape.
About TreatmentIn insurance treatment, the objective is "functional restoration," so there may be limitations on detailed design specifications. On the other hand, with free treatment, it is easier to spend more time in pursuit of the desired result, such as adjusting the width of the bifold by millimeters, making thorough fine adjustments to the left-right difference, and combining techniques as needed.
Estimated cost: Because it is not covered by insurance,full payment on one's own accountwill be.
Blepharoplasty by a "Plastic Surgeon" of Kyoto University, M.D.
At the Kamogawa Clinic, we do not take the view that "we don't care how it looks because it is covered by insurance. What we value is the basic stance of plastic surgery, which is to restore the degraded function properly and to make it as natural and beautiful as possible, as close to the original state as possible. Even with insurance, we proceed with surgery while confirming the anatomical structure millimeter by millimeter, and carefully suturing the surgery to the finest detail.
In the consultation, we first objectively evaluate whether the patient meets the criteria for insurance coverage and accurately determine the necessity of the treatment. Then, as a specialist, we will explain in a sincere and easy-to-understand manner whether the patient's goals can be fully realized within the scope of insurance coverage, or whether free treatment is appropriate for more detailed design adjustments.
Eyelid surgery for droopy eyelid from all over Osaka
Many patients come to our clinic from various areas, mainly in Osaka City. Since droopy eyelids vary greatly from person to person in symptoms and background, and can occur regardless of age or lifestyle, we offer a wide range of consultations. We can provide information on age-related droopy eyelids, as well as those caused by congenital factors, and treatment and surgery aimed at correcting post-traumatic changes.
Second opinions for ptosis are also available
For those who are considering ptosis surgery, as well as for those who have already undergone consultation and treatment at other hospitals but still have concerns, we are happy to provide a second opinion consultation. If you have questions about the diagnosis or treatment plan, or if you have concerns about the surgery or its progress, we will carefully sort out your concerns from a professional standpoint and help you make a choice with confidence. We will then propose a treatment direction that is satisfactory to the patient.
What is ptosis?
Ptosis is defined anatomically as "an abnormally low position of the upper eyelid margin," but its essence lies in "a disruption of the mechanism of elevation by the upper eyelid raising muscle system. Normally, the eyelid is raised by contraction of the oculomotor muscle, which is innervated by the oculomotor nerve, and the force of the contraction is transmitted through the tendon membrane to the eyelid plate, which is the core tissue of the eyelid. The sympathetically innervated Müller muscle assists in this process. Ptosis is caused by inefficient transmission or insufficient output of the muscles themselves.
Ptosis is present at birth or shortly after birth and is mainly due to the underdevelopment of the eyelid elevator muscle itself or the replacement of muscle tissue with fat or fibrous tissue (myogenic). From a plastic surgery perspective, it is important to manage the risk of complications such as disuse amblyopia and strabismus due to obstructed vision. In addition, the continued elevation of the chin to facilitate vision (chin up) may affect postural and spinal development during growth, so early identification and appropriate timing of surgery is required.
Aponeurotic ptosis is the most common form of ptosis in adults. This is caused by the tendon membrane of the levator tendon, which connects the muscle to the eyelid plate, stretching, loosening, or detaching (detachment) from the plate due to aging or years of mechanical stress, even though the strength of the levator muscle itself is preserved. Known triggers include long-term use of hard contact lenses, the habit of rubbing the eyes due to allergies, etc., and the effects after cataracts or other eye surgery. It is easy to imagine that this condition is like an engine that has power, but the transmission part is loose and spinning at a standstill. In some cases, ptosis may be due to a systemic disease such as myasthenia gravis or a neurological cause such as oculomotor nerve palsy. The specialist is required to make a differential diagnosis as necessary, rather than simply dismissing it as an age-related phenomenon.
Pseudoptosis is a condition in which the eyelid appears to droop, even though the function of the elevator muscles itself is technically preserved. It is an important clinical concept because it can be easily overlooked because there is no problem with the function of the elevator muscles, but it can greatly affect the outcome if the treatment plan is incorrect. Typical examples of this condition are as follows
Eyelid skin laxity: A condition in which the skin under the eyebrows sags due to aging or other factors and covers the black eye like a parasol.
Eyebrow drooping: The eyebrow itself drops due to weakness of the frontalis muscle or facial nerve paralysis, and the weight of the eyebrow pushes the upper eyelid down.
In these cases, excision of sagging skin and brow elevation are often indicated rather than shortening of the elevator muscles.
Compensatory effects of ptosis and its impact on systemic symptoms
To compensate for the inability to raise the eyelids sufficiently, the body naturally performs compensatory movements. A typical pattern is to use the frontalis muscles strongly to lift the eyebrows and try to maintain vision. As a result, the forehead tends to form deep horizontal creases and the forehead muscles are constantly tense. This tension can cascade from the head and neck to the muscles surrounding the shoulder blades, triggering headaches (migraines) that are difficult to heal and chronic stiff shoulders. In addition, cases have been noted in which persistent irritation of the trigeminal nerve (supraorbital nerve) can affect the balance of the autonomic nervous system. Therefore, the treatment of a droopy eyelid is not only a surgery to improve the appearance of the eyelid, but also has a strong aspect as a functional reconstruction surgery that can lead to improvement of systemic problems through restoration of visual function.
"Could I Have a Droopy Eyelid?" Self-Check in 1 minute
Recently, I feel that my eyes look smaller" or "My eyelids feel heavy and tired in the evening. Don't assume that these symptoms are due to age,Eyelid droopingConsider the possibility of Ptosis is a condition in which the muscles that lift the eyelids weaken, making it difficult for the eyes to open fully. Here is a simple self-check that can be done quickly with a mirror.
Check in front of a mirror: Can you open your eyes without moving your eyebrows?
1) Look in front of you in the mirror and close your eyes.
2) Press both eyebrows lightly with fingers to secure them in place so they do not move.
3) Keep going and slowly open your eyes.
[Judgment
Smooth opening: The muscles that raise the eyelids are likely to be generally working normally.
Difficulty opening/heaviness: The eyelid raising muscle (the muscle that raises the eyelid) may be underactive.
Appearance Signs: Have you noticed an increase in "deep horizontal wrinkles" on your forehead?
A droopy eyelid makes it difficult to open the eyes using only the power of the eyelids, so the unconsciousForehead muscles (frontalis muscles)Try to maintain your vision by pulling up your eyebrows in the Look in the mirror and check for the following changes
- The wrinkles on the sides of my forehead are more defined than before.
- I think my eyebrows are higher than before.
- The space between the upper eyelid and the eyebrows appears to widen and the eyelid area appears to increase
Physical discomfort: Do you continue to have "stiff shoulders and headaches" with no clear cause?
When the eyelids are lowered, it is easy to assume a posture of chin forward or face up in order to see better, and furthermore, the forehead muscles remain tense. As a result, the following problems may occur
- Neck/shoulder stiffness is especially strong in the evening or later
- Heaviness behind the eyes / prone to migraine headaches
- I thought I rested, but my eyes are still tired.
*Self-check is only a guide. If more than one item of concern applies, we recommend evaluation by a specialist, as there may be hidden causes other than ptosis (e.g., drooping eyebrows, sagging skin, etc.).
What Happens If Left Untreated?" Effects of Ptosis
A droopy eyelid not only makes you look "sleepy" and "old," but also has a significant impact on your overall health and quality of life (QOL). Narrowed vision can increase the risk of falling, and postural problems can lead to chronic back pain.
In addition, constant muscle tension often leads to autonomic nervous system disturbances.
There is no need to give up and say, "It's just due to my age. At Kamogawa Clinic, a plastic surgeon will correctly diagnose the condition of your eyelids and carefully explain whether the condition can be improved with insurance and what kind of surgery is best for you. Why don't you come in for a consultation to check your current condition?
Can droopy eyelids be treated non-surgically?
Ptosis is not basically a disease that can be corrected only by self-care such as creams and massages. In most cases, it is caused by aging or congenital factors that weaken the muscles that lift the upper eyelid (the eyelid raising muscles) and the tissues that transmit this power.
Therefore, it is difficult to repair the cause itself with non-surgical methods, and surgical treatment is necessary to correct the symptoms at the root. If vision or tiredness is interfering with daily life, it is important to consider an appropriate treatment plan after evaluation by a specialist.
Which is better for ptosis, plastic surgery or ophthalmology?
Many people are confused as to whether plastic surgery or ophthalmology is the best place to consult for ptosis. Although both treat ptosis, there are differences in their areas of expertise.
Plastic surgery is a specialty that emphasizes not only the restoration of eyelid function, but also the overall arrangement of the eyelid, including the naturalness and visual balance of the finished product, such as the left-right difference and double lines. Ophthalmology, on the other hand, is strong in the evaluation and management of visual function and diseases of the eye itself.
For this reason, we recommend a consultation with a plastic surgeon if you wish to improve function and at the same time make it look as good as possible.
Is ptosis surgery covered by insurance?
Ptosis surgery is covered by insurance in many cases. If there is a medically recognized need for the treatment, such as a narrowing of the field of vision due to the drooping eyelid or difficulty in opening the eyes that interferes with daily life, it is likely to be covered by insurance. On the other hand, if there is little or no effect on your vision and only minor obstacles in your daily life, the treatment may not meet the insurance criteria and may not be covered by insurance. Please feel free to contact us for a consultation to confirm the condition of the patient and to guide you to the appropriate treatment plan, including whether or not it is covered by insurance.
Ptosis Surgery Flow
(1) Counseling (medical examination)
First, we will check the current condition of your eyelids, and after listening to your symptoms and wishes, we will propose a suitable surgical method. If you wish to have the surgery, we will discuss the schedule with you and schedule the surgery date.
(2) Day of surgery
The surgery is performed under local anesthesia and is as painless as possible. The plastic surgeon improves the droopy eyelid, taking into consideration the balance between function and result. The estimated surgery time, including anesthesia, is usually 1-2 hours. After the surgery, we will guide you on how to care for your eyelids to minimize swelling and internal bleeding.
(3) Progress examination (follow-up)
We follow up with our patients the next day, 1 week, 3 months, and 6 months after surgery to check their progress.
*Depending on the condition, a consultation may be held even after one month.
Precautions on the day of ptosis surgery
- For Contact Lens Users
You will be asked to remove your contacts before surgery. You may be asked to refrain from wearing them for a while after the surgery as well, which may hinder your recovery, so please bring your glasses on the day of the surgery. - Elderly persons are recommended to be accompanied.
On the day of surgery, it is a good idea to have a family member or friend accompany you just in case. - Please refrain from wearing makeup when coming to the clinic.
Please avoid wearing makeup on your face as much as possible on the day of your visit, as well as around your eyes.
How long is the downtime after blepharoplasty? When do you start working?
The recovery process for blepharoplasty varies from person to person depending on the condition of the eyelid and the surgical technique. Here is a summary of general downtime guidelines and points to keep in mind. By knowing the process in advance, it will be easier to stay calm after the surgery.
Surgery date ~ 1 week
After surgery, swelling and internal bleeding may occur. Swelling tends to be particularly strong on the first day or two, but most of the swelling will gradually subside over the next few days. Internal bleeding usually improves within a week or so.
Stitches are generally removed around 5 days after surgery. Once the stitches are removed, swelling and pain are often lessened, making it easier to return to daily activities.
During this period, however, it is important to avoid strenuous exercise or excessive activity and to be as restful as possible.
1 to 3 weeks
The swelling will largely subside, and the appearance will become much closer to natural. Note that the older the patient is, the more prolonged the swelling tends to be, so the speed of recovery varies from person to person.
1 week to 3 months
This is the time when the swelling and internal bleeding have almost completely subsided and the shape of the eye area is stable and established. Even if there are minor left-right differences that may become bothersome during the course of the procedure, they may adjust with time.
After Blepharoplasty (during downtime)
Refrain from exercise and strenuous activity.
Avoid strenuous or strenuous activities for 1-2 weeks after surgery to avoid unnecessary pressure on the eye area.
Do not touch or rub your eyes
After surgery, avoid pressing or touching the eyelids as much as possible. It is especially important to avoid strong friction until the swelling subsides.
Use makeup sparingly.
Avoid makeup around the eyes for about a week after surgery and wait for the skin and scars to settle.
Risks and Side Effects of Blepharoplasty
While droopy eyelid surgery can improve vision and the appearance of the eyes, like any other surgery, it carries certain risks and side effects. It is important to understand what can happen before surgery and to take appropriate postoperative care. Here is a summary of the main precautions.
After surgery, bacteria can enter the wound and cause infection. If infection occurs, symptoms such as redness, swelling, worsening pain, and pus may occur, and recovery may be delayed. To prevent this, it is important to adhere to the prescribed antibiotic regimen and keep the wound clean.
Bleeding may occur during or after surgery. Most are minor and subside within a short period of time, but in rare cases, bleeding may be excessive. If bleeding persists after surgery, or if there is a sudden increase in swelling, please consult your doctor as soon as possible.
Swelling and internal bleeding are common after surgery. Swelling tends to be strong in the early stages, peaking in a few days to a week, and then gradually subsiding. Internal bleeding may appear as a bluish-purple bruise, but most will lighten within one to two weeks.
After surgery, there may be a difference in the shape and opening of the eyes from left to right. In many cases, the difference is temporary due to swelling and will adjust over time. However, depending on the condition, additional adjustments or revision surgery may be necessary.
Although ptosis surgery is performed on the eyelid, in rare cases, discomfort or blurring of vision may occur. If they persist for a prolonged period of time, they require evaluation by a physician and appropriate action.
You may experience dryness and a colicky feeling in your eyes after surgery. This is due to temporary changes in the movement of the eyelids and the balance of tear fluid, and most cases improve with eye drops (e.g., artificial tears). If symptoms persist, additional treatment may be necessary.
There is a possibility of scarring at the incision site. Most scars are located in less conspicuous areas, such as the double fold line, and fade with time, but some scars may not disappear completely. To reduce the visibility of scars, it is important to follow the postoperative instructions for care.
Temporary numbness or sensory discomfort may occur after surgery. This is caused by irritation or swelling during the surgery, and most cases improve within a few weeks, but in rare cases, symptoms may remain.
There is a possibility of allergic reactions to the drugs, disinfectants, sutures, etc. used. If you experience a rash, itching, swelling, etc., please notify your doctor immediately.
Why Choose Us for Blepharoplasty Surgery?
Eyelid retraction surgery is an important treatment that not only improves the appearance of the eyes, but also affects the comfort of daily life, such as vision and fatigue. For this reason, our physicians with specialized knowledge and reliable techniques work together to provide the best treatment for each individual patient. We are committed to providing treatment with sincerity, giving first priority to the health and satisfaction of our patients, while giving full consideration to safety and establishing a system that allows patients to undergo surgery with peace of mind.
Ptosis Surgery Fees
| 30% of the cost | 20 percent of the cost | 10% burden | |
| one side | Approx. 28,000 yen | Approx. 20,000 yen | Approx. 10,000 yen |
| both sides | Approx. 50,000 yen | Approx. 32,000 yen | Approx. 16,000 yen |
Things to check before undergoing surgery
The major goal of ptosis surgery is to improve eyelid opening and restore visual function. By expanding the field of vision, the patient can expect to see more easily and more comfortably in everyday life.
On the other hand, it is important to understand the precautions and process in advance to avoid postoperative "it was different from what I expected" or "I did not know these symptoms would occur. Knowing the postoperative changes and possible symptoms will not only allow you to go into the surgery with peace of mind, but will also lead to appropriate aftercare.
1. possible post-operative symptoms and responses
While many people experience less headaches and stiff shoulders after surgery, not all people see the same improvement.
2. dryness of the eyes
When the eyelids are opened more easily by surgery, tears may evaporate more easily or the tear circulation (pump function) may change, resulting in temporary dry eye symptoms. Most of them will settle down with time, and as a general rule of thumb, they will improve in about six months.
Even if the left-right balance is carefully adjusted during surgery, the left-right difference may be noticeable at the time of suture removal due to swelling or other factors, or the eyes may look like so-called triangular eyes. In such cases, we will consider correction within two weeks or six months after the surgery to improve the situation, depending on the circumstances.
3. left-right difference and fine tuning
Even if the left-right balance is carefully adjusted during surgery, there may be a left-right difference at the time of suture removal due to swelling or other factors, or the so-called triangular eyes may appear. In such cases, depending on the situation, we will consider a correction about one week after the surgery to improve the situation.
In addition, the eyelids may open more easily, which may result in a lowering of the eyebrows and a noticeable skin cover. Depending on the situation, additional skin excision or other treatment may be necessary. In this case, we suggest an adjustment procedure six months after the surgery.
4. possible changes in the opposite eyelid/eyebrow
After surgery on one eyelid, the normally unproblematic eyelid on the opposite side may appear to droop. The doctor will carefully monitor the progress of these changes and consider additional treatment if necessary.
Frequently Asked Questions about Ptosis
Q. Is ptosis surgery covered by insurance?
A. In many cases, insurance will cover the treatment. If there are medically confirmed obstacles to daily life, such as narrow vision or difficulty in opening the eyes, there is a high possibility that insurance will cover the treatment. The applicability will be determined by a medical examination.
Q. Should I see a plastic surgeon or an ophthalmologist?
A. We can consult on either, but as plastic surgeons, we will evaluate and propose a treatment plan that includes "functional improvement" and "naturalness of the finished product (left-right difference and balance).
Q. How long does the surgery take? Is it a one-day surgery?
A. The surgery is performed under local anesthesia, and the estimated time is about 1 to 2 hours for both right and left sides, including anesthesia. You can go home on a day trip.
Q. Is there any pain?
A. Because local anesthesia is used, pain during the surgery is minimized as much as possible. There may be some discomfort or dull ache after the surgery, but this will be adjusted with analgesics as needed.
Q. How long is the downtime? When can I start working?
A. Swelling tends to be strong on the same day to the second day and settles down in a few days. Internal bleeding generally lightens within one to two weeks. The guideline for returning to work depends on the nature of the job, so please consult with us at the time of consultation.
Q. When will the stitches be removed? Do I need to go to the hospital?
A. Stitches are usually removed about 5 days after surgery. At our clinic, follow-up examinations are performed the next day, one week, and one month after the surgery.
Q. If I have surgery on one eye, does the other eye appear to drop?
A. After surgery on one side, the eyelid on the opposite (non-surgical) side may droop. In addition, the position of the eyebrows may change and skin cover may become a concern. We will carefully monitor the progress and suggest additional adjustments as necessary.
Q. Can droopy eyelids be treated with creams and massage?
A. Problems with the "eyelid lifting mechanism" such as the levator muscle or tendon membrane are often the cause of the problem, and it may be difficult to correct the root cause with self-care alone. First, it is important to evaluate the cause of the problem.
Q. Is there an order with other eye surgeries such as cataract surgery or LASIK?
A. If you have a schedule, please consult with us in advance, including the sequence and timing. Since it may take some time for vision to stabilize after blepharoplasty, we will plan comprehensively.
