Hi Regina, thanks for the question and the post-op photo.
There are several possible causes for ptosis that occur after upper blepharoplasty. I would start by comparing with the pre-op photo to see if there was any pre-existing ptosis and how much it has worsened.
The most common cause is usually swelling and internal bruising (blood clots) that may be affecting the function of the muscles that open the eye. If this is the case, then the ptosis will gradually resolve after 2-3 months. Occasionally scar tissue may form (adhesions) and this may require surgical correction.
Another possible cause is damage to the muscle or its attachments. If this is the case then the ptosis will not improve after a period of observation, and surgical correction is needed. A high crease (high skin-levator attachment) may sometimes interfere with levator muscle function and cause ptosis, this may require surgery to reset the fold lower.
To summarise, although there are many possible causes, it is important to wait until swelling has sufficiently subsided (at least 2-3 months), before deciding whether any surgical intervention is required.
