• Surgery for Marcus Gunn, Ptosis


    Question:

    I have Marcus Gunn jaw winking syndrome. My ptosis is mild. Can I have frontalis sling surgery to improve my cosmetic appearance? Does it really improve cosmetic appearance?


    Answer:

    If your ptosis is mild you may wish to consider either a Mueller's muscle resection or levator resection to improve your appearance. Of course these procedures do not influence the jaw wink associated with your Marcus Gunn ptosis. If you think the jaw wink is significantly cosmetically distracting, the levator muscle can be disinserted and a frontalis suspension placed. In this case, eyelid elevation will be entirely from the use of your brow.

    If you have unilateral ptosis, especially mild, you may find it difficult to raise one brow alone; especially if you are an adult. If you have bilateral ptosis, and undergo bilateral surgery, you would be more likely to experience a successful, aesthetic outcome. Remember, however, that if you wish to eliminate the wink, the levator muscle must be disinserted, and this renders the eyelid droopy. The sling is used to leverage an adjacent muscle (the brow) to elevate the lid.

    The complex decision regarding which procedure is optimal for your particular circumstance is best made with an ophthalmologist who is a oculofacial plastic surgeon who can review the risks and benefits of the operative choices.


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