Your eyelid is lower
than it used to be. We fix that.
Ptosis is a drooping upper eyelid — and it's more than cosmetic. When the lid drops far enough to block your visual field, it affects how you see, how you drive, and how tired your eyes feel by noon. Dr. Malitz repairs it with a single outpatient procedure.
Signs it might be ptosis:
✓ Your forehead is sore or fatigued by evening
✓ You tilt your chin up to see through the gap below your lid
✓ One eye looks noticeably smaller than the other in photos
✓ You feel like a curtain is partially blocking your upper vision
✓ Your eyes feel tired even after a full night of sleep
If this sounds familiar, it's worth an evaluation. We measure eyelid position and test your visual field — and we'll tell you honestly whether you need surgery or not.
The muscle that lifts your eyelid has stretched
Most patients adapt for years before realizing something is actually wrong. Here's why.
The levator muscle opens your upper eyelid. Over decades of use, it loosens — the tendon thins, the attachment weakens, and the lid sits lower than it should. One eye or both. That's ptosis.
It happens gradually. You compensate without thinking about it: your forehead muscles take over the lifting, your chin tilts up, you squint a little more. Most people don't connect the headache behind their brow to their eyelid position until someone points it out.
In Las Vegas, patients often notice it later than they should. You're already squinting against the sun, the glare off concrete, the dry wind. The desert masks the early signs. By the time you get here, the lid is usually affecting your visual field measurably.
Common causes
Age — the most frequent cause. The levator muscle stretches and the tendon weakens over time. Prior eye surgery — cataract surgery and other procedures can loosen the muscle attachment. Long-term contact lens wear — decades of pulling the lid to insert lenses takes a toll. Neurologic or muscular conditions — less common, but we screen for these. Congenital — present from birth, sometimes requiring early intervention.
How we diagnose it
We measure the margin reflex distance — how many millimeters your upper lid sits from the center of your pupil. We photograph both eyes under standardized lighting. And we run a visual field test to document whether the lid is blocking your peripheral vision. Insurance typically covers the repair when the visual field test confirms functional impairment.
Two approaches. We'll tell you which one fits.
Not every drooping lid needs surgery. But when it does, the repair is straightforward and the results are reliable.
Ptosis repair
An outpatient procedure under local anesthesia. Dr. Malitz tightens or reattaches the levator muscle through an incision hidden in the eyelid crease. The scar folds into the natural line — it's not visible once healed.
Most patients return to normal activity within a week. Mild bruising fades over ten to fourteen days. The goal is specific: put the lid back where it belongs and make both eyes match.
Insurance: Typically covered when the visual field test confirms the lid is blocking your vision. We handle the documentation and prior authorization.
Upneeq® eye drops
Upneeq® (oxymetazoline 0.1%) is a once-daily prescription eye drop that lifts the upper lid by stimulating the Müller's muscle. It's FDA-approved for acquired ptosis in adults.
The effect is temporary — a few hours per drop. It works best for mild cases. Some patients use it to preview what a lift would look like before deciding on surgery. Others prefer it as a daily solution and skip surgery entirely.
Honest assessment: If your ptosis is moderate or severe, drops won't be enough. We'll tell you that upfront rather than sell you something that won't solve the problem.
From consultation to recovery
No surprises. Here's how it works.
Consultation
Dr. Malitz examines your eyelid position, photographs both eyes, and runs a visual field test. You'll know in one visit whether you need the repair and whether insurance will cover it. If surgery is recommended, we schedule it — typically within a few weeks.
Procedure day
Local anesthesia — numbing injections around the eyelid. You're awake but won't feel the surgery. Dr. Malitz tightens the levator muscle and sets the lid height, sometimes asking you to open your eyes during the procedure to check symmetry in real time. About 45 minutes to an hour per lid.
First week
Expect swelling and bruising — it looks worse than it feels. Cold compresses for the first 48 hours. Most patients manage discomfort with over-the-counter pain relief. Stitches are removed at your follow-up visit, usually around one week. Avoid bending, lifting, and strenuous activity during this time.
Full recovery
Bruising largely resolves within two weeks. The lid position stabilizes over six to eight weeks as swelling fully subsides. Most patients see the final result by the two-month mark. Dr. Malitz follows you through the full recovery — your result is his result.
Eyelid surgery heals differently in the desert.
Your post-op instructions aren't generic. They're built for the climate you actually live in.
UV protection during healing
Healing eyelid skin is thin and vulnerable. In Las Vegas sunlight, quality sunglasses are part of the prescription — not a suggestion. Wraparounds preferred for the first month.
Aggressive lubrication
Desert air and A/C pull moisture from healing tissue. We prescribe preservative-free drops on a Las Vegas-specific schedule — more frequent than standard protocols. Most patients use them longer than they expect.
Swelling and dry heat
Low humidity can slow surface healing. We adjust your post-op regimen to keep the incision site hydrated. A bedside humidifier for the first two weeks makes a measurable difference.
Most ptosis repairs are covered by insurance.
Here's how the process works — no guessing required.
Insurance-covered repair
When a visual field test documents that the drooping lid blocks your peripheral vision, ptosis repair is a functional, medically necessary procedure — not cosmetic. Most insurance plans cover it. We obtain prior authorization before scheduling surgery so you know your out-of-pocket cost before you commit.
Cosmetic or self-pay
If the ptosis is mild and doesn't meet the functional threshold, or if you're pursuing the repair purely for appearance, it would be considered cosmetic and not covered by insurance. We'll discuss self-pay pricing at your consultation. Either way, you'll know the cost before any decision is made.
We accept most major insurance plans. Perla, our practice coordinator, handles the prior authorization process and will walk you through your coverage before you schedule anything.
What patients ask us most
Straight answers.
Think your eyelid might be the problem?
One visit. We'll measure the lid, test your visual field, and give you a straight answer — repair, drops, or nothing needed. Your first visit is with the surgeon, not a tech.
Or call us directly: 702-362-3900 · W Flamingo Rd, Las Vegas