San Diego Oculoplastic Surgeons

Ptosis Correction

I began noticing my right eyelid droops&is bigger than my left eye. I've read a lot&I know often ptosis isnt insured. My ENTIRE life my right eye has always twitched, always waters, aches, &always feels heavy. Its very dangerous when driving.Ive always been scared to tell anyone for fear of noticing. Im finally going to tell my dr but my question is do you think my case would be insurable and correctable? I'd like my right eye to feel normal and my eyes as a whole to be even. Thanks.

Hi, thank you for sharing your photograph.  From the photo, you appear to have ptosis of the right upper eyelid.  Given your history that the right eyelid has been symptomatic your whole life and your upper eyelid crease is indistinct, there is likely a congenital component to your ptosis.  This can be evaluated in more depth with measurement of the levator function, presence of eyelid lag and by review of old photographs.  The treatment (which is often covered by insurance) would be a levator repair.  Best of luck in your care.  

Bobby S. Korn, MD, PhD

San Diego Oculoplastic Surgeon

Upper Eyelid Hollowness After Ptosis Repair

Hi, I am 32 years old Asian female. Apr 2011, I had a surgery to repair ptosis. However, my left upper eyelid became too hollow, stiff and sunken. I am frustrated that my eyelid are hugely assymetrical. I am fearful of another surgery as it may damage muscle function. I've read that fillers don't work and the only solution is fat grafting. I'm looking up fat grafting to correct this, and I'd like to know, are oculoplastic surgeons or plastic surgeon better at this procedure?

Hi, sorry to hear about your eyelid asymmetry.  First, it appears that you have a levator dehiscence ptosis of the left upper eyelid as well as volume loss of the upper eyelid (superior sulcus) as evidenced by the eyelid position MRD1 1.0 and elevated eyelid crease.   What did you left eye look prior to any surgery?  Was the crease as high or indistinct?  Were there multiple folds?  Is there an element of congenital ptosis (present since birth?)  A good history and review of old photographs would help to determine a treatment plan.  What kind of ptosis repair did you have - anterior/posterior?  Filler or fat would not be my first choice but rather a repair of the levator dehiscence.  Best of luck in your care.  

Bobby S. Korn, MD, PhD

San Diego Oculoplastic Surgeon

Will I Be Able to Close my Eyes After Eyelid Surgery?

does the eyelid surgery leave the lids pulled open more so, causing difficulty to close them?

When performing blepharoplasty on the upper eyelids, conservative skin marking should be performed to allow normal closure of the upper eyelids.  The decision to remove skin only, skin + muscle, skin + muscle + fat depends on many factors including age, ethnicity, and the degree of dermatochalasis and fat prolapse.  One shoe does not fit all.  

For lower lid blepharoplasty, a conservative approach should also be taken to prevent the development of lower eyelid retraction and incomplete closure of the eyelids.  In this case, lower eyelid tightening should be performed if there is laxity of the lid.  Skin removal should be performed only judiciously and in conjunction with some type of lower eyelid retinacular support.  

The consequences of incomplete eyelid closure include dry eye syndrome and even scarring of the cornea (clear part of eye).  In general, it's easy to remove more skin later but difficult to add! 

Best of luck with your care. 

Bobby S. Korn, MD, PhD

San Diego Oculoplastic Surgeon