Matheson A. Harris, MD

If you are concerned about your eyes as well as the eyelids, an oculoplastic surgeon (both an ophthalmologist and eyelid surgeon) can evaluate your eyes and determine why the eyelid appears to be drooping. 

It appears from your photos that you have left upper eyelid ptosis (a droopy eyelid). You'll need to be evaluated in person, but this may require a surgery to lift the left upper eyelid.  An oculoplastic surgeon can determine the cause of the ptosis and perform a few measurements and tests to decide the best way to fix it. 

 It appears you actually have a ptosis (droopy eyelid) of the right upper eyelid, which is making the asymmetry apparent. You would likely want to have that right side elevated or have surgery on both sides to make them even.

There really isn't a single qualification that guarantees a surgeon knows how to properly perform a blepharoplasty. Lots of board certified physicians perform blepharoplasty on occasion. Rather than rely on paper certificates to choose your surgeon, inquire about how often they perform the procedure and what their results are. If they are doing at least 10-20 eyelid surgeries a month, and they have lots of good before and after photos with excellent reviews, you are likely (but not guaranteed) to have a good outcome. If they are doing the occasional blepharoplasty between lots of breast augmentations or face-lifts, etc., you have to be more judicious.  

From your photo, it does look like you have mild ptosis. It would be wise to have an eye exam with an oculoplastic specialist who can both check out the vision as well as the eyelid. There are many options for treatment depending on what is found. 

You need to see a pediatric ophthalmologist. If this lost muscle can be seen on an MRI or CT scan, it is possible they could retrieve it and reattach it. If too much time has passed and it is scarred down in a way that it wouldn't function properly, you could benefit from another strabismus procedure to straighten the eye. 

Thanks for sharing your photos. You  could definitely use filler or surgery to get a nice result, however, one will be fairly temporary and the other more permanent.  There are certain risks with using filler in the tear trough area which you would want to discuss with your surgeon before going forward. See a oculoplastic surgeon in your area. 

Testing required by surgery centers before any procedure is at their sole discretion in most cases. It could be due to a policy set forth by the anesthesia providers or simply by the lawyers who want to protect the center from bad outcomes.  When you have a high volume of patients, many surgical centers default to checking everyone for a certain baseline amount of things to hopefully catch the few patients with serious, unseen issues that could affect their surgery or lead to complications.  It's not ideal, but it is common place. 

Even with local anesthesia, it isn't a good idea to drive after upper or lower blepharoplasty. Your vision may be impaired by mild bleeding, swelling, and the ointments applied after surgery.  Just play it safe and have a driver take you home. You can lay the seat back and get the ice started :)

After 10 days, sutures could potentially be removed, but you'll want to see your surgeon to ensure the wound is healing well and there is no other reason to leave them in longer.