Hi, I'm a 28 year old white female. I had ptosis repair on my upper right lid 6 months ago and my eyes are still shaped unevenly. Also the right eyelid has less surface area than the left. Is it going to stay like this? What can I do? In all pictures the right eye is wider than the left. It is depressing me. Also my brow on the right side is lower than it used to be.
Uneven Eye Shapes? (photo)
Doctor Answers 5
Uneven eyelids after ptosis surgery
You have mild left upper eyelid ptosis (and relative right upper eyelid retraction). The retraction could be due to compensation from the left upper lid ptosis (Herings phenomenon). See an oculoplastic surgeon for evaluation.
Ptosis often requires multiple procedures.
By the nature of how the procedure is done, ptosis surgery is often requires multiple touch ups. You should follow up with your occuloplastic surgeon.
The photo is less than idea, since your head is slightly tilted. But it does seem that the right eyelid is slightly higher. As mentioned when onesided ptosis surgery is performed and the droopy eye is corrected, it is possible that the other [non operated] eyelid will drop due to a complex neurological phenomenon termed Hering's law.
Furthermore, the eyebrow on the operated side will naturally settle down because your unconscious drive to open the more droopy eyelid with your eyebrow is no longer present.
At 6 months, one would expect the results to be final. If you are unhappy with the asymmetry, I would recommend a consultation with an ASOPRS trained Oculoplastics surgeon. If you are happy with the more open right eyelid, then subtley raising the left eyelid would be the more predictable surgery. It is more difficult to lower an eyelid as predictably.
If you would like a second opinion [and you definitely need an in person evaluation], I have provided a link below to find an AOSPRS surgeon near you.
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Unilateral ptosis repair can be appropriate.
However, many times there is ptosis present on both sides but it is more dramatic on one side. Occasionally patients will insist on surgery on only the "bad" side. After surgery, the uncorrected side can then fall. Only then does it become apparent that the good side also needs some support as well. I suspect that is what you are experiencing. You will need a highly experienced eyelid surgery to address this.
Based on the photograph the question is difficult to answer about lid asymmetry.
It looks as though the right upper lid is somewhat higher than the left will photograph is not particularly good. Sometimes repair of ptosis in one eye can generate through neurophysiological mechanisms that requires correction of the opposite. Nevertheless the problem here is complex and should be dealt with by someone experienced in eyelid surgery.