Hello.. My eyes are asymmetrical like the photo. below the eyebrows in the right picture, lose fat and now sunk. I think a fill is necessary to replace de lost fat.. Is there anything I can do?
Doctor Answers (4)
Excessively hollow upper eyelid
It is difficult to assess from this picture but it appears as if your levator attachment is attenuated as well because the supratarsal crease appears to be higher than normal. Repair of the levator aponeurosis may be beneficial. Fat grafting is difficult to predict in the lid and can lead to irregularities or lumpiness.
Asymmetric Upper Eyelids
Regarding : "Non-Symmetrical Eyelids Hello.. My eyes are asymmetrical like the photo. below the eyebrows in the right picture, lose fat and now sunk. I think a fill is necessary to replace de lost fat.. Is there anything I can do?"
The merged photo is not great but demonstrates a major loss of the upper lid tarsal fold. This suggests that the insertion of the Levator muscle lifting the upper lid into the upper lid skin and tarsal plate was either largely missing (at birth) or that it broke and went away later in life (acquired ptosis).
This is repairable with several operations. Brazil has some of the best Plastic surgeons in the world. consult one or more who specialize in eyelid surgery. They should be able to help you.
Dr. Peter Aldea
Hollowness of the Upper Eyelid Might Mean Trouble...
Most patients with asymmetry of the upper eyelids are completely normal. However, a percentage of these patients will have what is called "levator dehiscence". The upper eyelids move up and down. The "up muscle" is called the levator ( lifter upper, or 'elevator' for you Latin aficionados). The attachment of the levator to the lid is complex, and it includes fibers to the skin as well as to the cartilage in the upper eyelid. Sometimes due to injury, or sometimes just due to evil spirits plain bad luck, the levator becomes detached from the lid, but not the skin. As the levator tries to keep the eyelid open, it ends up pulling harder and harder on the skin, resulting in sometimes dramatic lifting of the skin into the eyeball socket, creating an asymmetry. I typically repair these problems under local anaesthesia with the patient awake, particularly if they have already had upper eyelid surgery or a previous repair, since the muscle tendon is very thin (think tissue paper that is wet). A few sutures placed with the patient opening and closing their eyes to check on levels, and voila, the problem is solved. It can get tricky in a few situations, but most of the time, these problems respond well to treatment.
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Thanks for posting the photos. My opinion is you are within normal anatomic variation for the orbital region. If you are still unhappy with this asymmetry than either fillers (like Restylane or Stem Cell Fat grafts) or excision can be done. From MIAMI Dr. Darryl J. Blinski, 305 598 0091
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