Asymmetrical upper eyelids after facial trauma? (Photos)

I suffered a ZMC fracture about a year ago and immediately after the swelling went down I noticed that my upper eyelids looked different. Sagging skin above the right eye creates a drooping look and the left eyelid hangs lower when looking down. First photo shows my eyelids in their resting positions. In the other two photos, I am manipulating one eyelid to match the other. I prefer the look of both eyelids hanging lower instead of lifted. What can I do to achieve the symmetry I am looking for?

Doctor Answers 5

Drooping upper eylid- ptosis

You have a traumatic ptosis. It is not from the soft tissue swelling or displacement. It is from injury to the tendon that moves your upper lid. You will probably require a tightening of the tendon which technically would be called 'levator imbrication'.

Talmage Raine MD FACS

Chicago Plastic Surgeon
4.6 out of 5 stars 9 reviews

Asymmetrical upper eyelids after facial trauma?

Consult with a Plastic Surgeon about lifting or lowering your eyelids.  Discuss all of this thoroughly with the Doctor.

Fred Suess, MD (retired)
San Francisco Plastic Surgeon
4.5 out of 5 stars 8 reviews

Asymmetrical upper eyelids after facial trauma?

Thank you for your question. You need to see an expert craniofacial surgeon who does a lot of trauma. A ZMC fracture that is incompletely reduced (not fixed in the correct position), can lead to increased orbital volume. This sets the affected globe (eyeball) back in the socket (enophthalmos) and can affect the vertical orientation of the globe. Your left eye appears lower than your right (vertical dystopia). You will require a CT scan to closely evaluate fracture reduction and orbital volume. If your zygoma was incompletely reduced, you may require osteotomies, reduction, and fixation. If your zygoma is in the appropriate position, then you could consider seeing in occuloplastic surgeon for treatment of ptosis, which could result from swelling after the injury. It's important to identify the underlying etiology, so that the correct surgical treatment can be performed.

Austin Hayes, MD
Portland Plastic Surgeon
5.0 out of 5 stars 32 reviews

See oculoplastic specialist for eyelid ptosis evaluation

You need to see an oculoplastic specialist for in person evaluation. You have upper eyelid ptosis but there may also be other issues going on such as underlying bony injury.

Mehryar (Ray) Taban, MD, FACS
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 72 reviews

This would be consistent with ptosis after facial trauma.

This can be corrected with reconstructive surgery.  See a fellowship trained oculofacial surgeon for assessment of your ptosis.  A detailed consultation will determine which approach to ptosis correction will be best for you.

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.