How can I fix my eyelids? They don't match. (Photo)

Question

About 4 years ago I had a severe case of pink eye. My eye was swollen for several days. Since then it has never been the same and I hate how it looks in photos. Is surgery the only answer or can I do something else to get it back to normal ??

W. John Bull, MD · Answer

It appears that the left upper eyelid levator muscle has either stretched or separated from the attachment on the tarsal plate of the eyelid, which then makes the left eyelid droop and the eyelid crease very high. This of course, then does not match the right eye. If you look at the photo, it also shows that the eyebrow is higher on the left side. This is your brain trying to fix the problem by pulling with other muscles to open the left eye. This procedure involves an incision in the left upper eyelid to fix the muscle and help make the eyelid creases symmetrical. I sugest getting a consultation with a surgeon who specializes in this procdure such as an occuloplastic surgeon or a plastic surgeon that does this procedure.

James R. Gordon, MD, FACS, FAAO · Answer

Your left upper eyelid has been stretched and now droops. In order to see better you unintentionally use your eyebrow to help assist in the elevation of the lid. There are a few techniques used to correct this problem. An oculoplastic surgeon can evaluate your condition in the office and guide you with the appropriate treatment.

Kenneth D. Steinsapir, MD · Answer

You have a left upper eyelid levator dehiscence ptosis.  This can be repaired with ptosis surgery.  You also need to have a hard upper eyelid crease made so that the left upper eyelid looks much more like the right side.  I recommend seeing several fellowship trained oculoplastic surgeons.  The American Society for Ophthalmic Plastic and Reconstructive Surgery maintains a regional directory on their website that can help you find a well qualified surgeon close to home.

Kamran Khoobehi, MD · Answer

You have left upper lid ptosis and the only way to correct it would be surgery. This is done under local anesthesia and recovery would be 10 days. Please see you local plastic surgeon or  oculoplastic surgeons.

Geoffrey Kwitko, MD, FACS · Answer

it appears that you have a levator dehiscense . That means the muscle that raises your eyelid has slipped off the upper lid abit. The only way to fix this is with a ptosis repair which is a levator advancement to get the lid to its normal height

Amiya Prasad, MD - Account Suspended · Answer

I’m a board certified cosmetic oculofacial plastic surgeon practicing
in Manhattan and Long Island for over 20 years. I specialize in cosmetic and
reconstructive surgery in the eyelid area and I deal a lot with revision
surgery for complex reconstructions as well as complications of infections and
cosmetic surgery.

Pink eye is a condition called conjunctivitis. This is an infection
where the eyes are always wet and tearing, but it eventually gets better.
However, conjunctivitis does not change the space around your eye. In your
photo, I can see that the left eye has a very high crease. High creases are a
result of loss of volume in the orbit or eye socket, specifically there is loss
of orbital fat or fat that’s normally around the eyes. This also happens in
patients who have infection such as preseptal cellulitis or orbital cellulitis.

To address this hollow area, there are both surgical and non-surgical options.
Prior to the use of fillers, my approach for patients with high creases due to cosmetic
surgery is fat grafting. I would harvest fat from an area of the body and place
it into the hollow space in different levels. This way, the fat would heal and
the body would readily take it. This process involves taking cells or tissue
out of one area, taking them away from the blood supply, putting them in
another area, then hoping the blood supply will take. One of the challenges is
if the fat doesn’t take, which is why grafting often requires multiple
procedures. There are other methods such as dermis fat grafting, which is a
different approach that involves an incision on the eyelid, and the placement
of a combination of skin and fat placed into that space. Again, it is surgical
graft, therefore there is some unpredictability.

In some patients who have a hollow appearance, we can also use fillers
such as Restylane and Juvederm. This is a conservative way to fill part of that
orbital space. It’s generally not advised to place it in the high area inside
the orbit. It doesn’t seem to follow any type of predictable result, but we can actually get a nice cosmetic result with just the
filler alone. We’ve also combined the filler with platelet-rich plasma (PRP) to
have a synergistic effect that would stimulate tissue growth and healing.

It’s important that you meet with doctors and get some opinions. I
would recommend oculoplastic or oculofacial plastic surgeons. The eyes are a
very specialized area and you would be best served with someone who does this
as a significant part of what they do in their practice. In addition, get some
opinions of what would be best for you. It’s very important that you
communicate and work with the doctor you’re comfortable with in terms of the
risks and benefits. There’s obviously no perfect solution for this. I hope that
was helpful, I wish you the best of luck, and thank you for your question.

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