30 y.o female suffering from eyelid ptosis and seeking advice on rectifying the problem. Before/after pictures attached (Photo)

I had surgery in 2014 to make forehead smaller/shave the bones to give a more feminine appearance. This left my eyes looking smaller with 1 eye bigger than the other. I then had botox numerous times from 2014-2016 which has only made the problem worse. I'm unsure what to do next, or what sort of surgery I should seek to rectify this problem. I know I would need scans of my skull to see what is causing the problem, and am willing to travel to a surgeon who will able to deal with this issue. Thanks

Doctor Answers 5

The paradigm of cosmetic surgery in Beverly Hills is the chopped up torso on Rodeo Drive.

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That means you have to be very careful what you look for.  Your main problem is not the unnecessary forehead shaving that you had in 2014.  The issue you had then is still an issue now.  You have upper eyelid ptosis with a compensatory brow lift.  You have a particular type of upper eyelid ptosis which is called anterior levator disinsertion ptosis.  This also tends to make the upper eyelids look hollow. You also have lash ptosis. The heavy eyelids looks dull an lifeless.  If you decide to add volume to the forehead head, it should not be done with implants or bone cement.  This always looks horrible (think frontal bossing).  I would start with a careful personal consultation.  Look for solutions that make sense now.  You have likely been traumatized by the result of the original surgery and it is important to know that you do not need to directly "undo" this surgery to improve your appearance.

Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Eyelid Asymmetry

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Based on the photographs, you have a brow asymmetry (left brow higher than right) and slightly more skin on the right upper eyelid relative to the left (which is likely related to the higher brow on the left side). I would not recommend ptosis surgery based on the photographs you have provided because if you look at your corneal light reflex (the white dot in the middle of your pupil) in the first photograph, the distance to your upper eyelid appears normal and even on the two sides. I think what you are noticing is a brow and skin difference in the upper eyelids. I would suggest seeing an oculoplastic surgeon to do a formal in-office evaluation to decide how best to achieve symmetry in your case.

Mahsa Sohrab, MD
New Haven Oculoplastic Surgeon

Asymmetric eyes

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The first photo does not show ptosis, it shows eyelid crease asymmetry. This is due to loss of volume in the upper lid. This can be improved simply with fillers or an upper lid blepharoplasty, depends on which side you like better.

Peter T. Truong, MD
Fresno Oculoplastic Surgeon
4.9 out of 5 stars 42 reviews

Asymmetric eyelid ptosis with brow elevation

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You have bilateral upper eyelid ptosis (droopy upper eyelid) which is worse on left side. The eyelid ptosis is causing brow compensation as the brow is elevated in order to assist lift the droopy eyelid, which is worse on the left side. The treatment is eyelid ptosis surgery, which can be done under local anesthesia or conscious sedation. See following link and video. See an oculoplastic surgeon.

Mehryar (Ray) Taban, MD, FACS
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 91 reviews

Its not the brow, it's your ptosis

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It's not your brow it's your ptosis. I would stop these additional treatments that you're getting such as the Botox for a bit and go see an experienced oculoplastic surgeon in your area. You may need an external elevator tendon advancement or another procedure known as a Putterman procedure to improve your ptosis. It's a little hard to say based on just your photos but get a few in-person evaluations where you live. There is no shortage of good oculoplastics surgeons in Southern California.

Chase Lay, MD
Bay Area Facial Plastic Surgeon
4.9 out of 5 stars 80 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.