Uneven eyes after ptosis surgery. Can they be evened out? (Photo)

The eyelid margin position of the two eyes is good. The problem is that the upper eyelid fold is not right. The problem is that you likely had surgery by a reconstructive ptosis surgeon. They are strictly only concerned with the position of the eyelid margin. If you are fixing a heavy eyelid the height of the eyelid margin matching the height of the other eyelid margin is how they measure their results. However you as a patient were hoping that when the upper eyelid was fixed that the two eyes would look similar. However there is much more to making the eyelids look similar than just fixing the position of the upper eyelid margin. It is possible to fix the upper eyelid fold but this requires an anterior crease incision and a reconstruction of the upper eyelid. Undoubtedly you have levator disinsertion with retraction of the preaponeuotic fat pad. Surgery is needed to make a more robust ptosis repair with correction of the disinserted levator aponeurosis and reposition of the upper eyelid crease and preaponeurotic fat pad. Your original surgeon is not likely familiar with this type of work. Your eyes can be your best feature.

Hello! Thank you for your question.You have extra saggy skin above your eyes and your eye area downward. For more symmetrical and fresh look I suggest you brow lift and upper eyelid blepharoplasty. If you can provide photos with better lighting, from the side of your face and 1 meter away I would be able to make a proper evaluation. Please keep in mind that %100 symmetry is not achievable in any case. Best Regards!

As we age, our eyelids naturally sag and droop. A combination approach would be best to see visible improvement. In terms of non-surgical treatment options, I would recommend a Chemical Brow Lift (using Botox, Dysport, Xeomin, or Jeuveau) and filler injections to rejuvenate the temples, eyebrow, eyelid, eye troughs, upper eye hollows, and forehead. I typically combine this with Ultherapy and thread lifting to lift the brow; RF and skin tightening laser treatments to stimulate collagen production and rejuvenate the skin; and laser or superficial RF devices for improvements in texture, color, and any crepey skin around the eyes as needed. In some cases, surgery is the best solution to achieve the desired results. See an expert for a formal consultation. Best, Dr. Emer.​

Thanks for posing the question. The symmetry of the eyes is a common concern with patients before and after surgery. Interestingly, your asymmetry here is not related as much to ptosis, which is a droop of the eyelid margin, but more so an asymmetry of the volume in the “sulcus”, the space between the eyelid margin and the brow. Your left eye has less volume and so it looks deflated, and the skin is folded onto itself. What you need to improve things is an upper blepharoplasty with attempts to not just remove more skin on one side, but even out the volume which can be done with fat repositioning of the upper eyelid, fat grafting, and other techniques. I recommend consultation with an oculofacial plastic surgeon with a lot of aesthetic eyelid experience.

It is relatively frequent to have small asymmetry in upper eyelid fold or position of lid margin after ptosis repair. You should consult your surgeon to see how to deal with this small asymmetry. Good luck.

Hello,

A revision upper blepharoplasty or revision ptosis surgery could benefit you. I would recommend to consult with a board certified plastic surgeon well versed in this area.

Best of luck,

Randal Haworth

On the left side, it seems to be loosened so better to get revision ptosis correction. Our clinic's ptosis correction is such a great and special surgery so if you have further questions then please let me know. Thank you!