Would I benefit more from bleph to fix my asymmetrical eyelids or lateral brow lift to fix eyelids and droopy tails?

Question

I have very asymmetric eyelids and eyebrow tails. my right side (picture left) is noticeably more droopy than the left. Would I benefit more from a blepharoplasty to fix my asymmetrical eyelids or a lateral brow lift to fix both my eyelids and my droopy tails? Note: I have had my left eye ptosis looked at by 3 different oculoplastic surgeons and I am not a candidate for surgery. I'm not interested in correcting my ptosis at this time.

Kenneth D. Steinsapir, MD · Answer

You have upper eyelid ptosis and your ptosis is repairable. Perhaps the surgeons you have seen are reconstructive ptosis surgeons. I often will operate on as little as a 1/2 millimeter of ptosis. Most surgeons are not comfortable with this and will quote ptosis surgery as accurate plus or minus a millimeter. That is 2 millimeters. This is simply not accurate enough for aesthetic surgery. The lateral area that you attribute too asymmetric eyebrow tails is not the correct analysis. What is going on is that you have bilateral central levator disinsertion. The ptosis is stronger on the left side. This does stimulate a compensatory eyebrow elevation. The left side is higher than the right because the ptosis is worse on that side. If you did have a temporal brow lift ( I do not recommend this), it will heighten your awareness of the upper eyelid ptosis. The fix here is to repair the ptosis, reconstruct the upper eyelid creases by lowering them, and performing an anchor blepharoplasty to support the upper eyelid lashes. The right upper eyelid has a fold. You are missing the fold on the left side due to the compensatory eyebrow elevation. Fixing the ptosis and correcting the crease will restore the appearance of the fold on the left side. This work will allow the eyebrows too relax to a more natural position. Please be aware that posterior approach ptosis surgery (so-called scarless ptosis surgery or Mueller's muscle conjunctival resection ptosis surgery) is not the right surgery for you. You need an anterior levator resection ptosis surgery. Your eyes can be your best feature. There is no substitute for an actual in person assessment.

Would I benefit more from bleph to fix my asymmetrical eyelids or lateral brow lift to fix eyelids and droopy tails?

Answers (1)

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