Drooping of Upper Eyelid Due to Injury? (photo)

Question

I was hit right below my eyebrow in a sports collision about five years ago. It resulted in an immediate swelling of the area that turned into a black eye lasting for many weeks. Five years later, my left eyelid still has a slight droop. What can I do to fix this and how much would it cost?

Mehryar (Ray) Taban, MD, FACS · Answer

You may have suffered from an eye socket fracture (orbital fracture) which can cause the eye to sink back (enophthalmos) which can make the eye appear smaller. There could be other factors involved too which is difficult to assess by a 2D photo. It is best if you see an oculoplastic specialist for evaluation.

Kenneth D. Steinsapir, MD · Answer

I suspect that you may have fractured your left orbit at the time of the sports injury. If your appearance bothers you enough, consider seeing a fellowship trained oculoplastic surgeon to be assessed. Generally this will entail getting an orbital CT scan to assess the integrity of the orbital bones. Even though you are 5 years out, there are many options to address this. Or you may decide upon learning precisely why you have this issue and what would be involved in addressing it, you might just live with the asymmetry but you will be far better informed. The American Society for Ophthalmic Plastic and Reconstructive Surgery maintains a geographic directory that will help you find a well qualified surgeon.

Vincent N. Zubowicz, MD · Answer

In the photographs I do not see a significant difference in the position of the eyelids. The left upper lid has less "lid show" probably due to asymmetric soft tissue volume of the lids. This can be addressed with eyelid surgery although it is very modest and probably not worth it.

Mario J. Imola, MD, DDS · Answer

Your photo shows primarily brow asymmetry with your left brow positioned lower than the right. Your left eyelid may or may not demonstrate ptosis (drooping). An in-person physical exam would be able to sort this out. High quality comparison photos from before your trauma would be useful in determining if the problem was related to the sports trauma. A unilateral left browlift and possibly ptosis correction may be indicated. Consult with experienced eyelid surgeons.

Darryl J. Blinski, MD · Answer

I would be very careful in offering a surgery at this stage. This could be a normal anatomic variant to your facial structures. Obtain ONLY in person evaluations

William Portuese, MD · Answer

The photos show the patient's left eyelid and eyebrow slightly lower than the right side. A left-sided minimal blepharoplasty where small amount of skin could be removed from the patient's left eyelid to make it balance and matched to the right side.

Stephen Weber MD, FACS · Answer

What is apparent from the photo you posted is that your left eyebrow (right side of this photo) sits lower than the right eyebrow. It would be alot easier to assess this in person to see what a subtle lift of that eyebrow does for improving symmetry. I would not recommend anything be done with your eyelids but you could consider either a Botox browlift or a surgical browlift to improve symmetry. I hope this information is helpful.

Thomas A. Narsete, MD (retired) · Answer

It is hard to evaluate this without an exam. Based on your pictures, the bone structure of your eyes is asymmetric. Most patients have this. In an exam, I would want to know if the eyelid function and levator muscle are normal. Under this last circumstance, your appearance may be normal for your bone structure, and no surgery is warranted. All the best

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