I am a 35-year-old female. I'm not sure what this problem is or how to fix it. I have had a slight extra crease in my left eye my whole life, but as I've gotten older it's become much more prominent, especially later in the day when I'm tired. I went to see an Ophthalmologist today who basically told me there is nothing wrong, but I can see eyes are clearly different.
Answer: You don't have to be a rocket eyelid specialist to understand that something is wrong. What your ophthalmologist is doing is explaining that he or she does not understand what they are looking at. Rather than be embarrassed by admitting to that lack of knowledge, they are say nothing is wrong when plainly there is an explanation for what is going on. On the right side (your right side) you have an normal outie eyelid fold ( antiform fold). On your left side, you have an innie eyelid fold (synform fold) (essentially no fold). The difference between the two sides is caused by an abnormal attachment of the internal structures in the left upper eyelid. The levator aponeurosis, which is the tendon that connects the muscle that opens the eyelid to the hard platform structure (tarsus) is centrally disinserted. The slipping tendon retracts into the orbit and takes with it the internal fusion where the anterior orbital septum meets the levator aponeurosis. Anterior orbital fat that helps form the upper eyelid fold lives between the septum and the levator aponeurosis. Where these structures fuse makes the upper eyelid crease. This point had also slipped. The tendon that raises the eyelid has slipped but one does not see upper eyelid ptosis due to eyebrow compensation. You can see that the left eyebrow is significantly higher than the right eyebrow. That also causes the left upper eyelid to look more hollow. Some of the upper eyelid fold volume is contributed by the anterior orbital fat and some of the volume is contributed by the fat that lives just below the eyebrow. The fix for this problem is to perform an aesthetic reconstructive surgery to repair the slipping tendon. It is identified and reattached the the superior edge of the tarsus. This is done through an anterior crease incision that will make a new eyelid crease and a much lower location such as 7.5 mm above the eyelid margin. Anterior orbital fat is repositioned so it descends to the new crease location. An anchor blepharoplasty is performed to make a new hard crease. By repairing the levator aponeurosis, generally the eyebrow will relax to a more normal position and allow the two sides to appear to be much more symmetric. Do not have filler to fill up the upper eyelid fold. This treatment will make the sub brow more full but it will not look right. Don't ask a surgeon who does not understand this anatomy to make this repair. Your eyes can be your best feature.
Helpful 6 people found this helpful
Answer: You don't have to be a rocket eyelid specialist to understand that something is wrong. What your ophthalmologist is doing is explaining that he or she does not understand what they are looking at. Rather than be embarrassed by admitting to that lack of knowledge, they are say nothing is wrong when plainly there is an explanation for what is going on. On the right side (your right side) you have an normal outie eyelid fold ( antiform fold). On your left side, you have an innie eyelid fold (synform fold) (essentially no fold). The difference between the two sides is caused by an abnormal attachment of the internal structures in the left upper eyelid. The levator aponeurosis, which is the tendon that connects the muscle that opens the eyelid to the hard platform structure (tarsus) is centrally disinserted. The slipping tendon retracts into the orbit and takes with it the internal fusion where the anterior orbital septum meets the levator aponeurosis. Anterior orbital fat that helps form the upper eyelid fold lives between the septum and the levator aponeurosis. Where these structures fuse makes the upper eyelid crease. This point had also slipped. The tendon that raises the eyelid has slipped but one does not see upper eyelid ptosis due to eyebrow compensation. You can see that the left eyebrow is significantly higher than the right eyebrow. That also causes the left upper eyelid to look more hollow. Some of the upper eyelid fold volume is contributed by the anterior orbital fat and some of the volume is contributed by the fat that lives just below the eyebrow. The fix for this problem is to perform an aesthetic reconstructive surgery to repair the slipping tendon. It is identified and reattached the the superior edge of the tarsus. This is done through an anterior crease incision that will make a new eyelid crease and a much lower location such as 7.5 mm above the eyelid margin. Anterior orbital fat is repositioned so it descends to the new crease location. An anchor blepharoplasty is performed to make a new hard crease. By repairing the levator aponeurosis, generally the eyebrow will relax to a more normal position and allow the two sides to appear to be much more symmetric. Do not have filler to fill up the upper eyelid fold. This treatment will make the sub brow more full but it will not look right. Don't ask a surgeon who does not understand this anatomy to make this repair. Your eyes can be your best feature.
Helpful 6 people found this helpful
Answer: Non-Surgical Chemical Brow Lift for Eyelid Rejuvenation -- add Ultherapy, Thread Lifting, RF Skin Tightening, Laser Treatments 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.
Helpful
Answer: Non-Surgical Chemical Brow Lift for Eyelid Rejuvenation -- add Ultherapy, Thread Lifting, RF Skin Tightening, Laser Treatments 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.
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October 7, 2022
Answer: Blepharolplasty This is a common question. Every single person is asymmetric throughout their body and this includes the eyes.
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October 7, 2022
Answer: Blepharolplasty This is a common question. Every single person is asymmetric throughout their body and this includes the eyes.
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September 25, 2022
Answer: How blepharoplasty may correct eye asymmetry Thank you for your question and photo. You may be a candidate for a blepharoplasty procedure to balance the shape of the eyes and create a more symmetrical appearance. This minimally invasive surgery can reduce the lid droopiness over the right eye while redefining the extra crease you describe over the left.
Helpful
September 25, 2022
Answer: How blepharoplasty may correct eye asymmetry Thank you for your question and photo. You may be a candidate for a blepharoplasty procedure to balance the shape of the eyes and create a more symmetrical appearance. This minimally invasive surgery can reduce the lid droopiness over the right eye while redefining the extra crease you describe over the left.
Helpful
August 29, 2022
Answer: Upper eyelid asymmetry Yes, your upper eyelid asymmetry can be improved. You likely need asymmetric upper blepharoplasty with small amount filler added to left side although more detailed evaluation is needed to determine accurately and to assess any subtle ptosis. See an expert.
Helpful
August 29, 2022
Answer: Upper eyelid asymmetry Yes, your upper eyelid asymmetry can be improved. You likely need asymmetric upper blepharoplasty with small amount filler added to left side although more detailed evaluation is needed to determine accurately and to assess any subtle ptosis. See an expert.
Helpful
August 29, 2022
Answer: Botox and upper eyelid filler Thank you for your question and posting an appropriate picture. You seem to be a good candidate for a small amount of Botox in the lateral portion of the brow as well as upper eyelid hyaluronic acid filler like Juvederm Volbella to address your asymmetry. Of course it is best to have a consultation either in person or virtually.
Helpful
August 29, 2022
Answer: Botox and upper eyelid filler Thank you for your question and posting an appropriate picture. You seem to be a good candidate for a small amount of Botox in the lateral portion of the brow as well as upper eyelid hyaluronic acid filler like Juvederm Volbella to address your asymmetry. Of course it is best to have a consultation either in person or virtually.
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