Excess skin/asymmetry 10+ years after Ptosis Surgery what do you recommend? (photos)

Question

I had mild ptosis in my right and received surgery for it about 10 years ago. Over the past few years, I've noticed excessive skin in my right eye which causes asymmetry. Would you recommend I receive another bleph procedure to remove this skin? Brow lift? or less invasive (Botox, dermapen, thermage, co2 laser)? I've met with a few ocularplastic surgeons who have given me different recommendations.

Bhupendra C.K. Patel, MD, FRCS · Answer

Your ptosis surgery was very well done, and you have a nice long-term result, so this is good!!
You have very mild asymmetry of your brows.
Mainly, you have asymmetric skin creases with that little fold on the right upper eyelid. Botox will achieve little, and thermage will give too subtle a result to satisfy you. We do use the CO2 laser to tighten skin but in your case, the fold is more than the improvement that a CO2 laser would give you. The best option is to reform a crease on the right side, which closely matches the left side. With a prior ptosis surgery, it is important for your surgeon to have details of your prior surgery: i.e., was it done via the anterior or conjunctival approaches?

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