Eyes 2 Different Sizes: Excess Eyelid Skin or Unsuccessful Ptosis Surgery? (photo)

I had revision ptosis surgery on my right eye 2 months ago for under-correction, and my eyes still are uneven looking. Do I need another revision, or is there something with the shape of the eye, eyelid skin, or other that requires a different type of surgery? The surgeon was satisfied with the 2nd surgery but I'm still uncomfortable with the result and want to know if the ptosis surgery was again unsuccessful or something else needs to be done to even out eyes.

Doctor Answers 6

Ptosis Revision, Upper Eyelid Surgery, Or Brow Lift?

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              Tough question.  Rarely, are two eyelids perfectly symmetric.  Your right eyelid may have 1 to 2 mm of ptosis (hard to tell based upon aspect of gaze and camera angle).  Is your right eyelid better than before surgery?  If it is, you may want to stop the revisions, particularly if your surgeon is happy with the result. 

                No two sides of the face are symmetric.   One aperture is always smaller.  In addition, your right brow appears 2 mm lower than left.  If the brows were lifted to be symmetric, that may take care of the additional loose skin.  However, upper eyelid surgery (skin removal) may be needed as well.  These things all need to be sorted out on a physical exam.  Hope this helps.  Good luck.

Eyelid ptosis revision

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I recommend waiting 6 months for final result. Upper lid swelling, scar tissue that will improve, eyelid skin and brow symmetry can all be factors. At that time, if  the eyelid appears asymmetric I would consult with your surgeon. Good luck!  

Malena Amato, MD, FACS
Austin Oculoplastic Surgeon

Recurrent Ptosis

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Any honest surgeon will let you know that ptosis surgery is complicated and that recurrence of ptosis and/or failure of the surgery is a real possibility.  I agree that the right upper eyelid is ptotic, but also agree that further surgical intervention is probably best held off for at least 6 months. Your right eyebrow also sits lower than your left, enhancing the relative asymmetry.

Stephen Prendiville, MD
Fort Myers Facial Plastic Surgeon
4.9 out of 5 stars 104 reviews

Revision eyelid ptosis surgery

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Based on the photos, you do have ptosis of the right eye and smaller vertical opening compared to the left. It's hard to discern on single view photo but it appears that your right cheek is also flatter and less projecting. You right eyebrow also appears lower. Your right eye may be positioned slightly behind the left eye and that will make the right eyes appears smaller. Most people are asymmetric, it's just a matter of degree of asymmetry that we can tolerate or accept. I would recommend that you wait at least 6 months before any additional procedure done on that eyelid. As far as another revision is concerned, seek out a couple of opinions from other surgeons who have experiences with ptosis repair. 

Best Wishes,

Stewart Wang, MD, FACS
Los Angeles Plastic Surgeon
4.6 out of 5 stars 28 reviews

Revisional ptosis surgery

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You do have right upper eyelid ptosis.  Ptosis surgery is not always easy and revision ptosis surgery is even harder.  However, there is a technique that more predictably works in those who have had multiple previous ptosis surgeries. The technique is called full-thickness eyelid resection for revisional ptosis surgery. Seen an oculoplastic surgeon.

Mehryar (Ray) Taban, MD, FACS
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 91 reviews


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Recurrent ptosis surgery can be challenging, but is possible. At this point, I would not jump in to have surgery a third time right away.

My recommendation is to wait at least 6 months to allow the scarring to further soften and mature, before attempting a third time.

If you plan on getting another opinion from an Oculoplastics surgeon, I would recommend getting copies of the operation reports from the first 2 surgeries, so that a more informed decision can be made regarding the next appropriate  step.

A.J. Amadi, MD
Seattle Oculoplastic Surgeon
5.0 out of 5 stars 42 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.