What options do I have to fix eye symmetry issue? (photo)

Question

Hello Dr's!! I am wondering what options I could have to fix the symmetry in my eyes. I had an orbital floor fracture repair done 7+ years ago and really starting to notice the difference in symmetry. For one, the upper lid has lax skin from loss of volume. Secondly, looks like a mild case of enophthalmos. Lastly, the undereye area for both eyes are darker and don't look fresh. The eye that had the surgery looks way worse all around. The eyebrow even tends to drop more. Any suggestions?

Marc Polacco, MD · Answer

Thank you for your question. Asymmetry after an orbital floor fracture, especially depending on severity, can be fairly common. Scar tissue and fat loss in the area are just a few potential contributing factors. I would favor small changes using filler, and maybe small surgical maneuvers depending on what needs to be addressed.

Zoran Potparic, MD · Answer

It appears that you have mild enophthalmos due to infraorbital volume loss after orbital flor fracture. CT scan can help to establish right diagnosis. Orbital floor repair with plate (if indicated) may  provide volume correction? Otherwise, periorbital fat and nano-fat grafts to upper eyelid may create more symmetry. Not sure whether you have ptosis? Good luck.

Kenneth D. Steinsapir, MD · Answer

The difference, at least with this photograph, is not noticeable. This impression may be different than an in person assessment.  This photograph does show some darkness around the eyes but this is pretty symmetric on the two sides. The photo shows that you have bilateral upper eyelid ptosis with a compensatory eyebrow elevation. You appear to have a secondary fold in the left upper eyelid and presume that this was the side with the orbit fracture. I recommend being skeptical of surgeons who want to add orbital volume or revise the fracture repair. Please keep in mind that this type of work is not cosmetic and generally will cause a number of down stream changes that will not enhance your appearance. Periocular pigmentation in the lower eyelid can be helped with thoughtfully performed hyaluronic acid filler. The upper eyelids would benefit from anterior levator resection ptosis surgery and an anchor blepharoplasty. Do not let a surgeon talk you into an upper blepharoplasty. They will want to remove your upper eyelid fold and take out your natural anterior orbital fat without repairing the ptosis. This will not make you look younger and better. It will make you look older. Please do not do this to yourself. There is no substitute for a detailed personal assessment. That does not happen in a "Zoom consultation." Your eyes can be your best feature.

What options do I have to fix eye symmetry issue? (photo)

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What options do I have to fix eye symmetry issue? (photo)

Answers (3)

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Everything you need to know about Eyelid Surgery

Our mission is to create a world where every investment in modern beauty is Worth It.