One year after blepharoplasty for ptosis and scar. More asymmetrical than before. What are my options now, if any? (Photo)

Question

Born with congenital ptosis and jaw winking syndrome in my left eye. Nine years ago I had a ptosis repair. The surgery was not done well & left me with a large scar & still droopy. A year ago I went in to repair this the surgeon told me all I would need was ONLY a blepharoplasty to remove the scar. I am now even more asymmetrical than before. I’m worried nothing can be done because the amount of puffiness, scar tissue, & lack of skin left(I’m 22) but I’m desperate. I can’t live with this.

Kenneth D. Steinsapir, MD · Answer

Congential ptosis does not mean that there is no help help for you. The ability to make this situation better will depend very much on precisely how much levator function you have. Levator function is a measure of the excursion of the levator palpebrae superior muscle. That is the muscle that lifts the eyelid. Provide there is more than 10 mm of levator function, it is possible to improve the position of the upper eyelid. Seventy percent of my practice is aesthetically revising unsatisfactory eyelid surgery. Most ptosis surgoens are reconstructive surgeons. They are not accustom to delivering a cosmetically acceptable result. You need better than close to have a successful result. You need a personal detailed consultation to determine what resources you have to improve the eyelid. Generally this will require redesigning the crease in both shape and location and removing the old scar. A revisional levator resection ptosis surgery can be performed to make the upper eyelid more open which will reduce the amount of eyelid platform that is visible. Your issue is not a lack of left eyelid skin. You have enough skin to make the change you need. An anchor blepharoplasty is a detail that almost no reconstructive ptosis surgoens perform is needed. The anchor blepharoplasty connects the skin and orbicularis oculi muscle to the edge of the levator aponeurosis. This supports the upper eyelid lashes so they don't droop down and shade the top of the cornea.

John Dean, MD · Answer

You were born without levator function on one eye. Congenital ptosis repair can allow you to open your eyes better but will never be able to completely match the function of the normal eyelid on the other side.  It appears that your surgeon was able to get your lid level close to the level of the opposite side while at the same time notu tightening things so tight that you can't close your eyelids. I believe that you have an excellent result and have very pretty eyes. Hopefully you can live with this.

One year after blepharoplasty for ptosis and scar. More asymmetrical than before. What are my options now, if any? (Photo)

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Everything you need to know about Ptosis Surgery

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One year after blepharoplasty for ptosis and scar. More asymmetrical than before. What are my options now, if any? (Photo)

Answers (2)

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Recommended reading

Everything you need to know about Ptosis Surgery

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