Will ptosis surgery make my eyes more almond shaped, or should I focus on the lower lid?

It is possible that the lower eyelids could be helped at the same time of the ptosis surgery with a lateral canthal procedure. A detailed personal consultation should assess basis for your issues to determine precisely what you need. In particular, while scarless ptosis surgery is very popular, it is often ineffective. The appropriateness of this surgery is not assessed on the basis of the neosynephrine drop test but rather the actual physical examination of your eyelids. I highly recommend seeing more than one surgeon before committing yourself to a particular approach.