Should I be concerned about ptosis? (photo)

Question

Not sure why they look like this, one has a lower crease and the other is super round, how would I fix this?

Kenneth D. Steinsapir, MD · Answer

The vast majority of surgeons you will meed regarding you issue will not help you achieve what you need. They will fall into two categories of surgeons: oculoplastic surgeons who do ptosis surgery and other surgeons who will tell you you need eyelid surgery but not ptosis surgery. Oculoplastic surgeons who do ptosis surgery will want to offer you a posterior approach ptosis surgery (Mueller's muscle conjunctival resection ptosis surgery) possibly only on the right upper eyelid. That surgery will not fix your issues. The second type of surgeon does blepharoplasty (cosmetic eyelid surgery ) but not ptosis surgery. The will simply try to do an upper blepharoplasty because that is the surgery they do not all patients who come to see them. That surgery is also not right for you. What you have is central levator disinsertion causing heaviness in both eyelids but the right upper eyelid is worse than the left upper eyelid. The disinserting levator which is the tendon that raises the upper eyelid slips back into the orbit. It takes with it the pre-aponeurotic fat that contributes volume in the upper eyelid fold making the eyelid look depleted. Adding to this problem, you have mild disinsertion of the lateral canthal angle. This is contributing to the rounded appearance of the eyes. To make you better, all of these issues need to be addressed. In both upper eyelids, the disinserting tendon needs to be repaired. The upper eyelid fold reconstructed with crease lowering and fold reconstruction, and the lateral canthal angles need to be repositioned. Sadly, my colleagues to not offer a comprehensive approach like this to repairing eyelids like your. Your eyes can be your best feature. There is no substitute for a detailed in person assessment.

Caner Kacmaz, MD · Answer

Hi! this is Arzu from Dr. Caner Kacmaz Clinic.Both eyelids need to be equalized with blepharoplasty. İf you need more information do not hasitate to contact with us.
Kind Regards

James R. Gordon, MD, FACS, FAAO · Answer

Thank you for sharing your question and posting your photo. For this issue you need to be examined in person by an experienced oculoplastic surgeon. From the photograph it is difficult to determine the underlying condition. 
Good luck!

Mats Hagstrom, MD (license on probation) · Answer

All people have facial asymmetry. You are no exception. During embryological development, the two sides of the faith develop independence from each other, and eventually fused in the midline. The basis for most facial symmetry is bone structure. It’s not uncommon for the left eye socket to sit higher in the skull and the right side. for this reason, the asymmetry can show eyelids and brow position as well.
I said no need for surgical intervention. The degree of asymmetry you have is very much within one standard deviation.
If you were under the assumption that the face was symmetrical, then you should consider resetting your baseline assessment for facial aesthetics.All people have a facial and body asymmetry.
Best,
Mats Hagstrom, MD

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